the big finish

the big finish

Sunday, July 26, 2015

A week in review...

Tonight, my kids are in three different countries building houses for folks that don't have one.  My oldest is in her last week in Guatemala, my middle guy is in Juarez finishing his summer and my youngest is in the DR building with church.  

That brings me to the sermon I heard on Thursday night at my church when we went to bless the missionaries.  The message was "If not now, when and if not you, then who?"

The message was clear to me and resonated in my soul.  If I am to be someone who lives the life I believe is good and right...I better walk the walk instead of talking the talk.  Lord knows, I can talk.  It's the walk that is hard.

Last week, I had the test.  I had a patient that was difficult to care for and it took everything I had to go to that house.  I was so conflicted in so many ways about the situation, the plan of care and the way it would turn out.  At first, I thought I would just go in and tell them what to do.  I mean, I'm the nurse, right?  I took all the things I would need to just steam roll them into seeing things my way, the "right" way.  I got in there and tried and didn't get anywhere.    As a matter of fact, I just made the situation worse.  Instead of understanding and then trying to be understood, I knew better.  I had the answer for this woman whose husband was dying before her eyes...but I didn't know the history of the family, the issues and the life they led before I showed up.  But, again, I had all the answers.

In the end, doing nothing different except offering kindness and a listening ear, the patient and family got what they wanted...a peaceful, quiet death at home.  

So, as I sat in church on Thursday night and listened to the Pastor speak, I realized that if it's to be me and it's to be now, I need to open my mind and heart and listen first.  I don't need to "know" what everyone should do so that I am content.  It's not about me at's about them and how to help them in their time of need.  Interestingly, that kind of thing is usually not clean, neat and easy but it is what I am called to do.

I am learning that we are who we are, meaning people don't change because they are dying.  Many times, families will assume the person will change to be something different in the last days, that if a person was not affectionate, because they are dying, they will start hugging and kissing.  It doesn't work that way.  I tell families that people die the way they lived.  Our job is to focus on loving them in the best way we know how, without changing who we are. 
"Managing expectations" I say and explain...

So what is the point of all of this?  I learned a big lesson about life this week.  While I know a lot about the end of life and dying, I do not know it all and, it is always better to listen and understand before expecting to be understood and listened to.  It's just the right thing to do and really, it is polite and honorable.  

I was telling someone that I have been a nurse for 30 years and there are still things to learn every day about caring and loving people.  I just need to keep my heart open to learn...

We'll tawk tomorrow,
I love you all,

Tuesday, June 30, 2015

A love story...right or wrong, you make the choice.

It's been a while,  hasn't it?  I have been in a different of indecision and self doubt.  I would begin to write and then stop.  I would wonder who in the world cares what I think...  Lately though, I have been feeling a nudge to write again, to put this short, tumultuous, wonderful life into perspective.  So here goes.  I have decided to redouble my efforts to kids and husband, of course...but also strangers and the unlovable and then write the stories.

I have been watching the feed on facebook and have not commented the supreme court's decision.  Not because I am not happy for the folks that want to get married but because I understand that my opinion is not going to change anyones mind and I do believe that people can think what they want.  They don't need me to tell them they are right or wrong.  

I do have a story though that made me think about love...all kinds and all genders and same genders, and how when a person loves another person...and does the things that are right, to is right.

Sometime last year, I was called in to admit a lady that was dying.  She was older and she was having strokes.  She had been declining for a long time and she had a "caregiver".  I arrived at the house to find two older woman...the one that was to be admitted to hospice care and the "caregiver".  

It didn't take long for me to see the relationship these two women had and the quiet communication and understanding even without the one being able to talk much.  It was clear to me that they were a team, together for what appeared to be many years.  As I asked questions, the wife answered them and explained the medical history of this patient in detail.  She told me her idiosyncracies and her favorite things.  She told me of their daily routine, complete with labels on things so she could remember, and of not leaving the house without her lest she fall, and of making her favorite meals to keep her strength up.

