Reiki and the dementia patient

She kept calling out repeatedly for help, with a loud, shrill, shaky voice.  “HELP, HELP, HELP, HELP….” I could not comfort her or reassure her that she was okay, nor could I get her to stop yelling for help.  The staff was getting weary and the other patients thought we were killing her…that fragile little 98 year old women with dementia in room 8. 

She came to our ER from a nursing home with the complaint of, “she won’t stop yelling for help and this is not her normal behavior.”  We worked her up for altered mental status~ and none of the tests revealed a reason for her behavior change… I tried everything to calm her; I dimmed the lights, I sat and held her hand, I turned the TV on and then off, I repositioned her repeatedly and called her daughter (who was in Florida).  The morning rolled on and she kept yelling.

The ER traffic flow subsided somewhat and an opportunity arose for me to have 15 uninterrupted moments with this women.  I turned off the lights, closed the door, turned on some music and performed Reiki on her.  I started from her head and went to her feet.  At first she didn’t appear to even realize I was there, let alone gently laying my hands on her head.  After approx. 2min she stopped yelling.  I continued.  The room was silent except for the soft music… I watched the monitor~ her pulse went from 112 to 88, her blood pressure went from 160/98 to 142/80 and her respirations went from 32 to 18. 

By the time I reached her pelvis, she was asleep.  She remained asleep for an hour and when she awoke she no longer cried for help.  The ER doc on duty that day was a skeptic of the power of Reiki~ he is no longer a skeptic! I gave report to the Nursing Home and sent her back…happy.

I took Reiki as a nursing elective last summer during my BSN classes…I have used it on many of my co-workers, family and patients.  The immediate relaxation it brings is amazing and powerful.  I do not often have time in the ER to perform Reiki on my patients but what a blessing it was for that elderly woman that day…and my co-workers love the 5min head and shoulder Reiki session at the nurses station!!

As nurses we have so many interventions available to us to relieve pain and suffering…it seems that in the last half of my nursing career the interventions went from physically assisting to chemically assisting~ I LOVE that we are now heading in a direction that allows us to get back to our roots…laying our hands on our patients is “old school” but it is what is lacking in our care today. Reiki, aromatherapy, hand massage, light touch, maybe even an old fashion bed bath and simply sitting and talking/listening to our patients are interventions that are free, and powerful…and according to the surveys on patient satisfaction~ those interventions are what get the most BRAVO’s from the patient.  These interventions allow us to be present with our patients…showing them that we do care about their issue and them.  These interventions also are what bring the most satisfaction to me as I care for my patients…

The patient that enters your heart

I met her as she ran into room 1 carrying his little grey body…the triage nurse was just ahead of her with scared eyes.   The mom, carrying the little grey body, was not crying.  I wanted to.  I took the little grey body from her, he was heavy and stiff, and laid him on the bed.  The triage nurse ran to get more help.  I grabbed the Pedi bag mask and began rescue breathing~ actually there was nothing to rescue but I couldn’t not do it…there was no pulse and no activity but asystole on the monitor…he was gone.

“Please don’t do that…it’s his time to go and I don’t want him to come back…he has had a bad life, and we have a do not resuscitate order.” 

The nurse in me began screaming … “I’m supposed to save him…do CPR…intubate him…not give up!”

My mind heard her but my heart couldn’t take it in…I continued until the doc came in…he still had no pulse and he was mottled and grey…his eyes were open.

“What happened?” the doc asked. 

“I just found him this way when I went to check on him.” She answered.  No tears.

As the doctor and mother talked about the boy’s chromosome disorder and his pain I unwrapped the blue car blanket that held his little body.  He was naked.  This bothered me greatly. 

“Why is he naked?” I asked her.

“He hated clothes.” She answered.  My heart hurt.

Time of death 8:04am. 

I asked her if I could clean him up (his body released fluids).  She said yes.  She sat down on the bed next to him but didn’t touch him.  Another woman came in who was crying.  The mother got up and went to her.  They hugged.  She asked me to give them a few minutes with him.  I covered him up with a warm blanket and left the room.  I know the warm blanket was useless but it made me feel better.  I went into the bathroom and cried. 

