Not the Sense I Wanted

So, for anyone thats ever gone to nursing school, chances are you've heard of Patricia Benner's "Novice to Expert" model. The five stages depict what stage of nursing you are in based on your experience and performance. THe stages range from being a:

-  "novice", which means you are by-the-book, no experience, new grad.
-  "Advanced Beginner", meaning you have enough experience to help formulate future guided actions, you start developing your "nursing spidey sense"
-  "Competent", meaning you usually have 2-3 years experience, you start thinking about your patients long term goals and health, rather than just the textbook here-and-now.
-  "Proficient"- Meaning you have learned from enough experiences to modify plans, change others perspectives, teach others your skills, and your nursing spidey sense is pretty strong.
-  "Expert"- Well, here is where you're just awesome. You've been a nurse for a looooooooong time and your Nursing spidey sense is just out of this world.


Now, what exactly do I mean by 'Nursing Spidey Sense'? Simple. Let me explain.

At the stage of a Novice, which I was not too long ago, I was so scared with my patients. I saw the more experienced nurses (I work with a lot of 'Competents and Proficients') and I would witness them catch a patient going downhill pretty early. I thought, how did you know? What if My patient is suffering and going downhill and I missed something in my assessment? My assessment skills aren't good enough, what if I am missing something simple, or something huge that could save their life? The more experienced nurses on my floor assured me that it was important that I just keep learning and always doing my best, always being on guard. I listened.

Now, almost hitting my one year anniversary in nursing, I feel like I have graduated to "Advanced beginner", and suddenly, I don't have that constant fear. I know I have a LOT to learn, but I feel comfortable in my assessments. I can feel my nursing spidey sense definitely getting stronger.

Point being, At the stage of a Novice, you have no nursing spidey sense. None. Zip. You go by facts, whats presented to you, lab values, evidence. There is no "intuition" developing just yet that something is wrong without any evidence.

Although I cannot speak from personal experience, from what I understand, "Expert" is when that same intuition of the nursing spidey sense is at its peak. You can enter a room and look at a patient and you just KNOW that something is very wrong with that patient before you even lay a stethoscope on them.

So, my nursing spidey sense is helping me in a lot of ways. I like having that "gut feeling" developing...it comes in handy when its time to make a decision. However, there are ways that it can be a huge bummer.

For instance, lately I seem to have developed the skill/spidey sense (I'm not sure which you could call it), of being able to predict if someone is dying or not. Not necessarily on my shift (in fact I do almost anything to NOT let you die on my shift!), but I've learned enough in nursing to know when someone just simply isn't going to pull through whatever they are going through.

I had a very kind patient not too long ago. He touched my heart with his generosity and patience, he was a very sweet elderly gentleman and was going through a lot of hard times. He had advanced stage lung cancer and frequent bouts of pneumonia, due to frequent aspirations related to the lung cancer and intubations. Well, one day I heard he was discharged and doing a little bit better. Well, a couple weeks later, I was doing a small rotation in my ICU, and I saw a man in one of the beds, intubated and hooked up to every possible wire and tube you can think of. Drips, tube feedings, multiple IV pumps, vital signs, you name it. I thought, "Wow, poor guy." But something made me look further, I saw his name and realized it was my guy. My heart dropped to the floor, along with my jaw. I couldn't believe the last I heard he was home and doing better and now he was in the ICU, unconscious. I walked closer to his room and watched him, watched the ventilator breathing air into his lungs methodically for him. I couldn't believe it. And I knew, at that point, regardless of all evidence, even though I knew nothing about his current medical status, I knew- that he was facing death any day now. I could feel it in the room, it was as if he wasn't even there any more. His lively and kindred spirit wasn't there and that deadweight feeling was left in the room, daunting.


As for on my floor, I work on an oncology unit. That being said, I've had multiple patients in the past that simply couldn't pull through the advanced cancer. This knowledge has helped me develop pretty early on in a patients diagnosis on whether or not I think they will make it, and sadly......I have been right, lately. And that makes it so hard, staying with these patients for weeks, months, prolonging the inevitable. Watching them suffer slowly. When you know they probably won't pull through and yet the family has no idea. Sometimes even the patient doesn't have an idea....but most of the time they do, too.

 This same sense has proved to be intact with patients outside of oncology as well. Recently I had an 83 year old with advanced end stage COPD. I knew he wasn't going to make it til the end of the week. In fact, (and this was the first patient I ever did this for), I prepped him for a code blue on my shift. I made sure my IV was definitely intact, made sure the room had a lot of spce, made sure the code cart was handy, because I was that sure he was looking at the light.  He died that week.


I was just blessed enough to have about 8 days off from work, I went on vacation and had some free brain time, away from all the nursing and death and living. The only medicine I had to think about was my own, and I gave my cousin a bandaid and some neosporin. 

However, when I got home, the very first night I had to sleep, I had this awful- frighteningly lifelike dream. I was at work, and in the dream I was standing over a patient's bed. She was a young female, in her 40s. She was a mom, I knew that in my head in the dream. I also knew she had advanced cancer and she was going to die, soon. In the dream I was faced with the ultimate daunting task, the husband asked me, "Is she going to die? What do you think? I've heard what the doctors have said, but what do you say? When will it happen?"  No nurse ever wants to answer that question, ever. In the dream we were in an absolute white room, white floors,white walls, no furniture. I sat there in the dream checking her foley output, knowing how much it decreases before death. I held her hand and told him nonverbally what I thought, what he already knew.

What kind of dream is that? What happened to dreams about princes and frogs and fairytales? Seriously, but it just goes to show that a nurses mind never shuts out the world of medicine. Once you start developing that nursing spidey sense, it never shuts off, even if its in your dreams as well.

I love my nursing spidey sense. Like I said, its been handy when deciding what to do next with my patients and helps guiding long term thinking for your patient. But sometimes, I'd like to not be right about the death sense. :-\ Its a strange conundrum.



~WNB



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The Forbidden Nursing Word

If you go on to any nursing unit, anywhere- Chances are there will be a universal unwritten rule amongst the staff nurses that it is never acceptable to say 'boy, its a quiet night tonight'. The forbidden word in that sentence being "quiet". Also on the list of major forbidden words, "what a boring night."  It is okay to say these words only if you seek trauma/psychos/crazyshit to happen and you are the person willing to deal with all this crazyshit because you are the one that said it.



So that's the universal unwritten rule in nursing. But why is that? Doesn't that just add to our job dissatisfaction? Are we not allowed to bask in the joy of having a slow moment when not all of your patients are going ballistic? Why are we one of the few professions where we are not allowed to say "its so quiet. I'm going to enjoy this moment." Nurses believe in karmic balance, we believe in jinxes, we believe in full moons. At least on my unit. We all know that if that word is said, we can expect things to start picking up. In a bad way.

We believe in jinxes. Way too heavily. A couple of weeks ago, I was bragging profusely to a coworker that despite working on this job for nearly 6 years, I had never been assaulted. Kicked, punched, hit, bitten, scratched. Nothing. What happens 4 hours later? I got punched. Big time. By a patient. If that's not enough to make you think twice about the jinx phenomenon- Get this: We had a quiet night last night- not much going on. We were all walking on ice- afraid to say that word, but were finally happy to be able to take a little bit of a deep breath. Then- Out of the blue- 2am- we get a code blue. One of our patients stopped breathing. We of course call out all the stops and whatnot, run the code. The patient ended up not making it. After the code, during the time I was sitting down with the resident having him sign the papers, he told me- "I think this is my fault." I asked him, what do you mean?  He said back, "Earlier this shift I was bragging to the other residents I've never had to pronounce any of my patients dead yet."

After he said that, I wanted to punch him in the face. Why would someone ever bring that karmic invite on?...

Lately the unit has been......insane. I have never particularly enjoyed psychiatric patients, and in the past two weeks I've been punched by a psych patient, and taken 4 knives away from another. Both under my direct supervision. And besides those incidents, its just been a run for our money in every way. A true test of patience, strength, passion and endurance.


