Wednesday, October 30, 2013

Rest in the quiet...

Today, I went to see a gentleman that I have grown to adore.  He is in his last stages of cancer but is not ready to leave his loud, chaotic and lovely family.  He wants to stay here although he hasn't really been out of bed much and has daily pain.  

I walked in the front door and the place was so still, quiet...and peaceful.  I could hear the TV on upstairs, but no voices from people in the house.  At first, I felt like an intruder...but fought the urge to announce myself.  I sat in the kitchen looking out the window, watching the sun peak around the clouds, listening to the hum of this home.

It's been a rough couple of  weeks.  Lying in the hospital, trying to figure out what lies ahead and hoping the medical folks are all wrong, makes life beyond rough.  This man was told he was going home to die and the records I read about the state of his body seemed to second that opinion. But, get a man home to his own bed, his loving wife and family and watch the sweetness of family love heal all kinds of ills.

Yes, it took some doing to get him mostly comfortable, to take the pain medication as needed without taking too much and to recover from being told he is not going to last very long but he did it.  

Today, because he is not ready to leave, decided that he needs to get stronger.  He wants to walk around his bedroom and progress from there.  He slowly sat on the side of the bed and turned a nice shade of green.  We cranked his O2 up and cheered him on.  After about two minutes of trying, he had to lie down again.  I got him situated and told him that some days, it just doesn't work...and he let me know that he just needed a minute and he was getting out of that bed.  I realized that this man fought cancer this way, raised his family this way, loved and lived his life this way.  He lived ferociously and he is gonna die that way.  Okay, then...I thought...that's what we are gonna do.  He sat up again, took 10 deep breaths and grabbed his walker and before I knew it, he was across the room. He turned nice and green again, was grimacing from a painful spot on his back, and was running low on energy but...he made it to the bathroom and sat down on the bench.  Then, he took a few more deep breaths and headed back to bed.  His determination will get him through the transition from life to death. 

We got him comfortable and began to talk.  He understands what is happening to his body and that this is probably close to the end of his  time here.  He just prefers to ask for information when he is ready and not a moment before.  Far be it for me to do anything else.  He is dying as he lived and it's my job to help him do that.

As I was saying goodbye, I told him of how I walked in and the house seemed to quiet and peaceful...how I feel so lucky to be here with them at this time.  I tried to remind him that his family is here and willing to do whatever he wants to help him and he said he knew that.

It has to be so difficult to know that sooner rather than later, you aren't going to be in the day to day workings of life.  I often wonder how people can be so straight forward, so brave when they are facing death.  I think anyone who looks death in the eye, declares that at the end, they want to be home with family and  then continues to live well is amazing.  The nice thing for me is...most days, those are the kind of folks I get to hang out with.

When I walk in a house, and there is an overwhelming feeling of peace, I know we are doing the right thing for that family. I sensed that today and encouraged my patient to rest in that quiet place, at home, in love, knowing it's going to be okay...

We'll tawk tomorrow,
I love you all,

Sunday, October 13, 2013


Went to church today as I try to do every Sunday.  It seemed very routine and I was going through the motions.   After it was over...I was so glad I went.

I have told you this before, when my Queen was born, I decided that it was time to find a place to praise God that I was given such a gift as this kid...and honestly, I  have always felt connected to a holy higher power...

Through the years, I have sat through services that have stirred my heart and services that I have cleaned my entire house, washed the car and put dinner in the crock pot..all in my head while not feeling any spiritual feelings.  I went to church today feeling like I had too much to do, not enough time to do it and I would be able to sort everything out while at church.  

I had no expectations at all and if you want to know the truth, felt like a total hypocrite.  I have been less than kind during the week, haven't thought of service in the holy sense and ran my mouth way too much.  This week was one for the books...

I walked in late, sat in my usual spot and checked my phone...then I glanced up at the altar and saw a man with my pastor that I had never seen before.  "Great", I thought, "He is gonna be here asking for something"....

I dutifully went through the prayers and listened to the gospel.  It was the reading about the 10 lepers that were healed and the one that turned around to thank Jesus for healing him...yeah, I have heard that one before. 

The gentleman that I didn't recognize got up to preach..."Here we go" I thought and drifted into my head.  He began to talk about how he was ill and it rocked his world, and when all was said and done, he was healed...he got better.  He then talked about how he had such gratitude because he had gotten better and it had changed his life.  He weaved it into the story of the lepers and how the 9 ran off and lived their life, just as before....busy and unaware.  He talked about how health is not an entitlement, that we are lucky to have it and it isn't a given and when we are healthy...it is a gift.   He talked about the leper, who was a samaritan,was marginalized and how he stopped to thank Jesus before he ran back to life. He related it to being in the valley and not taking things for granted...living a life of gratitude...that when we live a life of gratitude it is living a life of praise and prayer on a daily basis.