Finally, feeling comfortable enough to ask, I asked her "their" story.  She told me they  met 35ish years ago and had been together ever since.  They took care of each other, bought a house, traveled for vacations, rooted for the Broncos, went to games and then when she got too sick,  they watched them at home.  Their life was one and they were deeply attached and loved each other very much.

As the days went on, the patient's wife took beautiful care of her and made sure her every need was tended to.  She watched as her love was failing, starting to forget who she was and the back and forth banter that they enjoyed over the years.  It was a very difficult time as it is for everyone watching the love of their life fade away.

As the time inched closer, the phone calls  to me became more frequent and difficult.  She did not want her to die and for her, being at home with her, even in the declining state she was in was better than her leaving.  She agonized over the decisions of keeping her at home or trying more life sustaining methods to keep her with us longer.  As with all folks close to death, the patient was fine.  She was "turning inward" and doing the work of leaving this place.  I spent many an hour at the house with the wife at the kitchen table...comforting her, telling her she would be devastated but she would take comfort in how she loved her all these years and off this earth.

Still,  I thought that we were stuck and that she wasn't going to be ready when the time came.  I prayed to God for peace and comfort for this lady and her love as she slowly left us.

A few mornings later, I got a call that she was gone.  Nothing fancy...just quietly left us.  I went to the house to do my work and asked the wife how it all went.  She told me through a veil of tears that she finished caring for her and getting her ready for bed when she noticed her breathing had changed.  She sensed that she was leaving her.   She climbed in bed with her, held her and kissed her face while she took her last breaths...then she relaxed and she was gone.  She held her for a while longer and called me.

As she explained those last minutes of life, I listened and tried to think of a better way to leave this earth.  To have your love close, holding you tight and kissing you gently while your leave this place...all the while telling you what you mean to them.

I was so proud of this wife and told her through my own tears. She had done everything right and I told her so.

After all my work was done, I got in my car and sat.  I asked myself why that "love" is different and should not be allowed by my God.  Why a love that withstood the test of time and difficulties of life was not equal to other loves that I have witnessed.  What makes my love for my husband better than what I had the honor to witness at the end of that life?  For me, it isn't.  I hoped that I would have the courage to climb in bed with Jim when the time comes and tell him what he meant to me and how my life was good with him.  Will I have that courage?  Will I feel that deep, abiding love to do that?  Hopefully, I will but I believe that we all do the best we can at the time.  

So, yes...I guess my opinion is very transparent.  Deep abiding love is love, be it a man or a woman.  So what am I to do with that experience?  

What does that look like?  Being kind, trying not to judge, and being present in the moment with folks.  Am I good at it?  I am sure you know the answer to that. But, I owe that to you and you owe that to me.  And when I stand before my God, I know that I will have done my best.

How about you?

We'll tawk tomorrow.
I love you all,

Thursday, April 9, 2015

Cosmic or profound or holy? C...all of the above.

Today was a day like no other.  I want to say it was profound...

I sat across from a man that had to make a difficult decision.  A life changing decision and a decision that would be something that he thought of often.  We talked for an hour and one half about his choices and then made the decision that made his heart ache but was the right one.  He stood tall and is letting nature take it's course.  It takes a special person to do that and an amazing human being to have the strength to make those kinds of decisions.  I am honored and humbled that I got to sit with him as he decided...

As I left the house, I knew that he was ready for whatever he had to deal with and I got the feeling that I was just where I was supposed to be at the time.    The feeling carried me most of the day until I arrived at a party.

My patient, just diagnosed with a terminal cancer, had planned a birthday party and wanted to have it.  We changed her medication plan to help her deal with the symptoms and I was to "stop" by and make sure we were winning.  We were...

I knocked on the door to find 6  "older" ladies with wine glasses in their hands getting ready to celebrate life.  I looked around and realized that I knew a few from taking care of family members.  I was introduced and revered as "Terry the nurse" that took care of my...  I felt a chill run up my spine as I talked to each one and asked how the family was and what they were doing.  I had made an impact in their lives and they were so happy to see me.  I found that interesting because I always think that no one really wants to see the "hospice nurse" because at the time, things are so tender and sad that it is something to push to the outer aspects of the brain.

