Monday, August 20, 2012

A vessel of Hope

She came to the ER for complaints of dizziness, intermittent nausea and fatigue x 5 days.  She denied vomiting, diarrhea or pain. She told me that she is never sick and that this is “really bothering me because I play field hockey and I have to be able to practice…preseason.” Her skin was warm, dry and pink and her eyes were bright. Pretty girl… I evaluated her in the routine way…heart sounds, lung sounds, and vitals.  I put her on the monitor after doing posturals and then had one of our techs do an EKG.  This patient’s mother was glued to her side, so I asked her to leave the room for a few minutes of what I assured her were just routine questions we ask every teenager.  Her mother reluctantly left the room.  I sat on the stool to the left of the stretcher and asked the routine questions regarding drugs, alcohol, abuse and sexual history.  Pt. has a new boyfriend and yes they had sex, “but only once and with protection.” I collected a urine sample and left the room after I let her mother back in.
An hour and a half later after all test results were back, the only thing that was “wrong” with my little 17 year old girl was that she was pregnant.  I sat at the computer and tried to gather my thoughts. The PA on duty was not a usual for us and he was being quite flip about the fact that this young woman’s life was about to change…big time.  His answer, “you play you pay.”  I told him I that he was being as ass and that I would go and talk to them if he wanted…”ya, sure, whatever.”  I took her chart and went to the far end of the hall.  I leaned against the wall and closed my eyes…I was cheering at a tournament game for basketball and my boyfriend was playing.  I was 17 years old as was he.  The next day I was going to take a pregnancy test…the memory hit me hard, and I knew this girl was already concerned she may be pregnant and she was scared. 
I asked God to meet me in this patient’s room…to comfort this young woman~ and her mother ~as this news was going to change lives today.  Taking a deep breath I opened the door and went in.  I once again took the stool seat to the left of the stretcher.  I again asked the mom to step out of the room…(now this was difficult for me because I know that as a mother I would have wanted to be there…but far too often in this job do I see parents that do not support their children in these circumstances~  and the patient by law has a right under these circumstances to privacy.) I knew in that moment that this mother feared that I would be saying her daughter was pregnant…I saw it in her eyes and in the way she got up to shaky feet and left the room~ just before closing the door she told her daughter she loved her and in that moment I knew she would be a help to this young woman.
Her eyes were fearful as she sat there biting her fingernail…she looked so young in that moment.  I told her everything was medically fine but that the blood and urine samples confirmed that she was about 3 months pregnant.  Tears immediately filled her eyes and sobs escaped her mouth.  I sat on the bed and held her…she clung to me tightly and continued to cry.  I rocked her and just let her cry…I knew this pain and I knew the fear that was now slithering into her mind.  “thank you,” she said as she reached for a tissue~ when she stopped crying and blew her nose I asked her if she wanted her mother.  “will you stay in here with me?” 
I went to get her mother and we went back into the room, “Your pregnant, aren’t you?” she asked hesitantly… “yes,” she answered with her head down.  I stood off to the side and prayed.  “This is going to kill your father.”  A tirade of tears assaulted my young patient and I tried desperately to stay silent.
“Mom…please, don’t you think I know that…” she cried.  In that moment the mother began crying herself and went to her daughter and gathered her in her arms and wept with her.  I started to leave and my patient asked me to stay.  I stopped and just sat on the stool.  I took a deep breath and cleared my throat…I, in that moment, told them my story~ My teenage pregnancy and beyond.  The fear that turned to joy as my daughter blessed my “husband” and I’s life in ways that we never thought possible and how God used her to grow us into the people he wanted us to be…I told them that it was painful, embarrassing and life altering BUT that it was truly a blessing and I wouldn’t go back and change one bit of it…I told them they had many options to consider and that I could help with anything they needed.  They thanked me and I was thankful that I had that story to share, because in that moment their lives looked black and fearful~
Sometimes I wonder why I stay in bedside nursing…the hours are long and working every other weekend gets really old…the ER is a beast that just roars continually with pain and suffering ~~ but every once in a while I know that I was placed in a patient’s life that day for the purpose of hope and healing.  I received a thank you card yesterday from this patient…she was keeping her baby and going to go to a local college and stay home to have help.  Her parents are being supportive and she has hope for a nice future…Amen!!