I've discovered something about myself in all of this though, a new defense mechanism I didn't even really know I had in me. On the unit, there have been moments where everything is coming at you at once, you are having the worst possible night, no one can help you because everyone else is having a bad night too (in addition to your hospital being severely understaffed), and you face a decision: You lose it and throw a complete temper tantrum on the floor/ run out of the hospital screaming, or you find SOME way to keep yourself together. Not just together,  but you have to be able to put on a smile and keep calm entirely in front of your patients and not let them see you're having a bad night in any way. Its definitely not easy.

So my new defense mechanism is something new. In order to prevent my inner psyche from going completely nuts, I went into what I see as an emotional shutdown. I went through the motions. I did what I had to do. I said only what needed to be said. I remained calm. I thought things through. I did my job. But I wasn't emotionally there...I couldn't be. Its like my brain and body were still working but my mind and soul weren't.

On my particular unit, we can't really take breaks. There are only two nurses on staff at all times and leaving the floor is not allowed. So my break consists of eating a sandwich at the nurses station. Also, being that there are times we are severely understaffed and have no aide, if a call light or problem arises while you are sitting and eating your sandwich- you must go attend to this. So really, you don't get a "true break". There have been night shifts where I couldn't even find the 4 minutes it took to pee until about 5 am. That's why nurses have extraordinary bladders. They expand :-)

But all this has definitely made me re-think whether or not I chose the right career. Its gotten me pretty low in the dumps, and its brought on a lot of thought. Lets start with the good- I am incredibly thankful for where I have gone in life. Meaning- I love having the medical knowledge database in my head. I love figuring out the mysteries, I love diagnosing people, I love applying medical knowledge, I love explaining things to laypeople, I love knowing more than the residents (hehe). I love the fact that when I have kids, I will know how to help them medically. I love that If I'm first responder to any accident as a drivebyer- I can apply basic medical attention. I can respond to emergencies on airplanes. I want to learn more and more and more about the medical field and apply it all. Its like a giant equation, a giant puzzle- and I want to collect all the pieces.



I keep revolving back to the fact that I should have just followed my heart. My true heart. I just, once again, didn't have enough confidence in myself to believe I could succeed. I should have gotten a job that allowed me to exercise my creative artistic side at work. With Pixar. Or with a graphic design company. As a Writer. As a music-video design artist. As a movie-maker. ANY other job on this planet that could let me make art every day......that....would be my ultimate key to happiness. Sure I can make art on the side now. But in my time off- when I'm exhausted. When my mind is absolutely reeling from the shift I just had.

I think I'm mad at myself for just feeling this jaded after only five months of nursing. I wouldn't say that I am burned out, but the fire is lit and it shouldn't be. Not this early. I have to fix things. I'm tired of holding it all together. I'm tired of pretending to be strong.


_WNB.



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Kind of Incredible

So under my care this week is an elderly gentleman, recently placed under the code status of: DNR. For my non-medical readers, this means one thing: If he were to die, if his heart were to stop beating, if he were to stop breathing, we would not do anything except say a goodbye prayer...we would not call a code, we would not start CPR.

In addition, we also placed this patient on something called "hospice care". This differs from a DNR based on the fact that a DNR says we won't do anything if he were to die, the term "hospice" means that we are going to stop all treatment to stop disease progression, and purely focus on helping him have no pain, until the moment he does die. Which, being that we stop fighting his disease (cancer), will be soon.


Now this case is common and yet all too unique (but isnt every patient?). This gentleman was diagnosed with cancer long ago and has spent years fighting this battle, as many have. He's had years to come to terms with his diagnosis, what he is doing...his life, his death. But just recently did they decide to change him to hospice...does this mean he gave up on life? No. It means he's done, he's done fighting. He's ready to face whats next.

Now, whats incredible, is the following: As an RN, all of the patients I've had under my care that have died- it was always unexpected. Sometimes I knew they may have been dying but didn't realize it was so close, other times it took me by complete surprise. Shock. They were supposed to have pulled through. I always thought, Oh my god- I was just holding their hand only two days ago. I was just taking care of them. Did I do everything I could have? If Only I had known they were going to die in days....would I have changed my care? WOuld I have stayed to sit with them longer? Would I have that "I'm sorry" look in my eye? Would that make it worse?

So, this is the first time (as an RN) that I have had someone under my direct care that knew, he accepted, the fact that death was upon his doorstep. Tomorrow, next week, next month, maybe.

It may seem strange, morbid even- to imagine this if you have never had the opportunity. Anyone who ever has had the opportunity and it was a loved one, I'm so sorry. To talk with someone, to take care of someone that could not be on this earth the next day and everyone knows it. Its not unexpected. To take care of someone, knowing you may see their obituary in the paper that week. To hold someones hand.


And, to answer my own questions- Yes. It did change my way of practice. Whether that be a good thing or a bad, I don't know exactly. Yes, we did have a small euphemistic conversation about his illness, about passing on. Yes, he was a little depressed and I sat with him a little longer. Yes, I didn't know what to say and it was obvious. Yes, I did have the empathetic look in my eye.


Yes, I did turn around after I said goodbye this morning, Yes- I did go back and give him another hand squeeze, to tell him it really was a pleasure taking care of him. He is probably going to be transferred today, so I told him it was a pleasure taking care of him, in case I wouldn't see him again. On the surface I was talking about if he got transferred before I got back. But we both knew what I was really talking about.

And he smiled.


Its not something you can ever take lightly, death. When someone is that close to whats next- that close to an eternity of darkness or perhaps an eternity of bliss, they are close. They know its coming. They can mentally prepare. It will never not be weird.




I hope its an eternity of bliss.



~ WNB



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Unexpecting the Expected

So I just found out tonight that the patient from This Post from the other day has died.

:-(


Like I said in my prior blog about her case, I kind of had a bad feeling that she just wasn't going to make it......but to accept it as reality? Thats a whole other ball game.


Its this incredibley eerie feeling that literally on Saturday I was taking care of her and by monday she had passed. It happened so fast. On Friday it started with a worrisome wheeze. By Saturday she couldn't breathe. By Sunday she was back in the ICU. And now what bothers me the most is that her husband is alone.

The story that I've heard from other employees is that she wanted to pass. She was mad at her family for even putting her on a breathing machine. She didn't want to die like that, and neither would I. I don't blame her.

It just kills me that such a nice soul, a nice person, had to die in pain. At least she wasn't alone. She had such a wonderful caring husband, by her side for every minute.

It just......feels funny. You know? Although I've had many many many patients that have died in my care before, as an aide, even some where I was the first one to find them passed, some took their last breath in front of me....but this is only my second as an RN. And they were very similar cases. Not similar medically, but similar in the way they both touched my heart. They both taught me something extraordinary. I will never forget.

The weirdest and hardest part is that they weren't even under my direct care upon their passing. I couldn't even hold their hand. And when I did have them under my care, I had no idea that the very hand I was holding would be gone in two days. In fact with both cases, I didn't even find out about the death until a couple of days after. Here I am thinking how they are probably doing much better by now, and then I hear that she passed. Sigh.  She was supposed to get better. She kept telling me how she couldn't wait to just recover from this surgery and get back to normal. Back to normal...

I hope she died in peace with everything. I hope her husband isn't alone.


I know as an RN or any health care personnel, we aren't supposed to get attached...but I can't explain it. Its just a weird feeling. Like nothing me or any of the other nurses did, helped. It was all for nothing because now she's gone. Its a hard gulp to accept, but I will accept it in time. Its part of nursing, all part of the emotional toll.

Like I said, what matters to me most is that I hope her husband is OK. :(


Thanks for reading, with love- ~WNB



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This Ain't Goodbye

"You and I were friends from outerspace, afraid to let go. The only two who understood this place..."


Okay. I'm not even sure where to begin, to be honest.

