The hospital's on my mind...

I took a 6 month leave from working at the hospital after Cameron was born and I missed it horribly.  I love that I can do what I love one day a week, and truly admire bedside nurses who manage to work full-time in the hospital for many years of their lives.  Most can't do it.  The majority of nurses spend only a few years at the bedside, then move on in their careers to management, office nursing, home health or a slew of other career options.

It is not for the weak of heart, mind, feet or back.

I give enough physically and emotionally and intellectually in 12 hours to last me a week :).  And I love going back the next week for more.  This past weekend I cared for two particularly wonderful patients, whose stories touched me so deeply.  I can usually keep my emotions in check, but I shed many a tear that day and wanted to remember how these patients touched my life. 

My first patient was an 89 year old female who was legally blind, had been battling severe back pain for years and was currently admitted with pneumonia.  She had developed pleural effusions (fluid around her lungs) that had gotten worse overnight.  The morning I had her she was breathing rapidly and her heart rate was up, a sign the effusions had grown overnight.  It took two of us and a walker and about 30 minutes just to get her out of bed, all the while in excruciating pain from her compression fractures in her back nothing could be done about.  She had a 70 year old son who stood diligently by her bedside directing each of us in every step of her care.  I'm not going to lie, although he had the best of intentions, he made my work difficult.  He was critical, suffocating and not a whole lot of help, giving us non-helpful directions and negative comments as we tried to work with his mom.  BUT...I always try to give family members the benefit of the doubt.  They are scared, often exhausted, unsure of the next step and we signed up to take care of them too.  I could tell he loved her dearly, and I hope one of my three sons will be that devoted when I am 89 in the hospital! While we developed a relationship and he learned to trust me, I focused on what his mom needed most.  She shouted out what I had been wondering - but it still took me off guard.

"Can't I just die?!"

Her son and his wife quickly hurried to her side and my eyes filled up with tears.

"Please.  Let me stop hurting and suffering.  I just want to go!"

During moments like this I walk very carefully.  I am a patient advocate first, but I am well aware the family must reach such massive decisions together, in peace, in their own time.  Her son looked at me with tears flowing and blinking my tears back, I gave a gentle nod towards his mother, trying to convey so many things to him:  "I love her too, I will help you through this, she is an amazing woman, she deserves not to suffer, you deserve to have your mother with you as long as possible, I'm honored to help, go ahead and talk with her about it, you are a wonderful son."

Over the next hour as I came in and out of the room they called and put each of her children on speaker phone as my heartstrings were pulled as I heard multiple conversations like this:

Son: "You've been a great mom."
Mom: "Well, you've been a great son honey.  I loved being your mom."
Son: "You've got our blessing mom to go ahead and stop fighting and be comfortable and let go.  I love you Mom."

As the day went on I spoke quietly with the family, informed doctors, coordinated hospice, gave medication to pull the fluid off her lungs for comfort, and discontinued any further medical interventions.  To prevent bedsores we still needed to turn and bathe her, which at first she protested, but with my promise that her comfort was my priority, she allowed us to do so.  I put my charting, management, and other patients aside for a bit and took the luxury of spending extra time with her, bathing her with my aide, rubbing lotion on her back, turning music on and giving her as much dignity & comfort as she deserved at the end of her life. I watched a beautiful peace come over her and she began smiling, joking with her family, so relieved she didn't have to live in pain much longer.  I watched each of her grandchildren and great grandchildren who could drive come to her bedside to say goodbye.  And I cried. She was sent home with hospice the next day, and I know the family will have grieving in their future, I know she will find peace.

On my lunch break, I called my grandma.  I wanted to hear her voice.

Another patient of mine that day was a 51 year old gentleman who had lost his wife to lung cancer 10 months prior.  She had not smoked a day in her life.  He was still in complete shock and his grief was so fresh.  I had him for two days in a row.  The first day was consumed with logistics of test after test, conveying results and answering questions.  Finally on the afternoon of the second day, all tests had come back negative, and we had a chance to talk.  And talk he did.  I just listened. 

He told me of his wife's life, their children and how they were handling the loss, their business ventures, how she handled all the finances and he was surprised to find accounts he didn't know they had.  He spoke of how diagnosis to the grave was only eight weeks, and he spoke of the pain he felt watching her pass away and how hard her final moments were for him to watch.

But the part that got me was when he said the following:

"Julie, this may sound weird, but sometimes at night I just stand at the top of the stairs in the dark.  I want to feel her presence, smell her, hear something - anything.  So I stand there and wait.  And listen.  But there's been nothing.  Julie, I miss her."

The tears were flowing down both our cheeks (again!  same day! jeesh!).   He had been cleared for discharge by the doctors, diagnosed with just a virus (good news) at 3 that afternoon.  The hospital was not busy that day and I knew he was going home to his 5200 square foot home, alone, still not feeling well.  I told him I could give him another dose of medication, order dinner and rest until my shift was over.  He looked so relieved and said he'd be so grateful if he could do that.

These days teach me so much.  It's my hobby.  And I love it.