Tuesday, November 28, 2017

Full Circle

About 3.5 years ago, when I was a brand new nurse at GSMC-Marshall, I met a patient who’s name and story and family I could never forget.  I spent days and days with Mr. Marv and his family as he let go of the little bit of time he had left in his life.  In those 9 days, we laughed, we joked, we cut up, we cried...oh how we cried...and then we would laugh some more.   Mr.  Marv shaped my heart as a young nurse. I would walk into his room and he’d say “there’s my girl!” He was so very special to me, and his wife also.  

I was the only person in the room with him as he took his last breath. That moment was pivotal,  that moment changed me.  

A few weeks after Mr. Marv passed, I received a hand written note from his wife.  In it was the most sincere thank you,  kind words and an invitation to join her for lunch one day. She wrote her number on a sticky note.  I lost it.
I have thought about Mr. Marv and Mrs. Wanda over the years more than I have any other patient or family. It was to my disappointment, when I found the letter his wife wrote me in a box while moving this past week, that I still was unable to reach her.  

I came to work the day after I found the letter and stood at the counter to receive report.  To my complete disbelief I saw I was going to be caring for a patient by his same exact name.  Upon entering the room I asked, “is Mrs. Wanda your mother.” And sure enough, he was on the phone with her.  

I literally cried in that moment.  I was so happy to find her again, to find a piece of someone who has had such an impact on the way I care for and love my patients...especially the grieving and the dying. 

It’s not always easy...but every once in a while you hear that little voice inside of you that says, “There. There it is. That’s why you’re here” and you get this fullness and warmth in your heart and you smile because you know it’s true. 


I cannot wait for our lunch date ❤️❤️

Sunday, December 11, 2016

Not Always What It Seems

As nurses we are taught and learn many, many skills.  From dressing changes and heart sounds, to compassion and bedside manor.  Our assessment skills are endless.  We are trained to know signs, symptoms, and manifestations.  We are continuously on the lookout, watching your behavior, vital signs and health status.

We pay attention to the teensiest, tiniest, smallest of details, literally down to how many breaths you take per minute.  We learn your body and we monitor its every change.  We noticed your skin color when your blood pressure is elevated.  We check your blood sugar when you orientation is a little off.  Nurses know what labs to order when your urine output decreases and how to read your EKG when your heart races.  Most of us can tell if you have a bacterial disruption in your intestinal tract based off the smell of your poo 😜

For 12 hours we we watch, we listen, we look, we inspect, monitor, document, observe, and we adjust your medications, treatment and care based off our assessment.  We provide the best we can based on these details.  Most of the time we know what the doctor will order for you before we even call to ask.  Nurses pay attention. Nurses are THE number one most trusted professional in the United States.

But.

But sometimes we miss things.  Sometimes we are wrong.  Sometimes clinical manifestations present as one thing on the outside but are something completely different on the inside.

Sometimes the drug addict, who looks deathly, checks out with a near perfect bill of health (minus the positive UA)  and sometimes the yoga instructor is diagnosed with cancer having no signs or symptoms or family history.  Even though we spend our every waking moment assessing all the outward signs, sometimes it's just not what it seems.

Which brings me to my point: Not everything you see, not everything you hear about a person is true.  Your assessments are open to error.

Just because someone's social media portrays "happy" doesn't mean they don't suffer from depression.  Just because someone has a dog, a house, 4 children, and a spouse of 25 years doesn't always mean they fulfilled their dreams.

Just because a heartbeat is labeled "irregular" doesn't mean it's atrial flutter. And just because someone appears happy in their smile and in their laugh doesn't mean they're not somehow struggling in ways you cannot see.  

Sometimes our assessments about people are wrong. Sometimes our judgements are inaccurate.  Sometimes we jump to conclusions because we have seen the same manifestations so many times that it's easy to make cookie cutter labels.  Sometimes we get comfortable and rule out the truth because it's not "textbook."