But it was a celebration and a time to treasure every second of life in that house.  They joked and visited and loved each other like only 75 year old women could.  I felt so honored to be there and almost stayed to party with them.

But I left, and as I headed to the car, another woman showed up and got out.  She was another one of my widows and it was a short time.  Her husband was very ill and I worked fast and hard to get that family to a place of peace.  She  was so excited to see me and I told her..."You don't want to see me, I was present for such a difficult time in your life"  to which she responded, " I can not repay you and would love to see you again."  I told her that I go by her house most days and if I see her car...I will stop and we can visit.  And, I am sure I will.

I spend my days thinking when I am not on the phone with doctors, patients or my family.  I think about how hard life is, how unfair things can be and how quickly things can change.  I also think about the other side of that...when life is hard, it seems people come out of the woodwork to help, to love, and to make things easier.   As I told this son this morning,  "you are a wonderful son and a reflection of your mothers love...I can only hope my sons can step up and do what you have done for your mother."  Because he did and is and it is not the easy way out.  It is the way of a person with integrity and strength...

I called my husband and apologized for all the things I did to make him feel unloved this week.  Sometimes ( a lot of the time) I take him for granted.

This day was profound, cosmic, holy...all those things... One for the  record books.  I felt like I was exactly where I was supposed to be and do what I am called to folks. 

So, as I finish my week, try to love all these folks exactly where they are...I am thankful for those little signs that keep me going.  I prefer to believe that the holy spirit...the angel on my shoulder...knows that sometimes I need more than can be given by humans and gives me the holy and profound so I know that I got this.  I know that to be true as I mutter things that I never thought of before but come out of my mouth like a song of comfort and peace.  
I also thought of all my friends and how when we are 75, I can only hope that we can be together, remembering the good times, picking at each other and laughing about the times in life that we screwed up.  Just plain loving each other and knowing we did it right.  To see those ladies doing that today made me so happy!

I leave you with thoughts to ponder.  Life is hard, and wonderful and people are difficult but beautiful and loving.  I feel like I get so much more that what I give to familes and people.  I am so lucky to do what I do!

We'll tawk tomorrow,
I love you all,


Sunday, March 29, 2015

Learning to let go...

I just experienced my last spring break vacation with my last child.  He will finish high school in 2 short months and go to college after the summer.   The magical mystery tour of being parent to children at home will be over.  Yeah, I know they will come home but mine, for some reason, leave and do not move back.  They visit and we talk but it is very rare for them to spend more than a couple of weeks at home between gigs.

This year, another mother and I volunteered to be the cooks and "bottle washers" for the Varsity and JV baseball team  for the spring break trip. There were about 22 teenage boys. We were to feed the team, keep them hydrated and make sure they were okay.  In other words, be "Mom" while they were away from theirs.

As I was preparing for the trip, I began to realize what is about to happen.  My son will be leaving the nest in 2 months.  My days will not be based on getting home to make dinner for the family and the house will be empty if Jim is not home.  We are going to have to become a team of him and I because that is what we are going to be.  Might as well not fight it but make the best of the time left.

As we drove to Arizona, we talked and we dreamed and we counted our blessings.  We disagreed about plans and tried to figure out how it all should be.  Then, as time wore on and the miles went by, we rested into a comfortable silence.  We didn't need to talk and just looked at the passing scenery.  I began to think of how things will be when we are alone again.  It wasn't such a sad feeling as it has been in the past.  It was certainly bittersweet as I pondered where all the time has gone.  But then I began to think about all the things we got to do when they were growing up and cherished the memories.

We arrived in Arizona on Sunday night and began our "vacation".  The team arrived around dinner time and I put out 15 pounds of pulled pork that I made along with salads and desserts.  They ate it up and each one thanked me and told me it was good.  I smiled to myself and thought about how I am going to miss that.  The days turned into baseball, taping sore muscles, tending to boys that are not quite as together as they seem and listening to who they are.  They are good boys, negotiating high school and baseball, girls and themselves and who they are and who they wish to be.  They are deep and shallow, clean and dirty...growing and thinking they are all grown up.  It is an amazing transformation that kids negotiate at this time and I got to spend a week watching it. 

