Sunday, March 27, 2016

The wall...and I'm not talking Pink Floyd

As we left the US, things seemed as they always do...
Then, when you look to the right, you see the wall separating the US and Mexico...the wall that separates us.

As I turned from the wall to the neighborhood that we were driving in, it was obvious that what separates us is much more...

We have more and they have less.  I guess that is a simple statement and honestly when you pick it apart, it is not simple at all.  We have more stuff, more money, more food, more conveniences, more doors and windows to shield us from the cold.  We have more medical care, more cars that run and more electricity.  So, yes...we have more.  They have less...of all the things I mentioned.

But, do they really have less?  Sometimes I wonder.

Every year, I head across the border to build a house.  But, in my mind, I head across for other reasons...all having to do with what I want.  This year, I went because I wanted to hang with  my college boy and I knew that if I was there, he would have to talk to  me.  I had no plans of connecting with families or seeing anything I haven't seen before.  You see, I have been doing this since 1999 and know it all...

On Sunday, Jim and Howie and I went an scouted the site.  It was in Anapra and is built on a land fill...a dump.  The roads are cut through mounds of garbage and the smell is pungent.  If you look down, you can see garbage...diapers and feminine napkins, tiles, glass and things that were thrown out.  They have lost the sharp edges from people walking on the objects although if you listen when you walk...you can hear the crunch.

The site was right next to the home that some of the family lived already.  They wanted it built close, so they could add on and be together.    As we walked up, you could see they were not sure if it was true.  These three gringos were coming to figure out how to give us a house?  Jim smiled and used his limited spanish to assure them that indeed tomorrow morning, more gringos were coming to work.  

I always wonder what the big deal is when we build an 11 x 14 house with two rooms, two windows and one door.  But on Sunday, when I walked into the home they live in now...a 9 x 11 ish frame with a curtain dividing the house in half with two beds pushed together for 5 of the family members to sleep.  On the other side from the beds was a stove and two plastic chairs to be the kitchen and living room...no windows and a curtain for a door.  So yes, it is a big deal.

On Monday, we showed up...all 21 of us, to build.  We had a 80ish dynamo and a 7 year old on our team.  We were all there for our own reasons to build a house for a family.  That was really all we knew.  As the day went on, the family came over and spent time with us...not thanking us but wanting to help build the home that was to be theirs.  They weren't looking to have it built and then look it over and move in...they wanted to help create it with us.   As much as my rock hard heart didn't want to soften, to watch this family become more and more excited each day with this place to call home...it began to melt.

We framed walls, framed the roof, poured the concrete and smoothed it, drilled holes in the studs for the light and the ceiling fan, put chicken wire on the outside and insulated...the place was taking shape.

Then, Jesus, the father asked our group if we could go and visit his son and pray with him.  I didn't think anything of it because I was busy but as the day wore on, we decided we could break and go.  We piled in the vans and drove 15 blocks to a rented house where they live now while they wait.  He told us that his son was ill and in bed and that he was depressed.  

We arrived to find a 22 year old boy on his side with his eyes closed in a small room.  On a table next to the bed was his "things", his dressings and things I am used to.  We stood around and I kneeled next to him and began to ask about his condition.  His mother told me that he was unable to walk anymore and was losing function in his left arm....and then she pulled back the covers and showed me his bedsores from being in bed for 6 months.  She told me that she can't go out much because he is unable to be left alone and he needs her.  She started to cry.  I looked away and began to get angry...I felt so helpless.

I went into nurse mode, and asked a million questions about how she is caring for the sores, how she is keeping him off of the pressure points, about the plan of care for her boy.  As she answered I realized where I was.  I was in Juarez, Mexico where you don't get nurses to change dressings three days a week with fancy dressings and creams...you don't get cushions and wheel chairs to change the pressure on spots.  In Juarez, you get to care for your boy as best you can with gatorade to put on dressings and pack in wounds because it says it has vitamins and minerals.

I slowed down and began to ask her son about pain and movement and things like that.  He told me he has pain but can't afford the medication...ibuprofen...to help with it.  

I was humbled by his mother who was like any of us...a mother who loved her boy deeply and wanted to do whatever it took to try to make him well and out of pain.  I was humbled by the surroundings and the lack of medical care and information available to her to care for her boy.

On Wednesday night, we finished the house.  It was beautiful and we were all excited.  I couldn't get this boy off of my mind and went to the big grocery store to see what I could make for makeshift wound care to heal this boy.  I found dressings, antibiotic ointment and things to help this boy's skin.

On Thursday, we had a huge party and gave the home to the family.  It was a great day and the family was so happy.  Then, we all went up to see the boy again and I got to give the mom all the presents I bought her so she could help her boy heal.  We sat and I taught her everything I know about wound care and skin care and diet and healing.  We gave them a cooler with cold cuts for protien and we held hands while we talked.  Mothers who want the best for our boys do that.  I told her she was doing a fantastic job caring for her boy and to keep doing what she was doing.