The mother told me what funeral home to call and then she and the other woman left.  She left him with me.  I went back into room 1 and I unwrapped his little body from the blankets and I gently washed him up.  I cried.  I wanted to close his eyes.  I prayed for him.  I put him in a little hospital gown and put his cold, grey and blue body into the body bag, and I again cried as I zipped him in. 

I went to the nurse’s station, filled with chaos as usual, and I called the funeral home.  Security came and took his body.  I felt numb, sad, pissed off and confused.  I tried so hard not to judge the mother but I did.  My heart hurt over this boy~ over the detached last moments she had with him…I did not walk in her shoes and so I know that I have no business judging…

I closed my heart, took a deep breath and went into room 3 to start my patient’s IV and draw her blood.  I smiled and introduced myself…

Another life lesson learned.

Sitting in the waiting room I watched the others as we passed the time…were they waiting for a loved one, like I was? Or were they just the driver waiting to pick up the patient post- test? The elderly woman sitting by the large fern in the corner sat staring straight ahead, no expression, just staring.  She had on a clever little outfit; navy blue track suit with red trim, white slip on sneakers and a Vera Bradley bag (pink and light blue…didn’t really match her outfit) and she was alone.  The elderly man sitting a few seats over was watching Judge Judy on the TV (why is Judge Judy so popular anyway, the little woman annoys the crap out of me…) and biting his fingernails…he had on faded jeans, old Nike sneakers and a hoodie (just in case you were wondering) and then, there was me.  I sat in the corner, near the bathroom away from the others. I was situated so I could watch the door of the exam room in order to see the nurse come out to fetch me.  (I had on jeans, a new navy and tan stripped short sleeve shirt and my red nursing clogs…and a Tommy bag that was black…lol ) 

I sat in that waiting room, waiting on my husband who was having a procedure, (can you imagine that I had to wait in the waiting room and not in the procedure room….whatever!) and I prayed…I won’t get into particulars here but it’s been a few months of ongoing symptoms that finally were being checked out and I (we) am NOT used to being on this end of things!!  As I sat there I refused to give into the scary thoughts that kept trying to take hold in my mind…you know, cancer…tumor…metastasis….etc.… and instead I focused on the positive…the nurses I knew, so I was thankful for the wonderful treatment and care for my husband…his normal good health and our wonderful relationship…I thanked God for all of our blessings and for the test being performed today to “relieve our minds of anything bad being found” and for his full recovery…

As I sat there I also thought back an hour, to me sitting in the exam room with him and watching him answer questions…and then with him in the procedure room while waiting on the doc, as we laughed at the name of the equipment in the room and avoided talking about fearful things…I realized that I was nervous and felt so out of my element…I wanted to take my husband’s place, and do the procedure for him…I wanted to sooth his nervousness so I just joked and acted normal, or so I thought. ( I guess I didn’t hide my nervousness very well as he pointed out I was chewing my gum a hundred miles an hour and right leg was jumping up and down as my foot wiggled)  Seeing my strong, usually so in control husband lying on the stretcher in a Johnny, and with an IV in his arm was a moment I didn’t really care for.  I honestly did not like being on this end of things…

Praise Jesus that the test revealed NOTHING wrong!!!!  So the big fear of cancer is gone…Amen!!  I again thank God today for taking care of us and for giving us this moment in time…it does make things clearer…it does shift our thinking to what is important and what isn’t…and for me it does; once again, give me a perspective from the patient’s point of view.  We had a very good experience yesterday and I want that for all of my patients and their families.  The little things ARE important…like, I really appreciate how the nurse explained EVERYTHING to my husband and that she took her time and answered his questions…the area was clean and tidy…I wasn’t left alone long, and updates were quick. I am thankful for the reminder of how all of this is important to the patient and the family as they wait for answers…

Lessons from a phone....

My husband and I walked into a phone store, that shall remain nameless~  the store was brightly lite, the employees were well dressed in shirts and ties and the layout of the store was neat, clean and well organized…One would have thought that what would accompany such a store would be good customer service, joyful employees and that we would walk out of the store with new upgraded phones and a smile.  NOPE…the experience was less than stellar. The employee was well versed in his sales pitch but was not willing to go outside of that pitch to make a sale… and the irritation level that it left us with was a bit high! 

