I'm surrounded by death. Nearly every week someone I've grown to care about dies. This is the way it is in hospice nursing. And sometimes its so beautiful, guiding someone through their last days, supporting their family, giving them the tools they need to die peacefully and at home.
But this is not the type of job that you "just learn". It's an evolution of skills, and of personal growth. Learning to sit with someone when they are in deep emotional pain is challenging. I've learned that I sometimes hide behind my clinical skills, keep it nursing only. But dying is not just a clinical phenomenon. It's an emotional, spiritual, and physical journey.
One of my pts died last night, and though I now she's in a better place, I miss her. She was one of the patients that takes a hold of your heart strings, the kind that you bring home with you because you keep replaying your interactions, because you realize you have put her in your heart. She was a strong, graceful woman. She had 5 children, adopted 2, fostered many. She played piano at her church and sang better than Aretha Franklin. And she was a fighting spirit. This was her challenge. Her spirit did not want to give up even though her body was dying. And this gave her so much confict and struggle. As her nurse I visited her several times a week, taking her vitals, titrating her meds, troubleshooting every new symptom, but despite the nursing work, she pulled me out of my clinical safety zone. I sat with her many times as she lay conflicted, giving her the information she asked for but did not want to hear, "yes, your body is dying". I witnessed her pilgrimage of fighting to acceptance, and for some reason it just broke my heart. She broke my heart, with her kind eyes and her graceful way.
This is quite a job, and quite an art. Coming home from work you think you can just brush off your day. But so often you can't, so you cope, in whatever way works for you. And this takes figuring out. There is a lot of personal awareness that you must foster. Feeling angry at home could just mean you brought home your day. Wanting to leave a dying patient's home as soon as the clinical assessment is over could mean that you are uncomfortable sitting with their grief. Checking your voicemails in the middle of the weekend could mean that you are overly invested. This job is riddled with fine lines. And each working day I start new, knowing that I am still such a work in progress.
Monday, April 6, 2009
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3 comments:
aaaw, summer-you are so right on. your words are so so true and could not have been any more simply stated. i am so proud to know you as a co-worker and as a friend, great ones at that. you are such a wonderful hospice nurse. you have many many angels in heaven. i love you!
Summer you state the essence of living so beautifully even though it's about dying. The best of people find a place in your heart and you can't let them out. That's what makes them special people. That's what makes them never be forgotten. What is the sense of living if we just do it to be forgotten the moment we die? You have truly accomplished something if you are remembered six months after you die or five years down the road. Not mourned for but remembered. I was taught this by a person with the kindest, most resilient heart I know, a fighter to the end. She taught me some of my greatest lessons about life. She taught my heart. She still laughs in my ear. She was nine years old.
You know, I have lost quite a few patients in the short time I have been in the nursing home. What amazes me is the people who I don't feel like I got close to. The people who as much as I hate to say it, are really quite annoying. I lost a patient the other day who was like that. She was constantly on her bell and chanting "nurse, nurse...." in her raspy old voice. Asking the same questions over and over even though she knows the answer. Ringing her bell over and over to ask for whatever meds she can think of. Then I came in and found out she had dies. Now I miss all the stuff. My night isn't the same without telling her she needs to go to bed and she has already had her meds. Luckily I don't have guilt, because there were many nights when I did just sit with her knowing that she just wanted attention. I just never thought I would miss her when she was gone and now she is and I do. These people become a part of my daily routine and when they go, things seem so different. You will never learn how to deal with losing patients. At least that's how I feel about it. I am just glad when I get to see them in those last few hours because it helps feel better about their passing.
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