I'm not gonna pretend that being thankful on a daily basis is an easy thing or that it can be done all the time.  But, I think what he was talking about what remembering what is important.  Most of us know that our family, our loves and our time is what is important. But, I would be a liar if  I said that certain things are not important too. I wouldn't ask the folks impacted by the flood how important things are because as much as we can say things aren't important, that picture of grandma or your son's first tooth is a thing and if it floated away....well... 

It came back to thankfullness for me...not because I have this perfect life without pain and difficulty...we all do, in some way, don't we?   But, when I can look at my husband and be thankful...for his kindness when I am out of control, or when my 16 year old asks me to do the puzzle with him...I am thankful. Or...when I go to a patients house, who is dying, and watch his family feel thankful that he is home and they get to care for him, as difficult and sad as it is...I think that is what the point is today. When you have been in the shadow of the valley of darkness, it makes you appreciate the light...even when it seems like it's not that bright and is dimming by the minute...

Sometimes, you are the leper...and then you are healed.  I guess the question is, do you run back to your life and everything is the same or do you try to be thankful...to live in gratitude?  I always try to remember that no one gets out of this life without heartache and sadness, so why not try to treasure the times when everything is good and try to be thankful?

Yeah, I guess another week is done and I am humbled!
We'll tawk tomorrow,
I love you all,

Thursday, October 10, 2013

It's Terry, the nurse...

Lately, I have been tapped to tell stories of the nursing I do...the nursing that all of us who care for folks at end of life do.  I've told stories of being at home with folks, watching folks be loved until the end and even one person wanted to know about me!

All of the writer's say the same thing..."Isn't it so hard to do this work," and "How do you do this?"  

As I responded to the writer on Tuesday, "I'm not gonna pretend there isn't a bottle or two of pink wine consumed to soothe my tender heart...and I know that is not the best way to cope, but it is not really that sad.  Hard...yes...but sad...not always."   He went on to talk about me and what kind of person I must be to do what I do...and I felt uncomfortable and told him so.  He asked me what d I want I wanted the article to be about...so I began.

I told him about Hospice care and how people who don't understand feel like they are giving up.  I reject that notion because it's simply not true. Hospice care is about living...more comfortably and in less fear.  It's about having control of the time you have...not sitting a chair in an infusion office being treated when they tell you it isn't helping and just making you sick, or being in a hospital when all you want to be is at home in your bed surrounded by your family, your pets and your stuff.

I spoke of our mission to help the family to feel supported while their loved one is dying.  The thing about being a hospice nurse is not that it is so hard or easy...we know that we are walking into...a family that is devastated, tired and wishing things were different. But, because we know that, it is our starting point for everything we do.  We don't go in and tell them, in their home, what they are going to do. We also know that when a person has fought hard and has been told this is what they need to do and they do it while enduring the disruption of life, nausea, baldness and fear...what they  really want back is control.  They want to feel better than they do, get a handle on pain and nausea and spend every moment they can with their family.  We know that and they don't even have to tell us...

When I walk into the home and convey that they are in control and my job is to help them be in control,  be comfortable and answer any questions they have with honesty...I can feel the chaos that is terminal illness quiet down.  I, and I know all of us, take the time to explain things once, twice...today, tommorrow and even in the middle of the night if the patient or family call us.

If I had a dollar for every yes I got from folks when I asked if they were happy to be home..

I say this to patients and family a lot and I always mean it, "We are going to help you".  While it is about symptoms...feeling less pain, nausea or whatever is physical that you need help with, it's also about changing the definition of cure, or success.  It's not my place to change anyone's mind or make a patient do something they don't want to do, but talking about things that are scary and have been avoided seem to give patients and family a different kind of comfort and a decrease in  the fear.  

I think of Hospice patients and their families as superheroes.  It takes a certain love and courage to acknowledge the path before them and then follow through. I am humbled daily and consider myself lucky to have this job and that I get to do what I do.  I witness humans doing what is good, right and holy on a daily basis. Yes, I know I witness incredible pain and suffering...from families losing a loved one or a patient not wanting to leave but, I get to help, to support and sometimes just wrap my arms around a caregiver and let them know they will make it...even when they think they can't.

So when people say that phrase, "You have to be a special person to do that kind of work"  I challenge them.  I am the one who gets to help, to watch the strength of love and family along with faith to get them through life's unbearable sadness.  They are the ones that are special people and I just walk in at the right time to be with them. 

So, when I knock on the door and then open it...I always say, "Hello, it's me, Terry, the nurse" and walk in knowing I am lucky and honored to be right where I am.

We'll tawk tomorrow,
I love you all,