This is dangerous...in nursing most definitely, and absolutely in life.  Our assessments, no matter how practiced, are not fool proof.  We all make mistakes....and we are ALL guilty of assessing each others lives and drawing up our own conclusions.

As nurses we are fair to our patients and we never count out possibilities. We should do the same with our family, friends and loved ones.  We should remember that people change.  We should be reminded that things aren't always as they seem.  And we should approach each other in the same way we do before our initial daily assessment....with an open mind and a new, fresh start.

Friday, October 7, 2016

The Rest Will Folllow

It's been quite some time since I've shared a blog post.  It's not that I haven't had meaningful  connections or stories to share, I've just been processing life and trying to make sense of it all.

I've sifted through some of my experiences the last few months and decided to share a story about a patient who had the most simple advice.

She was an elderly lady, in her late 80s and she was faced with a decision: Hospice.

She still had several living family members, most of who would visit her at bedside.  She was still in her right mind, able to make medical decisions herself.  She was loved in her community, with a history of giving back as much as possible.  The sweetest, most vibrant and cheerful patient I've had in a very long time.  She cracked jokes, kept a positive outlook and always, always smiled at me when I walked in the room.

Now some people think I'm crazy, but nursing is a give and receive profession.  As nurses, we give ourselves...we give our care, compassion, sympathy, our time.  But like I've always said, I receive just as much from my patients as I give to them.

Whenever I'm caring for someone at the end of life, I always muster up the courage to ask the tough questions.  What do you regret? What can you teach me? What is your best and single most important piece of life advice? Surprisingly, my patients are always happy to answer these questions and I feel it creates a bond.  A human bond. Something that reminds us both that outside of our age, outside of our life experiences, we are all the same.

So as the story goes, I asked her, " If you could give me one piece of advice for me to carry with me forever, what would it be?"

She smiled.  She thought.  She said,

"Sweetie.  Don't just DO things.  Do things because you want to, because they make you happy. All the rest will follow. Oh, and keep that smile."

I smiled back at her.  Simple enough.  After a few more words, I left the room, headed into the next.

Now, there's something to be said about advice.  People can give it all day long, but if you don't see them following their own beliefs,  the advice itself becomes less meaningful.  It doesn't carry as much weight.

Fast forward, she was my patient the next day.  I walked into the room, and she was her bright eyed self.  However, her family had a different demeanor.  The room seemed sad.  Quiet.  Stiff.  And then a family member spoke out..."But if you continue with treatment, you could get better and get out of here."

My patient spoke instantly and without hesitation.  "That's what you want.  That's not what I want."  And then she winked at me. The conversation ended right there.  There was no argument, no fighting, no explanation.

It seemed so easy for her...to make decisions, literally life decisions, without being influenced by the pressures of society or what other people thought was best for her life. I've never felt so happy about someone deciding on hospice. However, she had demonstrated the advice she had given me the day before and I just knew she meant what she said and I just knew she was happy with the decision she had made...and that's all that mattered to me at that point.

"Don't just do things, do things because you want to and because they make you happy."

She left the hospital the next day to go on hospice but she never made it home before she passed.  I went to her memorial a few days later and the room was so full of life.  I couldn't help but think that maybe it's because she lived so open and truthful and because she truly tried to make decisions for 80 years that made her happy.

They say happy is contagious.  That was made quite obvious at her memorial...and while I was sad the world lost such a kind and honest spirit, I was happy to have known her for even just a moment.

Wednesday, August 20, 2014

Mr. ****

I wish I could just type his name as the title of my post, but HIPAA says I can't. But I want to because people like him deserve to be recognized. 

I've been caring for him for over a month now. And although he hasn't been my patient throughout the entire duration of his time spent at GSMC, he has been on my mind and heart since the day he was admitted. 

As nurses, we care for all of our patients. But what no one tells you is there will be certain ones, for whatever reason, that really grab hold of you.

They inspire you, and teach you, and in their own special way, fill up an empty space inside of you.  I've written many posts, specifically dedicated to certain patients.  They consist of lessons and things I've learned through my experiences with them.  But even so, "He" has been different.  Maybe it's because he stayed a lot longer than  average, but I think it had a lot more to do than that. 