We decided to try one other phone store/electronic store just a hop skip and jump away~ What met us this time was very different. The store was dimly lit, overstocked and a bit disheveled in appearance, the employees were dressed in jeans and matching t-shirts… The difference, however, was the employees met us with a smile and a helpful hand, some laughter and we left them with a big sale…

What made the most difference?  The first impression of the employees…not the interior of the building or the way the employees were dressed…when it came down to it those outside appearance things didn’t mean squat…Now I have been the first to say that appearance means everything…that cleanliness wins out and nicely dressed employees is a must~ now I still think this, BUT none of that matters if the employee isn’t personable or if they don’t  give a rats ass that your there!! The difference in the appearance of the stores and the way the employees were dressed was huge…BUT so were the attitudes that they each carried. 

I guess there really is a lesson in even the smallest of things…For whatever reason, as I drove home with my new phone, I was thinking how the 2 stores and their employee’s approach really did make a difference to me and my husband. We will not go back to that first store…but we will go back to the second.  The guys that helped us out with the phones even got a courtesy photo and upload to my Facebook page (with their permission of course J).

I’ve read in many a report that nursing is the most trusted profession…why is that?  I’ve often thought that it was because of our origin…Nurse Nightingale and all that…the white uniforms, the cap, and the role of caregiver…

While I am not 100% sure why nursing is perceived by patients to be the most trust worthy profession, it is my honor to be in that profession.  I want my patients to trust me and I want them to respect me.  I want to take care of my patient in a way that leaves them feeling cared about and listened to…as well as taken care of with expert hands.  I want them to feel my heart when I care for them.  I used to think that it was about a clean room, a clean pressed and stain free uniform, nice hair, clean nails, and of course good care! …… but after my experience I KNOW it is more than that… while all of the above is nice and adds to the comfort of the patient and their family~ without caring and comfort from the nurse, the patient and their families could give a bleep what their room or their nurse looked like!!

The ER Beast

I usually write an inspiration to nurses on my blog and who knows maybe that is what this will end up being, but I feel the need to write about my experience yesterday and the decision that is solidified for me.  I work in the ER, in case you hadn’t gathered that from my blog already, and have done so for the last 11 years.  The ER can be a roaring beast that devours all in its path…or at times can be a gentle beast that lets those working there stay alive to come back another day. 

Yesterday was one of those days that just makes you want to find a corner to cry in…we had 2 nurses call out~ so we were short staffed from 7am -7pm and the patients just kept coming…our supervisory staff were all off to conferences so there was no physical help available from them…the rest of the hospital was dealing with their own issues and had no nurses to spare….(which makes me think of the Seinfeld episode where Elaine is in the public bathroom and asks the women next to her if she could spare a square….and sure enough the women says NO!) any way…

Our amazing team that worked yesterday pulled together and we got the job done and we did it very well!!!!  BUT for 12 hours we didn’t get a break…we ate sandwiches, sent to us from our cafeteria, on the run… we had full rooms and a full waiting room all day long so there was no break  to be had when a patient was discharged…just another patient put in the bed…we had a serious trauma come in, in the midst of the day…so that takes 2 nurses, a tech and a doc out of the mix for an hour… and again the nursing team, techs, docs and secretary all did an amazing job keeping up with all the patients, the orders and the chaos!! 

I have stayed in the ER for several reasons, the energy of it, the staff, the schedule isn’t bad, I am really good at ER nursing, most other types of nursing seem boring in comparison, and complacency. For me, this type of nursing seems to be losing its appeal. What I don’t love anymore is the chaos…controlled chaos is one thing but the chaos of yesterday, and the all too frequency of those days, is another…and for this 45 year old nurse I’ve about reached my limit.

The self-care routine that I have been doing has allowed me to stay sane while working and has allowed me to feel less burned out with nursing all together…but what if yesterday is the wave of our future in the ER…Our hospital is building a new hospital in another town, merging another hospital… and this ER is going to remain open but with no beds to admit them to…so the ER will be full at all times with critical patients that need to be transferred to the new hospital for admission(and we all know how long that takes!!!!)…call outs are ongoing as is not being able to find anyone to come in… and on and on it goes…

For now I will be increasing my self-care in order to remain where I am until another plan unfolds…and I do have a plan~~ Praise God!!