They played some good and not so good baseball on beautiful fields.  They played basketball and swam in the pool when they had free time.  They ate and ate and ate and I swear some of them were taller when we left than when they came.  

We did most dinners out on the patio by the grill.  The boys would go through the line and fill their plates and then sit down.  After they got settled, I played waitress...asking them if they needed anything else or brought them a drink or a napkin because they forgot.  It made me feel good.

I have spent a long time fighting change and feeling anxious about it.  But, for some reason, this time,  I am a little better.  Now, don't get me wrong...I will be sobbing when the time comes to say good bye to my boy but for now, I don't want to clutter my brain with worry.  It is coming whether I worry or not.  We have them, they grow up and they leave.  If we are is that easy.  Sometimes it's not.

So as usual...I have unsolicited advice.  Life is long and hard and busy...but then it's not.  It slows down.  That's when, for me, the regrets come.  I shoulda stopped and played more, I shoulda held them longer and kissed them more.  I shoulda...and if I knew then what I know now, I  woulda.

This time, as this one gets ready to fly to coop, I am not going to say I shoulda.  I kiss him a lot (more than he wants me to) and I spend any time I can get looking at him and loving him.  I also kiss the other two when they show up...a lot...and I kiss and hug their friends too.  I am not going to miss a second of this time.

I believe we are supposed to love in this lifetime and it will change everything.  I saw it last week with the baseball team.  I loved them, I tended to them and I fed them well...that's how I love and it was great.  

So, life is life and every day, we have a choice on how to respond to it...

I say!

We'll tawk tomorrow,
I love you all,

Tuesday, March 17, 2015

A tribute to a co-worker...

Day in and day out, at some time or another, I talk to someone about the end of their life.  I explain the choices, try very hard not to interject what I think and answer questions.  My husband tells me time and time again that I have a "warped' view of life because of it.  I am beginning to think he is right.

Death is such a part of my life, that I wonder how I will do when it comes to me.  I hope I will be calm, level headed and able to handle things...but hell, I'm not that now so why would I think I was going to change?

Like I have said many times before, I get a ring side seat to the worst and the best of life.  I get a gift almost every day to watch families explode apart and come together again and make things work.  Actually, most of the time, I am in awe of the folks I care for the strength they have.

It's a wonderful job but it takes a toll on a nurse.  My buddy, the one that  helps me care for this side of town decided she was going to get another job.  She was ready to have time to do the things she loved and not work or be thinking about her work 24/7.  When she called me to tell me, I started to cry and so did she.  I am sad to lose her to another place because her patients loved her dearly and when I covered for her, the visit was all about how awesome of a nurse and a person she is.  I have to admit that I got jealous at times and told them to tell her they liked me better!  

But, I totally understand.  Being a nurse, and even moreso, being a hospice nurse, you have to be all in.  You have to put your heart and soul into the folks you care for because  if it were  would want nothing less.  

That's what my friend, my co-worker, my toe nail cuttin' buddy and my happy hour girl did.  She put her heart, her soul and then some into her patients...until there was nothing left. 

Sometimes, after a particularly difficult situation, there is not enough "comfort" to make it through.  I believe that and I know that even I need to work harder and finding comfort  in other places than what I do now.  I also need to know when to say I need a break so I don't have to leave.  That, though, is easier said than done.

It's funny, as I read this, I could be talking about any nurse that I work with.  We work hard and want only the best for our patients and sometimes it consumes us.  It's easy to spot who is ready to crack and who is doing well.  

But again, it is a choice.  I don't have to do this kind of nursing if it is eating me up inside.  I can make a choice to find something else that will feed my soul.  That's what my buddy is doing.  She is not bitter and not negative...she is real and she is making good decisions for her life and her family.  I admire her so much for that.  The problem is, I am going to miss her...her heart, her smile and her awesome way of going above and beyond to care.  

So, my friend, I will miss you a lot...I will be ready to do happy hour after toe nails, and will tell every nurse that I meet what an awesome nurse I worked with in the last year.  May you paint and cook and raise chickens and love your son and husband and be present in every moment with what you love.  God knows you've made my life better by knowing you!