When it was time to leave, she cried and thanked us for caring about her boy.  I told her that we are mothers and we love our boys no matter who we are and where we are from...we are the same.  
We are mothers and fathers and family that loves deeply and wants only the best for our loves.  We are the same yet we are different.  In the US, we have dressings and help and medical care that is available if we need it...even when it is not the best.  We have something.  

But, at the end of the day, the family we built for was humble, thankful and joyful.  They cried when we handed the keys over and they cried when we talked of their boy...but through the tears, you could feel the joy of life.  The joy of having family around and the joy of being honored by caring for each other...

So I ask...who has more?  Are there things we can learn from each other?  While we toil away making money and buying the latest of this and that and worrying, they seem to accept what is and love each other.  Isn't life really all about the people we love?  I think because they live a hard life in so many ways, the joy they get from each other is apparent in all they do.  So I ask again, who has more?  Who deserves more?  Just questions to ponder as we go....

Back to the wall...this is the tall wall that is to keep the mexicans from coming into the US.  It goes on for miles and there are cameras and flood lights on our side and border patrol trucks at the ready... 

What do I know about walls?  If my boy needed care that I could not get here, or I had a home made of cardboard and pallets and was freezing, and tried everything I could do to change that in Mexico without luck...I would not rule out getting past that wall to a life where I was able to care for my family.  

That is what I learned on this trip...we are the same yet different, sad yet joyful and we all want to care for our loves...

We'll tawk tomorrow,
 I love you all,

Friday, March 11, 2016

Momma told me there'd be days like this.

Today was one of those days...the sky was so blue and it was warm and calm and smelled of spring.  Everywhere I looked, I could see hope.  I know it sounds so opposite after all the disgusting politics that are going on but today was just lovely.  When I turned the corner from my house, I saw a mamma dear and her babies hanging out waiting for me to go by.  I know it seems a little early, but life was that good.

I got to my first patients home and it was cool out and I shivered at I walked to his front door.  I did all the things I do, the IV's, dressings, empty the garbage, fix them breakfast...the things that my patients expect from me and then sat down to talk.  For some reason, today didn't feel so rushed.  I left his house, wishing him a great weekend and headed to patient number two.

This patient, I have had for a very long time.  She is old, frail and has the sweetest smile.  Today, though, things seemed different.  She was concerned, looking off into space and almost seemed like she was in pain.  Her caregiver was concerned and wondered what was going on.  I looked her over and really couldn't find anything obvious to think about or try to fix so I gently stroked her arm and watched her.  She was thinking, and it was obvious she had something on her mind.  Slowly and quietly (believe it or not) I asked her some questions...do you hurt anywhere? What can I do to help you?  You seem unsettled...what's going on?   Knowing her as I do, it was obvious she is unsettled but it didn't seem she was in pain.   Sometimes, I told the caregiver, there is work to be done that we don't understand and we just have to make sure we are supporting the patient in that work...just keep her comfortable, love her up and we will watch her.  Then I told her I was going to be around all weekend and to call me if she needed me.  I sat in the car in the driveway and wondered if she was heading out of this world...

My third, fourth and fifth visits were lovely.  Nice homes, nice people and a joy to care for.

My sixth and last visit of the day was around 3 pm.  I arrived to find my patient doing well and enjoying the day.  I did all the "assessment" things I need to do and sat in the recliner.  She sat in her chair and we began to talk.  We talked about her family, her grown kids, grand kids and how wonderful and smart they are.  We talked about her life when she was raising them and how different they were from each other.  We talked and talked and talked.  Before I knew it, I had been there an hour and 15 minutes.  I decided it was time to finish up, so I walked over to her medication planner and she and I talked through the medications and why she took them and when.  

Finally, we walked through the kitchen and stopped at the refrigerator to look at what she had on it.  It was filled with pictures of her life, when she was a young mother, her husband, her dogs.  She went from picture to picture and talked lovingly about the folks in them.  She told me of the grand kids, the daughters in laws, the great grandkids and when they had come to visit.  It was a 45 minute snippet of a life well lived and loved.  Finally, I asked her about the picture in the middle, one of her husband who is gone, smiling a huge smile right into the camera.  I looked over at her while she was talking about him and she had a big smile on her face.  She ran her hand over the pictures on the door of the refrigerator and then she turned to me and said, " I like these pictures here because whenever I go by, I look at them and remember what I good life I've lived".

She  walked me to the door and I bent down to give her a hug and I felt a sweet kiss on my cheek and heard a quiet " I love you" in my ear as I pulled away.  I told her I loved her too and I would see her next week...