I lost a really great friend this past weekend. Saturday morning.

I think I'm still in the Denial stage of grief. Its just so hard to......grasp. To really say to yourself, She is gone. I'm not going to see her anymore on random at work. I won't see her smiling face anymore, hear her laugh. I'm not in denial that she passed away. I get that. I understand that. I'm in denial I won't see her anymore, I guess. Its just so hard to believe.

It happened fast. She became very sick very quickly and after all, we all knew death was imminent, as much as we all hoped she would pull through on the last minute and be fine. She was diagnosed with Cancer in June and we all imagined her pulling through the chemotherapy rounds and then eventually returning back to work one day. None of us knew, ever even thought, that it would end like it did. Maybe thats why its still so hard to believe. She was supposed to make it.


She was hired where I work (at the hospital), on my floor, the same job as me, exactly a month after I. I met her when I was 18, five years ago. At the time I was only working alternating weekends, so I could toggle my other job and school as well. Therefore, she was my "weekend buddy", the only employee I really got to know at first. We were both still so new and we learned the ropes together, we had a lot of laughs and a lot of learning. Eventually I quit my other job and picked up a lot more shifts at the hospital and eventually met a lot more people and became very good friends with a lot more of my coworkers. But Ann was the first.


She was way too young to die. Just over middle age, she was just starting to prepare for retirement and the major second half of her life. She was just recently dieting to be healthier...for some reason I can't get that out of my mind. Just a week or so before she was diagnosed I remember her asking for some time off to get some health check-ups done. She was fine, then. Or so we thought.


Life is always full of "I should haves".  If I had known that her being diagnosed with cancer and admitted to our hospital would end in her passing, I would have gone to visit more. I would have given her more hugs. I went to visit on occasion because I knew there would be more times to visit, a lifetimes worth. I was wrong.


The earth shattering thought of it all comes down to this....she was "fine", and then two months later, she is not with us anymore. She was dieting, she was planning for the future, she was taking care of her daughter and mother, she was living her life, she was working full time, she was fine.

It could happen to any of us. It could happen to any of us that we become sick, or any of us could die at any passing moment, and then what?  Just like that? It's just hard to wrap your mind around. I think everyone naturally plans on and counts on the fact that they will live til their elder years and then its okay to pass away. I certainly do. I can't imagine myself not making it to the elder years, but then again, who actually plans on not doing so? Life just catches us so off guard its unbelievable.

Upon her recent passing, all of us at work have been sharing our favorite memories of her. Memories she never would have imagined would be her last in our minds.

Some of my favorite include this one time when staffing was an absolute mess one day at work and everyone was pulled to all different floors. I got pulled first to our psychiatric unit for a 1:1. Me and Ann were supposed to split the 8 hours and switch at 7pm. Well, 7 pm came and sure enough, she came down, but not to relieve me. She sat down right across from me, and told me she had been called down herself to watch another patient next door. So we spent the next four hours, right next to eachother (that never happens on 1:1's, ever), just talking, catching up and getting to know more about one another.

Which got me thinking, if you or I died right now, what would peoples last memories be with you? Do you approve of those memories? What would you change?

What would you wish you could have done before you died?

For some reason, every time I come close to death myself (I make it sound like this happens a lot but its actually usually made up in my mind *hypochondriac*) I find myself thinking, "I can't die yet. I haven't written a book yet." A written book is the one thing I want this world to remember me by. So why aren't I writing it? I am fine, I am healthy, I am not dying anytime soon. I have all the time in the foreseeable, fortunate lucky world. So if it means that much to me to do before I die, why aren't I writing it? Why wait until its too late?

I guess we always just leave those things to another day because "life" gets in the way. Our kids, our jobs, our responsibilities, our groceries, our errands. Our bucket lists can wait on another day, another time to start that, because today you have to run errands.

Being in the healthcare field, I know how much she was suffering. She is no longer in pain now and had a very painful and traumatizing last month of her life, which no one should ever haver to go through. Being on the patient and nurse in my life so far, I know the dynamics and suffering of what she went through and I don't even know if I would be strong enough to do it myself. She was one of the strongest people I knew.

So, knowing that, my only prayer is that Ann got to do what meant the most to her in life. Got to spend life with people she loved most and loved her most. I guess thats all anyone can ask for, when it comes down to the bare necessities, right?


Well, one day we will meet again. I know she will be waiting for us with her classic smile, and Styrofoam cup of water with "Ann" written on the side. Until then.....


"But this ain't goodbye
This is just the way love goes
When words aren't warm enough to keep away the cold.
This ain't goodbye
It's not where our story ends"

Love you always, remember you forever. Rest in Peace, Ann. < 3

~ WNB



. song lyrics by Train, "This Ain't Goodbye"

Wow...?

Well, the epic weekend has come to a close, and boy was it full of surprises and learning experiences.

I had a lot of panic attacks. My panic attacks are unnoticeable...as in unless you really, really, really, really REALLY know me, you don't notice they are happening to me. I honestly don't think my ex-boyfriend whom I dated for almost 4 years could notice, and he is always able to tell when I have a headache or stomachache. I don't even think my parents could tell. So I keep it very hidden. I don't have obvious symptoms (i.e. short of breath, rapid pulse, sweating) but instead I feel it in my stomach and I feel like my entire world is collapsing around me and that I am unprotected and vulnerable. Sometimes they can be 10 seconds to a couple of minutes and usually the only cure is to be alone for a couple of minutes, or if that is not possible then I usually just quiet down and sort of "give myself a hug" (i.e. just wrap my arms around my stomach so that I cover that sense of feeling "unprotected"). OK but enough about that. Point is, I usually only get them a couple times a month and extremely sporadically. But this weekend I was having a couple a day. Not sure why....My longest one was Saturday morning, after breakfast, before seeing anyone really--And before going to the service--it just came over me. I immediately excused myself, came back to our hotel room and just hid underneath my covers...in my nice dress....I mean really- Who does that? Me, I guess. Not often though, I promise.


Anyway, the memorial service was really excellent. I am usually not an emotional person, by any means. I used to be proud of myself that I could be in very traumatic situations and not shed a tear....it just literally wouldnt happen. No tears. I guess now I realize I just never had anything to cry about, til now. Now, being 23, I friggen cry in movies. WTF is that?   

But honestly, I had already shed my tears for my grandmother. Don't get me wrong- I was still very sad and still in disbelief- but what made me actually cry was seeing everybody else  cry. My rocks...my aunts and uncles. My mom. I don't like to cry in front of people because I can't just shed a tear. If I am going to cry, I am going to bawl. So I didn't want to bawl. So I kept telling myself to just play it cool, play it cool, don't cry....but, I did. Seeing everyone else cry is really what did it.    

Other than that, though, there was never another cry-moment. The rest of the weekend was spent with my amazing crazy family, and it really was just like that dream I had, sort of a premonition of how the weekend was going to go. We talked about grandma, we laughed, we told stories, we shared pictures, we felt her there with us, too.

But what I learned most of all, is something  I should have realized long ago and what will ring true with me for the rest of my life. Just as I did realize in my dream, my grandma (in the dream) was healthy again. In real life, before passing, she was extremely not-healthy and her quality of life was rapidly decreasing. She could no longer do some of her favorite activities. But in the dream she was back in full health, full laughter....playing games with everyone.

Well, through talking with family, they helped me come to realize that my grandmother is happy right now. We joked around that by now she is organizing some sort of big event in heaven, she has already joined a choir to sing in and play her accordion, she has met up with people from her past, she has made wrong things right, and most of all, she feels healthy again. And she will always be looking down on us. So I don't worry about her, I am not sad anymore. I am happy for her. She got her happiness back. And she will be around to visit us all on occasions :-)


My cousins are growing at an extreme rapid rate....like almost non-human! Its quite comical because after me, 23, the next 'group' is my sisters 'group', composed of 2 18 year olds, a 17 year old, and a 15 year old. For the past ten years it has been a constant struggle.... Do I sit with the adults? Do I sit with the kids? But this year I found it much more widely entertaining to stick with the "kids", except they're not kids anymore! They are going to college! Crazy to think about when you remember them being born. 

