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By Lorraine Thayer, RN
I cannot remember a time when I did not want to be a nurse.
I have been practicing for more than 25 years and not for one minute have I felt anything but gratitude about the opportunities this profession has afforded me. I learned about hospice early in my career. I worked in an impoverished area; many of my patients could not afford preventative health care. As a result many times their disease was beyond cure when I first met them. What we could offer was comfort and a peaceful passing. While my friends were busy working in operative suites and ICU’s and delivery rooms, I found my calling at the bedside of those for whom medicine had little to offer. Hospice nursing, however, had much to offer these men and women. This blog entry is about gratitude for the opportunity afforded me to spend the most intimate time of a person’s life with them.
When I was new to hospice, I believed everyone would die in their own home surrounded by the people they loved most. Thank you to John, a 22-year-old man with AIDS, who died in my arms in the middle of the night only a few minutes after he had told his family to go home he would see them in the morning. John taught me that sometimes a person needs to take that final walk alone. I have seen this happen many times over the years since that first young man.
When I was new to hospice, I believed that all deaths would be pain free. Thank you to Ann, a 76-year-old woman with cancer that had spread throughout all her major organs and to her bones. She had a great spiritual conviction. In this belief she felt that, as in childbirth, there needed to be pain associated with the dying process. Her family supported her decision. Although Ann suffered some physical pain, she was one of the most peaceful spiritual people I have ever known. Sometimes after leaving her house I cried for her. Silly me.
Thank you Ann, for teaching me each person’s journey is their own. There are many roads to get to the same destination.
When I was new to hospice, I believed everyone would benefit from the hospice philosophy. That my role was to walk them through the stages of dying. That when they did pass away, all their “issues” would be worked through allowing them a peaceful passing. Thank you Joanne, a 42-year-old woman who suffered a seizure on her honeymoon in Asia. Upon her return a brain cancer was identified for which there was no treatment. Joann’s place of comfort was denial. She did not want to work through any process. She lived each minute of her life never admitting her time was limited. One night, no different than any other Joanne went to sleep, never to awaken.
Thank you Joann, for teaching me that each of us is only guaranteed the minute we are living in, and nothing beyond.
I am no longer a new hospice nurse. I have years of experience and even an advanced degree. Yet I continue to learn about the joys that can be found towards the end of life.
I keep in my heart and prayers every person who has allowed me to join them in their journey. I am grateful for their kindness and generosity. My life has been forever changed and enhanced because I am a hospice nurse.
Guest SpeakerHi class,
Because many of you have shared, with me, that you would like a guest speaker to come and share his/her experience of conflict I have arranged for her to come and speak with you! It’s me. Like all of you, I once was a nursing student. I remember the thrill of passing the board exam and finally being recognized as an official “nurse”. It did not take me long to realize the great responsibilities that came along with this title once I started my new job. ‘The new nurse’ and ‘the new grad’ were common names that were assigned to me. Friendlier names like ‘the baby’ and ‘the little one’ I got used to. Although, deep down, I felt these names put me in a place of little power and having little to say, I kept quiet as I felt threatened by the possible ramifications that would follow if I confronted this matter. Most staff were quite accommodating and supportive, or at least that’s what I recall. There was one particular conflict that I had with a patient which took a huge toll on my emotions and made other conflicts seem insignificant.
“You Chinese people can go back to where you came from!” were the vivid words that were shouted at me on a Monday morning as I was washing a Caucasian man who was bedridden and had given me consent to provide care minutes before. “You boat people are dirty little whores!” he continued. My initial emotional reaction that I kept to myself was – ‘Well excuse me sir, first of all, I am not Chinese, and second of all, what gives you the right to treat me this way?’ Could it be his pain, his frustrations with life, or his racist attitude towards Chinese people? I remember taking a few steps backwards when he yelled at me and I told him that I will stop giving care if he continued to talk to me that way. He kept quiet. I continued to wash him and then he asked me if I knew how to speak English because I didn’t respond to his comments about being Chinese. I kept my silence as I quickly finished washing and left him in peace.
That same evening, I found out from the Social Worker that the client’s Chinese wife of 10 years left him recently after he had a stroke. The client spent a lot of his money to sponsor his wife to Canada in the past and worked really hard to support her throughout the years, being the breadwinner of the family. Now, the client barely has any money left and has no support systems in place.
Case StudyNancy recently graduated from her nursing program 6 months ago and has been working on an orthopedic surgery ward. The ward recently lost 7 full time nurses and is still trying to make up for lost staff. Due to these shortages, many newer nurses like Nancy, have been oriented to Charge Nurse duties, a task that is usually reserved for nurses working at least 1 year on the floor. Nancy is working her first shift as a Charge Nurse when a patient becomes verbally abusive…
At the nurses station Nancy is checking patient’s lab results for the day
“Nancy”, another nurse approaches her, “the man in room 18B is verbally abusive and refusing to calm down. We have tried many approaches but he just keeps saying offensive things to us and now he is threatening to hurt himself”.
Nancy is alarmed; she has never encountered a situation like this on her own. She decides she will go down to speak to the patient.
“Mr. Jones, what seems to be the problem?” Nancy asks. “The problem is all your idiot staff and the fact that they wont take me downstairs to smoke and have a sandwich!”
Nancy knew Mr. Jones was a total hip replacement and would require staff with him at all times. She also knew the unit was very short staffed, and unfortunately it would be difficult to pull someone off the floor to accompany Mr. Jones.
Nancy started to explain this to Mr. Jones but he just became more agitated. Nancy quickly left the room and wasn’t sure what to do! One of the more senior nurses approached Nancy.
“I get it, you are new here, she said, but you really don’t know what you are doing or how things work, do you!?! Ugh they should have put ME in charge.”
Nancy was feeling more overwhelmed. She decided to call Mr. Jones’ attending orthopedic surgeon. She explained the situation to him on the phone, and was cut off mid sentence. “Now Nancy, you girls should know to give Mr. Jones special care and attention based on his situation. Do you need a man to come in there and take him downstairs for his cigarette?” the doctor chuckled. Nancy was feeling very overwhelmed and wasn’t sure how she was going to handle all these conflicts.