What You Can't Find In Their Chart
" The best way to find yourself is to lose yourself in the service of others." Mahatma Gandhi
Tuesday, November 28, 2017
Full Circle
Sunday, December 11, 2016
Not Always What It Seems
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
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. ****
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.