My cousins from Florida, I see them grow up on Facebook, but its not the same as seeing them in person. And I haven't seen them in person in about 3 years or so...So last time I checked, they were still young teenagers. Well, this weekend they were mature, gorgeous, amazing kids *mini adults* and it was such a treasure to see them like so. One of my younger cousins, only 10, asked me what I was drinking today. I told him, wine. He says......"Are you old enough to drink wine?"  And I said, "yes, I'm 23."   Needless to say, he did not believe me! I guess everyone is growing at an alarming rate. I can't even believe i'm 23, actually. What kind of age is 23, anyway?


Well....time to hit it. Tomorrow is our epic 10 hour drive back home and I am lucky enough to be dropped off 3/4 of the way through to spend a fabulous night with my bestest college roommate EVER, and we will be seeing the Philadelphia fireworks on the fourth of July! So COOL! Im pretty sure it will come in second place after Amsterdam adventure in terms of best nights ever. I'll be sure to tell you all about its awesomeosity. :-) 


Before I leave you, I will leave you with delightful pictures:

This is SO SPECIAL. My grandfather came out today with a handful of my grandmothers jewelry, and said that grandma would be so happy for all of you girls to take a piece of her home with you. So we did! We all picked out some of her necklaces that fit our unique personalities, and I will forever cherish this, forever and ever and ever. And ever after that, too. And the cross- my grandmother loved to sew. Anything that could be sewn or embroidered, and she was on it. Well, She hand-made these crosses. I guess at one time she was making them to sell. Well, we found a box of them, all in different colors. We figured it would be nice for everyone of the family to have one, but would there be enough for all? Probably not. But alas, we counted them- and sure enough, to a tee- There was exactly enough embroidered crosses of hers to go around to every single family member-even our newly born 1 year old to the family. If that is not a direct gift to our family from my grandma in heaven- I don't know what is! So something more to forever cherish.....

Memorial service photos....Amazing to see her throughout her entire life span and how much we look like her!

This is the garden outside of her church....just gorgeous...

This is my cousin's first born!! Ahhhhh how are we old enough to have kids! AH! But he is just an ADORABLE bundle of JOY and I was so happy to have finally been able to meet him from Florida!

One of the 18 year old Floridian cousins trying to pretend like the grass is actually amazing to lie in like it is in the movies.....I never actually asked how it was but it sure didn't look amazing. But SHE is amazing!

This is my sister getting her hair braided by her one cousin, and my other cousin in front of her. I call them the three musketeers :)


Goodnight all! Thanks for reading....


~A writer in a Nurses Body
         

Blessed

Dreaming is such a special thing....it allows us to go on special journeys we can't actually do in real life on this earth. It allows us to talk to people we can't normally talk to, for various reasons. It allows us to do whatever we what to do, see whomever our subconscious wants us to see.


Last night, I was blessed enough in my dream to have been able to say goodbye, one last time to my grandmother.

Let me explain. It was truly an eerie dream and I wouldn't even be blogging about it if it weren't for it continuously popping back into my head. This coming weekend will be her memorial service, and lots and lots of relatives I know and that she knew will be attending. It will be a time not for mourning, per say but for a celebration of her wonderful life and time with us. It will be a time to spend time with other family and truly express how much we love one another through thick and thin.

Thats sort of what this dream was. It was the memorial weekend for her, just as it is coming, and everyone I expect to be there, was there. My families funny antics all happened, we laughed, we cried, we played jokes and pranks on one another. We were family. Most of all--my grandmother was there. In the dream, it was my understanding that although I knew we were there for her memorial services, that she had come back and had been revived and was in full health, full walking condition and everything, and was able to spend the weekend, and the weekend alone with us. We played board games. I saw her laugh one more time and smile once more in my sleep. She laughed at the childrens jokes once more, her giggly full-hearted laugh with her rosy cheeks.

Most importantly, we each got to say goodbye in the dream. I did. I got to see her once more.


Do you believe that ghosts can do this ? Do you believe they can "tap in" to our dream world and show themselves, for times like this ? Do you believe in any of that or do you think this was merely just a glimmer  of my subconscious envisioning her? Either way, I think, it doesn't matter. My mind conjured up a new experience with her, made from combining my subconscious already knows about her prior, and used all that to let me have one more memory, even if it is in a dream. One more memory.



I woke up happy.



~ WNB


Do you believe?

To Have Said Goodbye

I'm not sure how to say this....life post-Europe has been great. I have been seeing so many friends, old friends, friends, new friends.......I have been with family around the clock, both nuclear and out-of-state family...and this has all been a pretty happy time. But thats the thing. It makes me undeniably nervous. Nauseous.


With the recent *unexpected* passing of my maternal grandmother, it woke me up. That was my first close relative that has passed away....although I am with and around death so much at work and in other parts of my life, I was never a survivor until now.

It woke me up. It made me realize that we truly do take so much for granted, even if we are good people and don't intend to...Sometimes I think we think we are immortal. We forget death happens to all of us. We forget that our loved ones could die any minute, we could face death ourselves tomorrow and not know it. Any of us.

We forget that. Because its morbid, and depressing....But then the unexpected happens and we are left with not even being able to say goodbye.


This all has made me so jumpy, so anxious, so nervous....that I am going to lose more. If I lost my grandmother, I could lose my other grandmother too. I could lose my father who has a suspicious family history of heart disease. I could lose a close friend. It really has made me realize how fragile everyone is. How fragile I am.

I went to spend a week with my paternal grandmother this past week. Its been a long-due visit....and it shouldnt have been. I should be seeing her all the time. And with my maternal grandmother passing, it has motivated me to just drive out to see her and just....spend time with her. She tells me all the time when I am with her that she feels "guilty" that she is not "entertaining" me, but she doesn't even know that all I want is to just be around her.

With this newfound anxiety and feeling like I could lose it all in a second, I have been acting weird. I am trying so much harder to mentally-record special moments with loved ones I am afraid of losing....and when I can't rely on mental, I have been taking pictures with her too. Just savoring moments, taking it all in in case I have to remember it all tomorrow. Its eerie. I don't like being like this....but is it necessary, sometimes?

Everything happens for a reason. I firmly believe and know that. As unfortunate as it was, my grandmothers death happened for a reason....but what reason?

I guess we aren't always meant to know for what reason, but a reason there is. We just have to have faith.


I said earlier in my blog after it had just happened, that it didn't feel real. That I still expected to see her when I travelled next to North Carolina. To talk to her on the phone, still. To see a comment on one of my pictures on facebook from her. That her death was just a hiccup in her health and it was a quick hospital visit, but she's ok now. I'll see her. But thats not true, and Its starting to settle in now. For my mom and my aunt, they have both expressed it "settling in" when they call their house and their father will never more say, "Let me go get mom".

For me, it has hit in unexpected ways. The other day I browsed through my phone contacts and realized I had my grandmothers cell phone number saved. Did I ever even call it? Just to talk? Also, I was just viewing my blog followers and realized she registered as a blog follower, quite some time ago, so she could receive emails when I post. Its those little reminders that punch you in the stomach.

I feel extremely sad that she was so excited for me to be able to go to Europe...and she only got to see a few blogs. It kills me that she couldn't even have seen a single picture. If I had known, I would have made more of an effort to get pictures up for her to see.....but who ever knows? You can't live your life with the "If I had known...." racing through your negative thoughts. You didn't know. I didn't know. But I know now, and maybe the "reason" for it all is to make me stronger and to realize for the future how fragile life truly is, and to savor every breath, every moment. Say goodbye to people as if you won't see them again, tell them how much you love them. Every time you see them...


