Although I would probably describe myself as someone who doesn’t necessarily enjoy change, last year I decided to take a leap of faith, follow my heart’s longing, and become a home hospice nurse. I knew it would be a challenging year of an incredible amount of learning, and I thought that the most difficult aspect would be learning a new charting system. HA! Having worked most of my nursing career in the ICU, I have obviously said hundreds of goodbyes, so I did not anticipate having to learn how to do that.
But I was wrong. The charting came easy; it’s the goodbyes that are still difficult.
My supervisor said it best when she described being a hospice nurse as a “world of goodbyes.” I have thought hard about that for the past 24 hours because this week I have had several of them – each of them with many tears.
So what’s a day like in a world of goodbyes?
I look at my calendar, prioritize my patients’ needs, and based on those needs, strategize who to visit in what order, and call their families in between drives. Often, I pull over and take calls, rearrange the day and head in a totally different direction than I’d planned, chart on the side of the road, run into fast food restaurants (and even funeral homes) to use the bathroom, and have even been known to reconcile medication lists in a Kroger parking lot. I look forward to seeing pets like Sammy the yellow lab greet me at the door on Monday mornings, and watch as his best friend and owner, an Alzheimer’s victim, still remembers to share his donut with him. I cut up food so that a patient with a tremor can actually get to eat a meal. I listen to my patient tell me excitedly how much she enjoyed a visit from the music therapist, and that she sure hopes he comes back. I toss my tablet back in the bag because charting can wait – my patient wants to dance in her wheelchair to Tony Bennett, and I’m happy to be her dance partner for a few minutes. I tease the retired mountain climber about his beard, and then sit and read the letter from his friend across the country that he’s received in the mail this week, or flip through the wedding album of a couple married for 66 years, or hold a cold washcloth on the forehead of a cancer patient with intractable nausea because of her cancer while we wait for meds to kick in. I walk alongside spouses and children, and I teach them how to say goodbye.
And then I say goodbye – to my patient, to their pets, to their loved ones, to our weekly phone calls…
Yeah, charting is definitely the easy part. It’s those heart wrenching goodbyes that stink.
I pray I never, ever get used to them.
“I wonder if my first breath was as soul-stirring to my mother as her last breath was to me.” Anonymous