Maybe it's because I know he spent several years in the Air Force, delivering newspapers in Massachusetts. Maybe it's because I know the name of his wife and all his children...even his oldest son, that took his name, who passed away years ago.  Or the fact that he named his dog "POD."..because he found him outside the post office and called him "poor old dog" until he finally decided to take him home and then "POD" stood for "post office dog." 

Maybe it's because his wife brought in old family photos, in frames, and showed me their 62 years of a beautiful marriage together. (62 years this Saturday) Or that she sat at his bedside every single day, helping him bathe, and eat. Maybe it's because every morning before she got there he would ask, "where is my bride?" 

It could be that he, despite his deteriorating health, maintained his sense of humor.  I asked him one afternoon, "how are you feeling?" And he responded..."well, just as good as I did when I was 28, but just a little bit older." (I'm 28). Or the day I had to give him a soap suds enema and I asked, "how ya doing?" And his response was..."well, I've been a hell of a lot better, but I'm doing alright considering."

Maybe it's because I know he used to love duck hunting but never understood Canadian geese or that he could eat bananas all day, every day. 

Even today, after he told his wife that he didn't think he was going to make it, I asked him what he wanted his daily goal to be... He said, "Just get on my feet, I just want to get on my feet." 

Truth is, he left the hospital today, and he most likely isn't going to get better. And as selfish as it sounds, I just wanted to keep him at GSMC because the thought of coming back to work and him not being there is a loss for me.  

I loved his smile when I walked into his room. I loved the big hugs I received from his wife every morning, and the wave down the hall I got from his son.   I loved his positive spirit and sarcasm.  

As we wheeled him out today, I couldn't help but feel sorry for everyone who never got the chance to know him or his sweet family. 

What no one tells you is that sometimes...sometimes your patients help you more than you help them. 

Sunday, August 3, 2014

To Die Alone and Happy

A patient of mine, a few weeks ago, inspired me to me think about whether or not it is possible to die both alone and happy. More so, she forced me to think about whether or not I let the love, or lack of love, I receive from others define me. 

She was alone, but was she okay and content in the last quiet moments she held with only herself? Did she need someone there to validate the life she lived? Did she need reassurance that she was important and worthy and loved? If she did, there wasn't anyone there to do it...except the medical staff, complete strangers. 

And isn't that what we all want? To be important to someone, to be loved by the people we love, to have meaningful friendships/relationships with others? 

And it hurts when we realize we cannot force nor demand love. It hurts when the people who you think are supposed to care, don't.  When the people you hold closest to your heart, hardly acknowledge your existence.

I've experienced this many times, starting with my biological mother. Emotions regarding that non-existent relationship continued on and poured into other faucets of my life.  And those emotions are vicious cycle, especially if you feed the insecurities and the chronic self doubt while constantly desiring the love of someone else to define your worth.  It can eat you alive. It can literally destroy you. 

My patient died the next day. I was left wondering for days, and even now, about whether or not she was content in her own skin and comfortable enough with herself to die alone. Its not ideal to think about laying in a hospital bed, staring at white walls, listening to the occasional beeping of an IV pump while you die but did she "need" someone there? Did she need the presence of another being in order to feel at peace? To feel loved?

Maybe she didn't have friends or family in the area. Maybe they were too busy. 

My hope for her, and what I would like to believe is that she was okay... That she was at peace with the person she had become over her lifetime.  I hope that she was so comfortable with herself and confident in her character that being alone didn't make her feel any less cared for, less loved or less of a human. 

And while love is one of the greatest emotions we will ever feel, give and receive, the reality of death is that even with the physical presence of others, we all die alone. 

I plan to start living in such a way that the approval, reassurance, and love of others does not define me. That my value does not decrease just because others may not recognize it. 

Loving yourself is what I think it means to die happy.  Because in the end, we are alone... and if we don't love ourselves, the love we receive from others becomes meaningless.