As a conclusion to this eerie post, I leave you with an eerie finding. A week or so I stumbled across one of my county college's literature book that I have been published several times in, back in the day. The following poem is a poem I wrote back in 2006, to express the heartbreak of loss. Losing someone close to you. How that feels. It just seemed fitting that I just happened to stumble across it again, now. Like I wrote it for the future almost.....


"To Say Goodbye"

It's Learning
                    To say goodbye.
                                  To look through this fine print,
And see, eye for eye, the impact that has hit.
                    To say goodbye,
Is learning
                    That this is the hardest part of dying.
It's not the pain that comes with it....
                     Not the physical pain.
                                      It's the tearing.
                                                 The Ripping Away,
                                                          At an innocent heart.
                                                                             Innocent?

It's an Anger,
                        masking an inevitable sadness.
                                                           A fear.
                                                           A Hope.
A dream.

                                                           A truth.

It's pretending to be angry, so you don't have to;
                                Cry,
                                Let go.
An anger,
                For leaving us here.
                             For giving up.
                                         For seeing the light.
                                                     Without us.

For knowing that in the end, they chose death,
                     rather than pain.
                                             They chose heaven.
                                             They turned down life.
                                                           A change.
                                                           A chance?

An anger. A frustration.
                You should have stopped them.
                You should have been there.
You didn't say goodbye....So much anger.
You think about it,
                 over and over and over again.
        What could have gone differently?

Would it have been wrong to have asked you to stay?
                                Because of a need?
                                An inability to let go?
                                                    to say goodbye?
A fear?
             Of being alone?


One more chance......

                                     .....to say goodbye.



I love you Grandma. Miss you. Miss your smile.



~A Writer in a Nurse's Body




                         

Interesting Piece of History

Today was an amazing day at work.

It's going to be really hard to explain....truly.

Last night, I was lying in my bed, just waiting to fall asleep, staring at the moon, still sickly. And all of the sudden I felt this wave of.....joy? Relaxation? Serenity? Acceptance? Peace?

I swear I was not on any drugs!.....Well, other than Nyquil.

I think it was my Grandmother's spirit coming to say hello. Thats what I think.

All of the sudden, I just had all this confidence, all this warmth, that I was going to have an amazing day at work the next day. I could feel energy pouring calmly through me that would be used the next day (today). I could envision this energy being used to make my patients smile, to do those extra little things for every body. 

With my grandmother recently passing away in a hospital, and a couple of my relatives being with her there to experience it and tell me about it, it only made me remember again why I am in this profession. My aunt (my grandmothers oldest daughter) explained to me how much of a difference the care and love the nurses gave, how much the little things counted.

Some times at work I forget that. I do my job really well still- but I forget that who I am taking care of is someone's beloved grandma, grandpa, daughter, son, mom, dad, sister, brother, friend.... Just as my grandmother was to me, I would want absolutely nothing more than to have the best nurses take care of her and my family. In fact, if I had found out about what was going on while I was in Europe, in retrospect, my only wish would have been to pray that she did have good nurses.

So sometimes I forget, yes. I see my patients as individuals and forget that they are connected to so many others. But today I did not forget. I made it a point to treat every single patient as if they were my only, and as if they were my family. Of course this is hard to do when you have 23 patients, and I wanted desperately to stay on my shift longer, because I literally ran out of time to the very last second.

I worked day shift this weekend, which I do only on a rare blue moon. I have never been a huge fan of day shift, mainly because I usually find it rather painful and frightening to wake up before the sun, and function. However being on day shift this weekend helped me spend more time with my patients and do those 'little things'. Day shift is primarily responsible for getting everyone washed, ready for the day, teeth brushed, fed, washed again...so you get to spend a lot of 1:1 time with your patients. They get to know you, trust you.

Just like yesterday I shared the story of my 101 year old delightful patient that deserves all the respect in the world, today I encountered another type of patient that deserves all the respect. Veterans. 

I spent about 30 minutes just getting this one patient washed up, both yesterday and today. I really got to know him, and in just one day got to see him greatly progress in his health and effort. Through talking today he shared with me that he is used to being a patient in military hospitals, as he served for many years in his day.  He quotes, "Back in my day....back in the army hospitals, if you could walk, you were out there helping the nurses. There was no lying in bed all day like we have to do here. I'm getting sicker lying here. If I could I'd be out there helping you."

It was definitely an interesting piece of history that this man shared with me. History is great out of a textbook, but means so much more when coming from tales of personal experience. How interesting, to think that healing soldiers got back up and helped the nurses? To see that friendship, respect and camaraderie that must have been there....I would pay a million bucks.

Overall, it was an excellent day. I got to do little special things for a couple patients, and that makes all the difference to making or breaking your day.

I think I am probably going to fall into the early nurse burnout category...because I never want to stop. I know how many things I have to do, how many people need help, how many people need me at that moment and it never stops, and I have trouble leaving, even if its to pee or to go eat. If I weren't going to pass out from not eating for 12 hours, I would just work straight through and help every last patient with every last need. I eat my food quickly because I know I need to get back on the floor. I know this is not good. Thats how burnout happens....putting everyone else before yourself all the time... But, really, isn't that what I'm getting paid to do sort of? Shouldn't I?  Doesn't it sort of come in the job description?

I need to find the fine line and camp out on it. I need to find a balance of hard work, extra time with patients, making it to see all my patients, but also being fair to myself. Eat, pee, laugh, breathe.... I need to work on that.

~WNB

PS- It has also been finalized that I have some definite odd case of OCD. After working 12 hours and not eating dinner (I ran out of money, lol) I was definitely looking forward to coming home to a homecooked dinner leftover for me. On the drive home I was starving. I envisioned how awesome it would be to finally sit down and eat some dinner at home, while watching tv.

Well, I got home, changed out of my gross scrubs, went downstairs and threw some food in the microwave. As I stood there waiting, I realized the sink had dishes in it. Too many dishes. You can't wash your hands. That bothered me. So I decided to do the dishes. But then the wash machine was full with clean dishes, so I emptied that first. But then my food beeped ready. But I couldnt ignore the dishes now that I had started, I just couldn't. So I put the dirty dishes in and started the cycle. But then I realized the countertop was wet and dirty around the previous dish infested area and had to clean that too, despite food still being ready. After that I figured I might as well clean the dining area, which I did, because how can I stop at the countertop?


Eventually though, I did get to eat. :-) The funny thing is if you saw my room you would never peg me as a neat OCD freak, but thats because i know where everything is in my room despite it being messy. But if there is dishes in the sink, I just can't look at them. Can't do it. Have to wash them. Go figure!

Putting a pause on things

Hello everyone...

I lost wifi once I left Paris and therefore have yet to update you on the rest of my trip (London!). I just got home back to the USA and have found out that one of my beloved Grandmothers is no longer with us. Despite having full intentions on blogging tonight about London and then following that with a Europe reflection tomorrow sometime, I will not be doing either tonight and maybe not tomorrow...I just can't even think about Europe right now, honestly. I don't even want to look at my pictures. She passed when I was in Europe.


My grandmother lived in North Carolina and she was a very important figure in my growing up, despite being 10 hours away. Being so far, I only got to visit every couple of years or so, and looking back I wish I could change that now. But we always wish we could change things when its too late. All I can do now is pray and wish for her to be able to look down on us and that she is happy where she is now.

Sorry for the blogging interruption....maybe by the end of  this week...


I love you Grandma C <3 


~WNB

Sluggerlogs, Obituaries, and Long Beach Island

Unique title, yes? Betch' ya never heard of that one before, huh?

Anyway, they have nothing to do with each other. As I said this morning, they are just a collection of tidbits from the past week that I have collected to share with you.

Sluggerlogs:

Does anyone know what this has anything to do with anything? I don't.

