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,
Terry