There are days in my life that I rush through and when I get in bed, I can't remember what I've done.  I have regrets about those times as many of them were when I had three little kids and needed to get them through the day.  Now, I am trying to slow down and remember how my heart felt, what something smelled like and the colors in the room.  

I'm so glad I took the time today to slow down, listen and feel that kiss on the cheek and whisper I love you...because my heart felt like it was going to burst, the cheek felt soft against mine and all I could see was the bright light of love.

It was a beautiful day...and I have to try to make all my days like this...

We'll tawk tomorrow,
I love you all,

Saturday, March 5, 2016

If you don't laugh...you'll cry...

It's been that kind of week.  Honestly, every week seems to be that kind of week when you do Hospice nursing...so I guess this week has been no different except it was.

I like to make light of things that are intense...crack jokes, make fun of myself, and usually talk about how much wine I am going to drink when it's all over.  If I look at the team I work with, that is a way that we get through the days that are so difficult for families and for us...we laugh it off...and sometimes we all go out and drink wine too. 

When  you work with the dying, and do hospice care, you are on a team. (Thank God).  The team meets every two weeks to talk about the patients and the care they need and what we can do to make their time and their family's time with them better...sweeter and more profound.  The meetings have the nurses, the doctors, the chaplain, the social workers, the volunteers and who ever else is needed to make time better.  The meeting is mixed with questions, laughter, support and new ideas for the person's care.  It is something that I look forward to especially if I have a patient that I need help managing either symptom wise or emotion wise.  The thing that is not generally seen at this meeting is tears.  It is usually all business with an exchange of ideas as if we are fixing symptoms on a broken vehicle or dealing with a recipe that we haven't followed directions but need to change some of the ingredients to make it taste better.  We just don't cry a whole lot.  Now, we tell jokes...we laugh, but otherwise we are serious and down to business.

Last Thursdays meeting went along in the same fashion that we always do.  We started with the patients that have passed away and we talked about how peaceful the passing was and how the family is doing and then we asked our social workers to contact them for grief work and moved on.  It was very quick and solemn.  After that we moved on to the patients that we are caring for and the symptoms and things that we want to address.  We include the family and if they need support, we add that.  It was a really helpful meeting and we were done in record time so we could go and put out new ideas into action.

Just as we were breaking up, a nurse came in that was obviously upset.  She has been taking care of a patient for a long time and the end is near.  As she began to talk about the things she needed help with, she broke down in tears...and we all quieted down and stopped moving.  All at once, she was peppered with,"what can I do to help, should we do this, or should we do that?" to which this nurse just kept saying "yes, I need help."

You see, when you care for someone in their home, you become special to them even if you try not to and you try not to have them become special to you.  But, from the moment you knock on the door, sit in the chair by the bed, make a cup of coffee or food in their kitchen...you become family.  So how,does a nurse who needs to keep boundaries of some sort do that when you become family to folks week after week? 

The quick answer to that is...you don't.  You put your heart right in the middle of the situation and you do everything you can do to care for them like family.  Yep, that's what you do.  You know why?  Because when you let someone into that time of life when you are hanging by a thread and cannot deal with one more stranger,  we walk in.  When we walk in, we don't tell you that you are going to beat this cancer and live forever, although I wish we did.  No, what we tell you is what we can do for you at home...where you haven't been much because of symptoms or because  you have been doing chemo and it has been beating you down..in other words, you have had no control.  When we walk in, we give you your control back...you wanna sleep?  OK.  You want to take more pain medication because you still hurt?  We figure out what you need to take to get your pain controlled.  And your family is wondering how to help you?  We can give them ideas around that too so you and they can have the best time you can with what you are facing...

When we get you all organized and comfortable at home, we leave you with your family knowing we are a phone call away any time...day or night.  So yeah, we turn into family, them to us and us to them.

I don't know why we were a little surprised at the tears and frustration at the end of the meeting.  We have all felt that way more than we can even let on and I know many times in the meeting when I am caring for someone who I don't need help with but know I will miss, I swallow hard and say, "There fine, He's good...Just go to the next one" and raise my head high to keep the tears from sneaking out and down my cheeks.  For me, it's not because I am too tough to cry or because I can't...it's just sometimes I get afraid that when the tears start, I may not be able to stop them.

Thankfully, our team rallied around this awesome nurse and figured out what we needed to do to help her patient and to help her know that sometimes we do everything in our power to help and it doesn't work.  Kind of like life...we think we are on the right path and things go south...

So thank God for families...our own, our work families and I am thankful for my patient families as well.  The folks that have the courage to love people out of this world when they would rather be doing anything else.  

So...see...that's why I say, if you don't laugh, you'll cry.

We'll tawk tomorrow,
I love you all,