When I babysit the little four year old, I can usually understand *mostly* everything he says. I have a hard time understanding diction when like...normal people talk, and its even harder to not only understand what a young child is saying, but to then understand what he means by what he's saying. But I've gotten a LOT better at it. Last year at this time, If i didn't understand what either of them wanted, I would just give up and let them cry until they gave up or I figured it out. But now I can get it by watching their mannerisms too, the context of the situation and listening for diction better. And, they are getting older and easier to understand. The other day we were playing with his train set and he kept asking me to "click on the train over there to make it go choo choo" and I was like....why does he keep going back to the "clicking"?  Then I realized that the father bought him a Thomas the Tank Engine computer game, and it all made sense. So working with kids, half of the game is just going with the flow. I think thats an important lesson for nursing, too, doncha think?

Anyway, today I came across something that I was just like....what?

He is getting into the stage where when he is pissed at me, which happens often, he fancies screaming, "SLUGGERLOG!!!!" or sometimes he mixes it up with "SLUGGERHORN!"  Does any one that works with kids and kids products know what this is? Or if you say it outloud, does it sound like something else he might be saying?

It's probably from a TV show he's seen, or a movie....or something he picked up from a game or something. I will NEVER underestimate the power of TV on a child's brain. For the better but mostly for the worse.

So, here's my ethical dilemma. He is using the word as a demeaning sentence to me. If he were an adult equally pissed off, he would substitute SLuggerlog with something we consider to be a "curse" word. But he doesn't know any curse words. Yet. But he is using it as one, just without realizing it. Sometimes he would call me specifically a sluggerlog, and sometimes he would just shout it out in frustration. So can you punish a child for saying that, even if 1) you don't know what it actually means, and 2) its not really a bad word, just a....confusing word? 

Can you punish a child for calling you a "Happy Easter Bunny" if he meant it in a screaming and horrible bad way? Where do you draw the line?

Sluggerlog, will lead to the next word which will lead to the actual curse words soon. If they encourage the behavior of calling out any word in a moment of frustration, or to someone now, its like saying that is acceptable to do even when those words are defined as a curse word.  But is it OK?  I can't exactly tell him, "Don't say that, its not nice." Because.....I don't even know what it means, but I just get the general gist its not meant to be nice, in his mind, especially observing his tone of voice, facial expression and facial redness.



On to a newwww topic: Obituaries.

Ever re-visit a hobby or collection, or something you just used to do in the past, and realize that you were kind of insane?   I did yesterday.   I'm having relatives over in a couple weeks, and they will probably be sleeping over in my room. So I've been trying to clean it up a little, take out the junk, make it look like a 23 year old lives inside, not a 12 year old. 

Well, back when I was working Full Time as an aide, I was obviously seeing a LOT of patients, and I used to be obsessed with learning names. I was also obsessed with reading obituaries. If I had a patient and they died  long after after I had them, I would still remember them. I then felt compelled to cut out every obituary I knew the person for, and then proceed to write a little bit about the person that I could contribute on the back, and hang it on my wall as a memory. Everyone said I was crazy. And creepy. But I didn't see it. I just saw it as remembering old friends, old patients that I shared a part of my life with. People I shared last moments of life with. People that shared their life story with me. I just saw it as honoring them and remembering them when I looked at my wall.  Keep in mind that the obits were NOT the only thing on my wall! I have a huge wall full of literature that I wrote, memories, pictures I took, quotes, comics, etc.  SO the obits just sort of found places.  But people still thought I was crazy. But I kept doing it. Well, I must have saved and clipped at least 100 over the years. And kept them all. But they weren't all up on the wall. It got to be so many that I came to my senses mid-way and took down most. I kept up the ones that either I knew *personally* beyond the patient-nurse level, or were just patients that were extra-memorable. 

But I couldnt even manage to throw the rest out. I got a special folder and put them all in and filed it away. I felt like throwing them out was disrespect. That because at one time I took the time to remember and honor them and now I was just throwing them out? I couldn't get past it. I couldn't get past the sad concept that someones entire life....sometimes 100 years of life, was all wrapped up in a single column, and who ever even looked at it?

I always wanted to know more about my patients. Being a writer at heart, I always want to know your back-story. Why are you here, what are you thinking, whats your story?  So when I read the obits, I just want to know more about the lifestyle they led, the people they were before I met them as a patient. I just found it fascinating.

Well, being off at school, and not working FT anymore, I lost interest in clipping or even looking for them. Occasionally I would have a death on the floor and then look for the obit and then just read it, but not clip it, sometimes I would just occasionally read through the obits one random day and scan it for names I knew...But I grew out of the odd clipping/hanging them on wall "hobby".

So now, a couple years later in time, when I'm cleaning up my room, I stare at my entire wall. I think, "Should I take this down?" But I couldnt take the wall down. But I could take the obits down.

I thought it would be hard. But when I went up to them to re-read them, I couldn't even remember them as patients. The whole point was to remember them and hold on to them, and I forgot them anyway. I guess with the amount of patients I have seen, its easy to do. But still sad. So I'm looking at all these names, and thinking, they mean nothing to me on this wall now. So I took them all down and threw them out. It was sad, but not as meaningful as I thought it would be.

But looking back now, everyone was right. It was really creepy. And odd. I meant well. In my brain it made perfect sense. In reality, not so much.  So they are all gone now.


Do I have room for a third topic? Maybeeee. I'll make it quick.

I had a dream last night that I was in LBI (Jersey shore). We go here as an annual vacation and I look forward to it drastically every year. Its my favorite part of summer. As Ive mentioned before, I cannot stand the ocean, but I can't get enough of the beach. I love the beach, the sand, the smells, the shore type towns, the mini golfing....I love it all. But in my dream though, It happened to be a rainy and depressing week that we got to go. In my dream, I was sitting outside on some sort of fence, In a sweatshirt. I think I was reading a book? I remember looking down the boardwalk, and thinking:
" I can't believe its supposed to rain this whole week we're here. I can't believe our week is almost over and all I've done is sit here in the rain. Where did the time go? I need to get up. I need to live, I need to get out of the rain." So I finished the dream by running, running a long time in the sand on the beach. It felt so good.

Point is, that last thought in the dream is a huge metaphor for how my last entire week has been.

I wouldn't even know how to start explaining it all, if I tried and could. All I can say is that hopefully it will get better soon.I'm making a couple moves in the right direction to make things better. Health-wise, emotion wise, relationship-wise (with everyone), and so forth.  It will all be OK. I'm sure of that. I just need change, I think. I need something life-changing. I need to do something different. Get out of this routine I'm stuck mindlessly in.....


Thanks for reading everyone. I'll blog soon...:-)  

~ A Writer in a Nurse's Body

A Handy Phrase, and Filtering

Hi! So, first of all, how the heck did my day literally just go from getting out of clinical at 2pm to being 7pm?? what the heck did I do for the last 5 hours?? Seriously? I usually love daylight savings and having more light but this is really screwing me up....I see its light out and I think, "Oh, I have a lot more time in my day." But then I look down at the clock and it is SEVEN O FIVE. P.M. AND ITS STILL LIGHT OUT. At least when our days are short, when it gets dark dark at like 5, its a warning that you have to really get started on the rest of your night....now, we get our warning 7-8 and by then its like, crap...I have to eat dinner and do all my work. What have I been doing??

OK enough about nature.

This past weekend I picked up a really good phrase to use in nursing. I don't like to call it a "phrase" because I don't want to make it seem like "I use it on everybody" but.....well, nurses do. Nurses encounter a lot of similar situations and "classic" situations and need a "bag of phrases" to come out with that aren't "too cliche-y"...(example- "I'm dying"  "No of course not!")

I have had patients that told me they are dying or are afraid that they are sitting on their deathbed. And I know I will have the same occurrences when I'm a nurse. And thinking about it, I never know what to say.  "Am I dying??"  Me:  "Um, well.. Let me get your nurse."    I can't do that when I'm the nurse. I can't rely on the nurse anymore to think of things and fix things when I am the nurse. So, I needed something that I could say to patients when this situation arose. Well, this past weekend at work I had a patient that is certainly not doing well but I honestly wouldn't say she is dying. Maybe extremely depressed due to situational factors but not dying. But, while I happened to be in the room, she told her daughter, "I'm dying, aren't I?"   I sort of just stopped moving and stayed quiet and pretended to do something really important while her daughter thought of a response. But she shot right back to her mom, "Well Mom, We're all dying, day by day, but I don't think you're going anywhere anytime soon."