Take care of yourself, friend and let's get together soon.

We'll tawk tomorrow,
I love you all,

Thursday, February 5, 2015

A life that matters...

I went to a funeral last Sunday.  It was one of those funerals where the church was filled and the family was strong.  They got up and read psalms and readings and said wonderful things about the guy. 

He was a regular guy.  He was the father of 5 kids, husband of a wife of 50 plus years and I think, had it all right.  I mean, probably not all right but mostly.  He loved his wife dearly and daily and it seemed to exude from him.  Not in a loud, talkative, all over her type of love...but a quiet respect, a knowing look and a small smile as he looked her way.  They were a team.  

He was ill for quite a while.  He struggled daily to be and do what he wanted to and he kept the fight on for years.  His kids rallied to help their mom and he remained faithful and kind.  

The funeral was really nice and the readings were great and I began to drift into my "funeral" know, when I die, I will have this song and this pastor and blah, blah, blah.  Then one of his friends and coworkers got up to talk.  He began with the standard fair and then talked about how his life mattered.  

This man did not live a flashy life.  He lived in a small house, he had tons of kids, he did what he could for others...and as I listened...was a lot.  The coworker talked about how every person he came in contact with understood that they were special.  He didn't do it the same way every time but he did it.  He worked in a "group home for boys" and these were the boys that needed a guy like him.  He was in the perfect place. 

I began to think about our relationship and how he made me feel like I was special.  Many years ago, his daughter and I played softball together and he and his wife came to every game.  I had three little kids, and his daughter had two and we were having the time of our lives.  He and his wife would sit right behind home plate and give advice.  As I remember it, every time he was at my game, I would hit a shot out to right field that would turn the fielder around.  I would trundle around the bases and get a triple and sometimes I would make it all the way home.  From then on,  he was my good luck charm.

Fast forward 15 years to a man who was considering Hospice care and by the grace of God, I was in the office.  When I saw his name, I told the girls in the office he was my "good luck charm" and I had to take care of him.  I related the story to them.  

When I arrived to begin my care for him, we talked about the old days and I thanked him for coming to all of my softball games to see me play.  I told him that I used to wait for him to walk up the sidewalk and I knew I was having a great night at the plate.  As we visited, his daughter (who is my dear friend) informed me that he was coming to see her play, not me...and that was that.  I disagreed with her and told her...all these years, I was sure he was coming to cheer me on...sure he wanted to watch you play but he was there for me.  He made me feel like my little old softball game was important to him and he was there to cheer me on!

I spent the next few weeks caring for him and it was a joy to be able to give him a little of the love back that he gave me over the years.  But, even when I was the one offering the care and love, he never let me leave the house without a prayer.  I would pack my nurse bag up and he would say..."we have to have a prayer" and we would hold hands.  Then, true to his form, he would thank God for skills and having me with him as he was on his journey.  

I left the funeral thinking I want to be like him.  I want to live a life that matters...a life that is remembered well and lived well.  I muttered that to my husband a few times when we were driving home.  Then, I asked, what is a life that matters?  I would imagine to some, it is having an awesome house, great body and handsome husband.  I have 2 out of 3 there and it still doesn't seem to make me content.  So what else makes for a life that matters?  Is it stuff, is it great vacations, more money than time?  Is it a job that you love and great people to work with?  

I think it is all of that at different times in life.  I know that when I had three little ones and they didn't bite or get in trouble at school, I was living a life that matters.  Then I went to Juarez and Nicaragua in the 90's and saw poverty and thought going there and building was what was going to make my life matter.  And, it did...but I couldn't do that every day or every week or even every year.  As I hit the second century of my life...I couldn't figure out what makes my life matter.  I believe end of life care makes my life matter but I always end up getting more love and wisdom than I try to give.  Does that take away from what matters?