Wednesday, August 8, 2012

Gone but not forgotten

The room was dark and quiet as I finished up my nursing note.  My patient was tucked into her own bed and finally asleep as her daughter slowly ran her fingers through her mother's white curls.  I nodded good bye and stepped out.  Once in the car I checked my phone and found a message from the hospice intake worker that I had another patient to go and see...and urgent open.  I read the directions and something tugged at my brain telling me I knew this address.  I ran into the office to retrieve the paper work.  Once back in my car I opened the file.  The name was that of my friend... my friend that was NOT in the end stage of breast CA with mets.  "what is going on?" I muttered to myself.

I called the intake nurse and asked about the call for this patient.  "I got an urgent call from her doctor telling me that she had just returned from Boston after recieving trial medications that failed...and she is days from dying~  and she wants to die at home...she asked for you."  My heart raced and my stomach clenched...tears ran down my face as I heaved in deep breaths...this cant be true...I just talked to her a couple weeks ago and she said how well she was doing...

I prayed for the 20 min drive for courage, wisdom and strength...I prayed it wasnt true. 

I arrived to be welcomed at the door by my friend's husband who was in tears.  "Thank goodness your here...she cant breathe!"  I rushed into the bedroom to find my friend gasping for breath.  Before I could even hug her and find out what happened, I turned up her oxygen (since when did she start using oxygen, my brain yelled!!!) to 5 liters and turned the fan onto her, then started talking softly to her as I stroked her hair off of her forehead.  "Just breathe in and out slowly...thats it, nice and slow...Im here now and its all going to be okay...slow in and slow out...thats it, just relax and let the oxygen reach your cells...its okay, its going to be okay."

As I comforted my friend I surveyed the room.  She was lying on a hospital bed, oxygen was being fed to her by nasal cannula from the compressed air machine and there were a dozen pill bottles lined up on the bed stand.  My eyes found her husband and I gave him a questioning look.  He motioned me to meet him in the other room.  I continued soothing and calming my friend until she fell asleep and then went into the living room.

Between great sobs of anguish he told me, "She was sent home last night by ambulance from Brigham's and Woman' die.  They set up the home 02 and the bed.  They ordered her lots of pain meds and stuff for are we going to do this?  She was fine last week and then she just got so weak and couldn't breathe...they xrayed her and said the cancer was all through her lungs now..."

4 hours later, after her sister arrived, I was driving home with an ache in my chest that truly felt like I would stop breathing myself.  I could not stop crying. I had prepared my friend and her husband as best I could.(she didn't have long)..I told her I loved her and that I was so sorry for what was happening.  I told her how much her friendship had meant to me and that she was a wonderful mother to her children.  I told her that she taught me how to relax and that she showed me how to laugh with abandon~  I told her she would be greatly missed.  She couldn't talk but she nodded with tears streaming down her face...she grabbed my hands and mouthed  "I'm not ready." 

5 hours after that I was called to the hospital to be with her.  She was too air starved to stay at home comfortably and her family couldn't take it.  I arrived to a room full of family~ her 2 children (my kids ages) and her husband, sisters and friends.  She was getting hooked up to a morphine drip and she was no longer in the present . Her eyes were closed but she gripped my hand when I knelt beside her and kissed her face...I wept.  I was no longer her nurse...I was just her friend... I prayed for her and her family.  I then did something Ive never done before... I just knew I was suppose to sing her favorite song...I softly sang to her, Jesus lover of my soul, and I watched as her breathing slowed and a peace entered the room and her faced relaxed.  I was aware that all eyes were on me but I didn't care about being embarrassed, I cared about my friends comfort...her soul.  I sang the song 2 times and by the end of it she was gone...

It was one of the hardest, saddest and most incredible days of my life.  My daughter and I sang that song at her funeral because her husband requested we do so. It was a privilege to honor her in that way.  I tell you all this because I have been thinking alot about her lately. I miss her and I honestly miss working at a job that allows me to connect deeply to a person and their circumstance. 

How does your job allow you to connect to another human being???  Are you using your talents to make another person more comfortable??? What is your story of human connection???