So simple. So true. And yet why didn't I think of that? Its a good one to pull out on someone that really isn't dying but think they are. Of course no one actually knows if someone is going to die, but we can presume based on presenting data. Of course this isn't a fix for someone that you know really is  on their deathbed and they ask you, eye to eye, "Am I dying?"

I don't want to lie to a patient, ever. But....What are you supposed to say? Yes? Maybe by tomorrow? Next week? Next year? In an hour? Start praying? Call your family? So I still have to think about this one.

New topic: Filtering.

Lately, for like the past year, and its been getting progressively worse ( I don't know why), I am doing a horrible  job at filtering whatever decides to come out of my mouth. So, so, so  SO many times lately I will say something to somebody, or to a group, or write it on facebook or on this blog, or WHATEVER, and somehow it offends somebody. Whereas I never mean it like it comes out, it just sounds really bad the way I say things sometimes. Sometimes I realized I may  have or probably offended someone but they are just keeping quiet about it, and then I stress about it for the next week. Other times, like yesterday, someone literally said in a serious voice, "You realize you just insulted me?"  I was like......wait, what? I thought about what I said, thought about it again, and even thought about it again, and couldn't find where I was insulting her. Turns out she just misunderstood and what I said sounded completely different than what I was actually thinking, I guess. BUt I fixed it. I think. maybe. Anyway, regardless, I need to stoppppppp just talkinggggg. I have literally have to just say to myself, "OK. Seriously, just shut UP. STOP TALKING." If I don't talk, I can't say anything stupid or offend anyone.

I used to really filter my thoughts. I thought everything through, word by word, before I said it. But I hardly ever said anything. I didn't know  anything. I didn't have any opinions. Now I do. Now I want them to be known....I dont want to just be quiet. I guess that comes hand in hand with offending some people that don't agree? I just hate hurting people when I never intended it for it to be that way. Sometimes I say something in general that might be offensive, and it turns out that it highly relates to the person I am talking to and I didn't know it. Another reason to live in a cave and just stop talking forever. Sounds like a good idea to me.

My food industry opinions get my in trouble a lot....But I am trying really hard not to annoy people with that. I just seriously need to start filtering my thoughts! Stop blurting things out! Multiple times within the past month I have sounded like a complete idiot. Oh well. Life goes on.

But actually, some people out there say to not filter your thoughts. Because that makes you fake and not-honest. When you have to pre-meditate everything you say to cater to who you are talking to. Some people really just don't give a shit. Some people just have their opinions and people that don't agree can go....well, you know. Some people don't care if they offend a group of people or a person, because they don't need people. I don't need people either, but I genuinely hate offending people. I don't like being mean, ever, and don't ever mean to hurt anyone. Thats why I'd so much rather just stop talking ever. Too bad I have a blog I can't let go of....lol. But I usually am really careful (most of the time) on what I share on this blog.

OK I'm going to stop talking now.

~ WNB

I seriously just talk way too much. Stop talking.

It's A Strange Thing to get Used to

Death, that is.

Today  I attended a funeral (long story, no questions), which had an open casket viewing. To pay your respects to the deceased, it is common to go up to the casket and view the deceased and say a prayer or well wishes or whatever you want to call it.

Well, looking at a human body, that has passed away is something most people will never be comfortable with or get used to. Not that anyone should. Except funeral directors. Or autopsists. Because its kind of their job. But for everyone else, its normal to feel uncomfortable. I don't feel uncomfortable, but it does create a strange feeling working with the dead or viewing the dead.

In a casket, for example, the body is dressed up, groomed...it just looks as if they are sleeping. They are even in a sleeping position. They look peaceful.

Then, your eyes begin to play tricks on you. Even on me, who has been around this topic for 5 years now. Here is my theory: Our brains are so wired to see people breathing when people are sleeping, that our brains actually trick us into thinking that we see the chest still rising, even as they lie peacefully in their casket. Our brains are so wired into thinking we see the normal "twitches" a person has when sleeping, that we think we saw them too. Its almost alarming, so much so that for a second we think- Did that person just breathe? And then you remember.

Our brains don't often get the chance to learn the sight of seeing a human body that isn't breathing. So this is a strange sight for our brain and it does not like it.

Death is a strange thing in the hospital, too. It is one thing to view the deceased in a casket. They are nicely dressed, peaceful. Well, I cannot put in words what it is like working with the deceased in the hospital. Some of the time they are a complete mess because they just suffered through a code, and most likely CPR. They have tubes in them, IVs, foleys (sometimes), sometimes they are bleeding somewhere or everywhere...there is a lot of things that could happen. And, sometimes, they didn't suffer through a code but died peacefully in their bed. Well, the hospital bed. But even so, they are in a hospital gown..their hair is messy, they are "hospital-y".

There is something fascinating in the emotions department that comes out of you when you have a deceased patient in front of you that you just had a conversation with an hour ago, or 5 minutes ago, or that morning, or your last shift....Its very strange. One minute they were telling about their grandchildren, and the next...

I had a patient that I had worked with my entire winter break, and she was one out of 3 that was still on the floor 2 weeks later when I came back to help on a weekend. She was in the hospital for about a month and a half total (she left to go home for a day or two). So that really gives the staff a chance to get to know a person. It is even more tragic witnessing death in the hospital when the patient was walking and talking and "independent" when you remember them being admitted, to them being completely bedridden, unresponsive and hallucinogenic and barely breathing in their last minutes of life...(which has nothing to do with the hospital stay, simply just the course of the disease).

It's another story completely when you, as an aide or nurse, are selected to do the post-mortem care. I won't go into details to bore or gross anyone out, but it is strange, I can tell you that. You are with someones beloved grandpa, or grandma, or parent, or child...just after their death. It is very important to treat all patients with extreme and utmost respect at this moment (in case you already didn't all the time anyway).

I think a lot of people get scared when going up to a dead person...whether it be at a wake or if they are a new aide or new nurse that hasn't had experience in this department yet. Why are they scared? Different reasons, sometimes. I think people feel scared of the unknown, scared perhaps because they have never been around a dead person before, or scared that the person will come back to life, or maybe scared that the person's ghost is watching you watch the body. (Call me strange, but I always think about that). I am one of those people that believes in spirits, ghosts, souls, etc., and I wouldn't doubt for a second that the spirit sticks around most of the time when they first leave their body. But who knows.

So that is my depressing blog, on death. And, as if this blog weren't long enough already, I wanted to include at the end here my first "real" (aka not written before college) short story. It was not assigned to be about death, the assignment was just to write about a moment that you learned an epiphany, or a moment when you learned something that changed you forever. And I chose to write about the first patient that touched my life- and how I took care of her after she passed. I used pseudo-names in the story, names are not real.  I was 18 or 19 when I wrote the story. I'm going to include it at the end of this, so it is purely optional to read. But, this blog is also about writing, and this is a story about nursing, too. So its a double whammy that fits not only into this post, but perfectly into this blog. So feel free to read it, and to those of you that do, thank you! And feel free to comment if you like it, as always.

With Love,

~A Writer in a Nurse's Body


Related Posts You May Like:

Major Writing Mishap

Forbidden Euthanasia Topic

Death Can Only be Prolonged So Long

"Walls Made of Curtains"

The white latex gloves snapped as they wrapped around Lyn’s small sized hands. She threw her long brunette hair that laid upon the front of her scrubs into a messy bun and then took a deep breath as she stood before the curtain. She inhaled one last time, preparing herself to see her second dead body. Only this one had just died.

