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.

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. 

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. 

Distraction

I've lost count on the "lesson" numbers and the quotes, but since this is no longer a blog about "what I've learned in nursing school" and more about the lessons nursing is teaching me, I decided to change the format a little.  I'm still looking for a new blog name, so suggestions are welcome. :)

So here is today's lesson. 

My preceptor had a patient today who has dementia.  Early this morning while we were helping one of our other patients, he was out roaming the hall peeking into other rooms.  He was completely disoriented all day. It didn't matter how many times she escorted him back to his room, he wandered back out. She would take him back and no sooner than she would get back to the nurses station, the bed alarm was going off again. 

You could tell his mind was full of words he wanted to say, but couldn't get out.  You could see his frustration when he tried to explain to us things we could not understand. All he wanted to do was make sense of what was going on, and no matter how hard he tried, he couldn't...

There wasn't anyone available to sit with him, so my preceptor decided the next best thing was to take him to the nurses station.  And when I say she brought him to the nurses station, I mean he sat next to me, at my designated desk, IV pole and all. It's slightly comical when I imagine it now, I felt like it was bring your friend to work day.  We tried to entertain him with magaizines and a puzzle, but neither worked.  So we got out some washcloths and he finally sat there. 

He folded them meticulously. Fixing each wrinkle, and refolding the ones that were not perfect squares.  He placed them neatly in a pile, one on top of the other. When he finished he patted the top and looked over for approval.  We said thank you, and I pretended to take them to the linen closet to put them away. I secretly unfolded them all and brought them back again.  We repeated this process many times over.

I realized then that when we are lost and confused, sometimes all we need is the silent company of others and a temporary distraction to keep our mind from the thoughts that consume and frustrate us. 

For some of us it's cooking, writing, or getting lost in a good book.  Others prefer a long nap or a great movie.  Some like wine or dancing, and for others maybe it's folding washcloths.

I've heard people say before that distractions are bad, and just a way to avoid the inevitable truth. I disagree.  These distractions are not meant to be a permanent fix but a temporary way to give our tired hearts a break. Sometimes a distraction is all we need to ease our mind and give us a moment to focus on something other than our troubles.  

"It is what it is."

I have a really bad habit of wanting to take broken pieces and fix them immediately. Maybe that is why I love nursing, because it's the profession of taking care of, fixing, and making people feel better. Truth is, not every thing that appears broken is, and even if it were, sometimes it doesn't need to be fixed. 

I especially do this in my personal life. I like harmony, and when the littlest ripple is created, in my otherwise peaceful state of mind, I instantly begin looking for resolution. 

I had a patient this Tuesday who was scheduled for a below the knee amputation that afternoon.  It was cancelled last minute because he wasn't stable enough to handle the surgery.  

It was such a cliche and simple quote, but one that I give credit to in helping me with some recent disappointments. 

I went into his room to turn him, and he immediately smiled at me.  I was surprised because for most of the day he was sleeping. When he wasn't asleep, he was short with his words, answering only my questions.  I asked him how he was feeling and he said "ok." I then asked him if he was disappointed that his surgery was cancelled. He replied with, "It is what it is. I'm going to get it eventually, whether it be today, tomorrow, or a week from now." 

I smiled back at him and asked if he cared if I stayed a while to chat.  He didn't object, so I stayed and we talked for the next 20 minutes about fishing. I know our chat was more beneficial to me than it was to him. 

Sometimes situations are what they are, nothing more, nothing less.  Sometimes there is nothing we can do to immediately fix things to be the way we think they should be and sometimes time is all that is required for things to work themselves out. 

Until that time, it's better to focus on and talk about things that make you happy...like bass fishing in the summertime on the sand bar.  <3