 The movie “Wit” was very emotional and conflicting story about a woman (Vivian) who was diagnosed with metastatic stage IV ovarian cancer. It showed her views of the health care system while going through her illness, treatment, and inevitable death. This film makes you reflect on your daily practice as a nurse and how patients view your attitude, actions and comments and also those of other health care members.
This film portrays the relationships between the patient (Vivian Bearing) and her health care providers as one that lacks overt human compassion. In my opinion she was seen as a specimen, or as a research project that they gain to learn something from. For the most part to me it is an accurate portrayal of a doctor patient relationship; it was very cold. It starts off with Dr. Kelekian informing her of the diagnosis. He used medical terminology most of which took her sometime to understand and still she had unanswered questions. He didn’t give her any other alternative but to undergo aggressive chemotherapy. He played on her personality, career and personal belief; being a doctor and one that believes in being a scholar she agreed to aggressive experimental chemotherapy.
 Again you see this displayed numerous times with the resident doctor, Dr. Poisner. During the interview he was very direct and close ended with his questions not giving her a chance to explain and in some instances he even seemed like he was not paying attention to her. He repeated questions that she had initially given an answer to. He treated her in a clinical manner and not human like. He left her exposed on the examination table; during examination he made a sound as though he found something and when she asked if everything was ok he ignored her question and kept on talking. He didn’t explain any findings he only hurriedly left the room. When they did rounds he didn’t ask permission to touch or examine her body he just lifted the sheets and proceed with it and the other residents followed suit. They went on to explaining her condition, treatments signs and symptoms in front of her with medical terms that normally other patients would not understand. The ultimate showing that he considered her a research subject was when he found her to be unresponsive and pulseless and he called a code knowing that she was DNR and even after the primary nurse kept telling him and even tried to stop the code he let them proceed saying that she can’t die she is a research subject.
Nursing played a vital role in this movie. Her primary nurse Susan was the only one who saw Vivian as a person, one that is experiencing real symptoms that takes a toll on her body. Susan embodied a “caring professional” that tried to provide patient centered care along with upholding the professional standard of care. The IOM (Institute of Medicine) defines patient-centered care as: “Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.” Nurse Susan brought the caring, supportive, advocacy, sympathetic and empathetic aspects of nursing forward throughout the entire film. This was displayed from the first scene when she got upset at the resident for leaving the patient in an uncomfortable and compromising position on the pelvic exam table. The most memorable scenes for me were when Vivian expressed her sadness and anxiety and Susan took time out to sit with her and have an icicle while explaining and educating her about her condition and end of life care. Another scene was when she came to put the catheter in even though Vivian was out of it resting she still explained the procedure that she was about to perform and at the end instead of just leaving she put lotion on her hands as a measure to make her as comfortable as possible. Thirdly I loved how she tried to be a patient advocate and fought the resident doctor that called the code and asserted herself with the code team to get the patient’s wishes heard and acknowledged.
This film has had a positive effect on the way I will go forward with patient care. I will try to practice patient centered care as everyone is a unique individual that needs to be treated as such with respect and dignity. They should also be involved in their care. We must be knowledgeable and explain things in a manner that patients can understand and feel comfortable enough to ask questions. My role as a nurse includes far more than educating and caring for the patients it also involves standing up for the patient and being their advocate in times of need.
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