The Come to Jesus Talk

The come to Jesus talk is a conversation in which you lay it all out there, expose the truth, the reality of the situation, and usually the direness of it. I’ve given these talks more times than I can remember and mostly to drug addicts. Although, patients with heart attacks and heart failure come in a close second. I’m blunt. “If you don’t stop smoking, you’ll be dead in three months.” That patient’s HF was so bad, his only option was hips surgery, which no one would do unless he stopped smoking 2 packs a day.

Most of these talks are met with feigned interest by the patient, some with serious looks, some with shame. 25% of people who have heart attacks make lasting changes. Only 25%. What am I working towards as a nurse? What difference am I making? Are these CTJTs making any difference? I do my job, both as a nurse and as a Christian, give these people the knowledge and tools to help themselves and improve their lives. And most of them blow me off. I’ve learned to let it roll off my shoulders. If I let it bug me, my own stress level would ruin me and be unmanageable. Self preservation.

“Broken wrist. Only history is positive for meth.” Greaaaat. Meth withdrawal. My favorite. My look of annoyance must have shown since the night nurse giving report quickly added, “he’s not your typical meth head. Really nice guy.” Sure. My skepticism proved unnecessary, since, while I can usually spot a meth user 60 ft away, I would have had no idea without that positive lab report.

After a few days of having this patient on the unit, we had developed a good rapport. He requested his family not be told about the meth, so the day I discharged him from the hospital, I waited till his mom left, pulled up a chair, and asked him what was going on. The twenty minute conversation that followed broke my heart. His out of control ADHD, leading to his meth addiction, it seemed miraculous that no one knew about it. He started and still ran his own successful business, functioning normally in society. And that’s after ten years of daily meth use. 

“It will catch up with you,” I told him. “Drugs leave a trail and you cannot hide from its devastation. It will take your family, your job, and every other facet of your life.” He didn’t roll his eyes at me. We talked about the next steps, how to fight it. I gave him the literature, hidden in his boots, so the family wouldn’t find it. 

I didn’t cry. Until I got home. This talk didn’t roll off my shoulders, it stuck there like a monkey. “He still had a good life, a life worth saving,” my then-boyfriend assured me. “Some people are more worth saving than others.” Whew. I hate hat explanation. All life is worth fighting for, worth saving. I truly believe that. That boyfriend and I eventually broke up due to our differing opinions on abortion and other end of life issues, so looking back on those statements, it makes sense coming from him. It wasn’t a good enough answer for me though. I don’t decide who is worthy of saving.  I simply save as much as I am capable of saving.

The question though, is why do some stick with us more than others. Was it the good rapport I had with this patient? Was it the similarities I saw between us, the common ground in life? Was it the impressive and unorthodox nature of his drug addiction? Was it the hope that he could be one of the few that survived? Is it my own personal level of empathy on any given day? If you have an answer, please let me know. And let me know how to combat it, how to continue letting that monkey roll off my back.


One thought on “The Come to Jesus Talk

  1. We ALL have those that stick with us. Your compassion for those unfortunate souls is a testament to the quality of your own. I find that the CTJT (totally using this now) is an effective tool to finally hammer through whatever wall of resistance my patient has constructed. As a nurse, i love getting through to someone and being able to see their true self. It’s such an incredible emotional connection. Yet all we can do is comfort, support, advise, and encourage. Those who are suffering still have to walk their own paths. I keep a few in my heart and just hope that I shared a bit of light with them. ❤


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