Tuesday, September 25, 2012

Sorry ma'am, they're just trying to have you die more slowly.

So, surprisingly, the worst thing about nursing is not the stress, smells, torture, early mornings, late nights, no lunches, thrown out backs, ruined bladders, and continuous stress ulcers.

No, the worst thing about nursing is the denial. The denial that life ends. We all know it, and we all seem to accept it…until we walk through hospital doors apparently.

It's amazing the number of people I care for who are being kept alive with no dignity, no comfort, and no respect. Every day I have elderly people in bed, basically unresponsive, with tube feedings going because they can't eat, catheters in their bladder and butt because they are incontinent, central lines because they are an impossible stick for a peripheral IV, high flow oxygen because their lungs are weak or full of fluid, skin breaking down because despite our frequent turning and repositioning, it's super fragile and just can't take the constant pressure and friction, and ten thousand medications to crush and force into their body because everything is breaking down and by god, we will make it work with these pills!

Only it's not breaking down. It's naturally declining because guess what? WE ARE NOT IMMORTAL. Sure, there are things we can do to slow down the process, or make it happen a bit more gracefully and comfortably. And that's fine. But I really don't think tubes from every orifice of your body, constant needles, and complete loss of dignity are within the realm of comfort and grace.

You can say all you want, "Oh well, my family knows that if I get to that point, they need to let me go". In response, I will laugh in your face because I guarantee you 90% of the patients on my floor once said the same thing and now guess what? They have not been let go. And when they code, I am smashing them to smithereens while doing chest compressions, then replaying the gruesome scene over and over and over in my nightmares when I get home.

Only I got lucky last week and I had Mrs. O. Mrs. O was a few short years from being 100. I walked in the room and this little lady had a massive toothless grin for me that made my morning grump melt away. Her wild and wispy white hair was a perfect accessory to her laugh lines and wrinkles around her bright blue eyes. Every time I walked in the room, she had that smile. Sometimes she knew where she was, sometimes she didn't. But every time she would grab my hand and squeeze it, and more than once she cupped my face and told me she wanted to take me home. Um, no Mrs. O, I want to take YOU home! Her family showed me a picture of her from the week prior, standing in the kitchen holding her great grandbaby. Apparently the confusion and frailty was sudden, and surely she would bounce back and be her same self after a few days of IV antibiotics.

Yesterday I came back to work after the weekend. I was happy to see Mrs. O on my assignment list, but surprised she hadn't gone home. When I walked in, I saw why. This wispy, bubbly lady had become a gaunt, sleepy shell. She wouldn't swallow water, and would no longer squeeze my hand. The only indication that she was the same lady was the random smile she would flash in her sleep, her personality clearly showing through the veil of fading life. Yet her daughter continued to talk and walk about the room as if nothing had changed. She left for work like every other day, telling me she would be back that evening.

Mrs. O's breathing got more and more labored, and she became less and less responsive. I wheeled her outside in her bed to see the sun set for the last time at the family's request. Her family put flowers in her hair and sat out for a long time while I went back upstairs to take care of my other patients. When they came back up, the environment in the room became more peaceful, more accepting. And Mrs. O continued to sleep.

When I left for the evening, the daughter hugged me crying and said she'd see me Thursday when I come back for my next shift. I know that isn't true, and I won't see her on Thursday. I just nod, squeeze Mrs. O's hand, touch her crazy white wispies, and walk out the door.

Everyone deserves to be Mrs. O. Everyone deserves that love, that dignity, and that respect. That acceptance. That trust that Life knows what it's doing, and we truly do not have control. And every nurse deserves to experience what I did…because we all know it's few and far between outside of hospice. We deserve to be able to actually put to use the one thing that made us become nurses in the first place: celebrate life- beginning, middle, and end.

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