I learned on Sunday what makes a life matter...meeting people where they are and letting them know they are special...letting them know that they are special to me and that my life would not be the same if they weren't part of it and...not to use words but use actions and behaviors.  You see, my friend didn't come to every game and tell me that he was there to see was in his smile for me, his words of encouragement and his funny smile when I thanked him for coming to see me play.  He could have said he was there for his girl...but he didn't and it made my softball nights for many years and still makes me warm up inside when I think of him.

Because he did...he lived a life that mattered.  As I sat in that church, I felt the challenge to step it up and get going.  So, Thank you dear friend and know that you are an example of what matters, or living in a way that matters and I am going to make a daily effort  to make my life special person at a time!

May you rest in peace dear friend!

We'll tawk tomorrow,
I love you all,

Saturday, January 10, 2015

It's better to burn out...then to fade away

It's been a while since I have had the quiet brain to sit down and write my thoughts...but as I sit here, my house is quiet, my coffee is hot and my computer is charged so I am going to give it a try...

The other day, I sat at my computer when my boss walked up.  "How are you?" she asked.  "I'm good,  things are just hard right now with my patients" I replied, hoping that she would walk away and not ask anymore questions.  But, because she is an awesome person that happens to be my boss, she continued..."It seems like you have had your share of hard cases lately, and I can tell you are struggling.  You have to figure out how to back off a little so you don't burn out."   It's funny that she noticed because I have been thinking a lot about how to cope these days.  It's been on my mind for a month or two as I begin this new year.

People have been asking me how I do "it" with one of life's hardest times for families day after day, week after week until they are gone.  It is a great do I do it?  One would think that seeing suffering, dying and sadness becomes common place, that it becomes, as my son told me yesterday, "all in a days work."

Not so much...

There is so much in life that is how you look at it, wouldn't you agree?  It's perspective...

Last week, our community lost a father, son, cop and all around good guy who stopped to help a stranger.  It was cold, it was snowy and it was a situation that he could have just drove on and said, "I'm  off and I have other things to do" but he did not.  So in a split second, without notice, he was gone.  No diagnosis, no planning for the future, no pain medication for symptom time to change relationships if need nothing.  One minute here, the next minute gone and life as it was changed forever. 

I tell this story because usually, in hospice care, it is different.  I can't say that a family and patient that sign up don't have emotions and it is all wine and roses...but there is usually time to do some preparation for the changes to come.  There is planning that is offered, spiritual support if that is what the person and the family needs, explanations of how disease processes progress and time to talk, to fight, to love each other... 

There is always some comfort in caring for the it helping them come to terms with the end of life, or stopping the busy life and sitting and talking.  Many families will pull out the old pictures and recall the wonderful times and maybe not so wonderful times together...they comfort each other and understand the love that they had.  They learn things about each other that they didn't know and see each others hearts.  

I like to think that there is a measure of control that they can have back in the midst of the struggle.  They can choose to struggle or choose to stop the struggle.  Hospice puts those decisions in the hand of the person who has the terminal illness.  It takes it out of the hands of the doctors...

And finally, it allows the patient to be at their favorite chair with the dog or cat on their lap or in their bed with their love next to them.  They can sleep all night or be up all night and it is their choice...and that is a comfort unto itself.

From where I stand, being a hospice nurse is a blessing to me.  Oh yes,  my heart aches daily and I am pushing feelings to different parts of my heart but...I can't imagine doing anything else and Lord knows I've tried.

These thoughts leave me with two questions to ponder.

1.  Isn't living life the the fullest and living on the edge of "burn out" all just how you look at it, your perspective?

2.  When bad things happen to good people, and they do...people become softer, more loving and are ready at a moments notice to help...wouldn't the world be a gentler place if we acted like that most days?

I have no monopoly the "right" way to live or for that matter, die.  I just drive from home to home and family to family and ponder these things...hoping to be what each family needs at the time.  And some days I have the greatest ideas for helping that are epic fails...But, I try and to most people...that's all that matters.

So I'm gonna burn out I guess...continue to try to care for folks with my whole heart and deal with the fall out when I have time.  It's what I would want if the nurse was caring for my loves in my life...

Let's all burn out together from helping each other in this hard world...maybe soften it a little for someone else and each other!

We'll tawk tomorrow,
I love you all,