“Okay, I’m ready Melissa.” Lyn lightly touched the curtain in front of her as the two curtains that came together separated for her to enter the small make-shift room, walls made of curtain.

Melissa was leaning on the window-sill as she wrote Edith’s information on the body tag. She placed the body tag on Edith’s right big toe, and tied it really tight. At first, Lyn was worried that it would hurt Edith if it was too tight, cutting off the circulation to the foot.

Then she remembered, again.

Lyn took two steps over and touched Edith’s right pinkie, as she slowly let herself grab the whole hand. The top was cold to the touch, but the bottom still warm. She glanced at Edith’s watch that she was still wearing. It had only been an hour since she had passed. Lyn lifted the limp arm and unlatched the watch. It wasn’t right for a dead person to be wearing a working watch. It just reminded her that time went on without us. Time will always go on.

“Can I have that? I didn’t even see that. That goes in her valuables bag.” Said Melissa as she took the silver chain watch from Lyn’s open hand. Melissa then threw it in the plastic hospital bag and tied the top to enclose the belongings inside.

“What about everything else?” Lyn asked as she scanned the rest of the room. The faded red closet was open, there was Edith’s petite nightgown that she had specially ordered still hanging, and her small size 5 flat shoes beneath the gown.

“Only the valuables go with the body, you know that. Everything else is the family’s responsibility.”
But Edith doesn’t have any family, she thought to herself. Edith had told her that.

Lyn looked back at Edith and her small bag of valuables, “Well what the heck good does that do? Is Edith supposed to be guarding those items? Is that why they have to stay with her?”

Melissa finished zipping the bag, which was now just a giant-oversized plastic bag sitting on the still white linen on the wooden bed. It didn’t even resemble a body anymore, let alone Edith.

“Seriously Lyn. This is just the way it is.”

“Doesn’t she get to wear any clothes?”

Melissa shook her head, “They take care of that at the funeral home. The family arranges what she wears.”

Great, Lyn thought. Edith was going to be naked at her funeral.

“I guess so.” Lyn murmured.

There was a knock on the wooden door behind the curtain as the security guard entered the room, “Is she ready?”

“Depends on who you’re asking.” Lyn murmured.

“Yes Sir, Edith is ready.” Replied Melissa.

ER

I never know when to go to the ER. last time I went to the ER, I had a horrible experience. They treated me horribly and we got billed tremendously.

Right now I think I'm dying. My doctor sent me home with Tylenol and said it was a virus.

I'm always trying to out-diagnose my doctors and always think they are wrong and i usually don't listen to them.

Being a hypochondriac SUCKS. SO BAD.

Ive been convinced that I would wake up dead before, and low and behold I'm here and usually feel better the next day. If I went to the ER every time we would be living on the streets. They charge you like $500 AT LEAST for Tylenol in the ER and another $500 for the doctor to see you and tell you you're fine. Isn't our country lovely?

I guess if I die this time then at least I can say I tried went to go see my idiot doctor. That makes no sense. I would come back as a ghost and tell them. .

If it's this bad tomorrow then I'll probably go. If I'm still alive.

The "Forbidden" Euthanasia Topic

So every class that I seem to have in Nursing school, we always come to a point in the class where we address End-Of-Life issues. In Foundations it was how to do post-mortem care, and how to approach death and dying, and how to approach grieving families. In maternity it was mothers and babies....what happens, how do they die, how to prevent it, etc. In my Ethics class we tackled the big topic- When to let them go? How long do we fight? Living wills, advance directives, what to follow? In Med/Surg (now), it is all about how people die...and its scary because there are a bazillion ways. It's interesting because I watch America's Funniest Home videos and its remarkable how many injuries are on that show, and half the time I see someone fall in the video sent in, and I think, Ouch! Thats a spinal cord injury! Or, Ouch! thats a concussion. Or, wow, they better keep an eye out for increased intracranial pressure....there are so many ways someone can die that its a wonder we stay alive with everything that is thrown at us. Diseases, cancer, bacteria, viruses...injuries, falls, car accidents, violence, gun shot wounds...etc. But we survive. Sometimes. Sometimes nothing happens and we walk away from car accidents scrape-free. Or we get shot and it hits no vital organs.

Then there are those people that don't make it. Don't recover. I have had a ton of experience with death, mostly at work. This summer I walked in to a room and the family asked me to verify if she was dead or not...she was. I did my first post-mortem care when I was only 18. I have had over 50 deaths, I would guess. I have seen people take those last breaths.

In our country, we fight. We fight for our survival, its in our blood. We fight diseases. Doctors fight bacteria, viruses. But how much is too much? People go through so much to survive, and even so some will never get better. Elderly people that fall ill that never expressed wishes beforehand, and resusitated and intubated and kept on machines, sometimes for months. BIllions of dollars are spent just keeping people alive on artificial machines. They are suffering. Some are afraid to give up...some have families that are afraid to give up. Some don't know how to say to themselves that they are facing death.

I recently had a friend of a friend that lost his uncle from an inital injury and a long term battle of disability and illness thereafter. In trying to make both friends feel better I made a comment, "At least he had the kind of death that he knew it was coming and his family got to say Goodbye. Isn't that better than losing someone you love in a car accident?" when the last words you said were "Can you pick up some milk?" or "Don't be late to Jenny's soccer game?"...

But then I thought about it in silence. Which is better? When a patient and their family member(s) find out they are going to die, the grieving process begins. THey either start fighting or start...living, and dying. But it has begun, and the death looms in the air for as long as the patient lives. The sickness causes suffering, pain, unpleasant living conditions (chemo?), and the patient is unhappy...to gain what? A couple more months?

Don't get me wrong...I am all for fighting, for giving everything the medical community can offer if the patient can make a full or almost full recovery. THey will get better. Maybe a baby that has a life to live yet, or a teenager...or a parent, or even the elderly. If they have life to live yet and will get better. "Better" means a lot of different things to different people. Some people refuse to live if they can not go on their run every day, or walk. Some would go clinically insane if confined to a bed. Some end up stuck in a coma. Some have mental disabilities (stroke, hypoxemia, heart attack...). Those things might be too disabling for some to be happy, others not. Some would stay perfectly content living in a bed if they could watch tv all day.

I believe in the mind. My opinion is that the mind, to me, is most important. I would not be able to live without my complete mind. THat is worth living for, for me.

I don't believe in prolonging people's lives if they are never going to get better, or if they are going through pain, unesscessary pain, just to continue living for another month. During the last couple months, they should be enjoying themselves with their families, at home. Die naturally, that is what I stand for.

Dying naturally beats living artificially.

But I am too afraid to voice these opinions in my nursing classes. If i try I get these odd looks, mostly from professors that think I am all for Euthanasia and cutting living cords prematurely, the next Cullen case. I'm not. Cullen ended people's lives prematurally because he thought their life was not worth living for, that they were living artifically or for no reason. He ended peoples lives against their will, before they gave consent to be ready to die. That was not in his power, nor would I ever intentionally kill someone because they wanted to die, or because I thought they would be happier dead. So I don't want professors thinking they shouldnt pass me because they think I will be the next Cullen nurse. I stand for being happy when you die, to die naturally, to let life take its own course and die at home with your family, when your body is ready.

I would like to end with this great quote, "The simple view is that medicine exists to fight death and disease, and that is, it's most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war you cannot win, you don't want a general that fights to the point of total annihilation. You don't want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and when to surrender when he couldn't, someone who understood that the damage is greatest of all if all you do is fight til the bitter end." Atul Gawande- "Letting Go". **

THat sums up exactly how I feel. You Kill more soldiers if you fight a war you can not win, to keep them fighting until there are no soldiers left. I understand that some say, 'but you can't just give up...you have to stand up for what you are fighting for.' we just need to take a step back and think about what we are fighting for.

If you would like to read the very good article:
http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande

Ta ta, thanks for reading my depressing topic choice for this evening... night!

~ A writer in a nurses Body.