Ponderings of A Hospice Nurse

Six months.

That’s how long I’ve been a hospice & palliative care nurse.

And six months in, it’s taken me this long to really get the swing of things, to know how to navigate my way through days with hiccups and still manage to get home by 5 p.m., and SHUT DOWN…   and yet, I’m sure I really don’t quite have the “swing of things” very well just yet.  But I sure have learned a lot and now I appreciate even more all the senior living options such as Orchard Park of Permain Basin – independent living and Palm Vista Senior Living community out there. My advice is that, if you’re looking for living options for seniors, look into popular and reputable ones that can be found at summerfieldroseville.com/community-life/ or www.riverviewseniorliving.com/vip-respite-care/. And, since all of my journals are in a box somewhere downstairs in the seemingly unending sea of cardboard from my recent move, I shall journal right here, right now.

Memories from a year ago are beginning to pop up on FaceBook reminding me of the weeks prior to COVID – that season of work when, for months it seemed as though no one quite understood what was happening in the world better than the medical community inside the four walls of the hospital.

Months later I’d ride along shadowing the nurses training me to be a home hospice nurse, only to learn of their struggles with the virus while caring for their hospice patients.  You may be reading this and thinking that I should have known people were dealing with their own COVID circumstances on the outside of the hospital, but I can promise you – I was so focused on what was in front of me at the time, that there was no room in my brain to fathom what was happening on the outside as well.  It was all just too much.

But every one of those nurses who trained me risked contracting the virus in order to facilitate communication between the patients they’d come to know and love for many months or years, and their families who were quarantined and forbidden to visit.  And every one of those nurses caught COVID.

In between visiting patients as I became familiar with my new role as a hospice nurse, they told me stories, and I met the most fascinating people.

I won’t forget the elderly woman in her 90’s who held her phone book in her lap.  Filled with all of the names, phone numbers, and addresses of those she held most dear – she dared not let it out of her sight.  For 6+ months, she was unable to see her sons and daughters, hold her grandchildren, play bingo with her friends, or eat in the dining area with others.  “I’ve been eating alone in my room for six months on a paper plate.  Now they tell us we can go to the dining room again, but we have to sit six feet apart and there is plastic in between us.  We are old.  Most of us cannot see or hear.  What’s the use?  I’ll just stay in my room.”

Another man I wheel over to the window weekly so that he can see the faces of the family he raised.  Confused, he motions for his daughter to come in.  She can’t.  She’s not allowed, and he doesn’t understand.

Isolation is not good.  We were not meant to live like this, and I refuse to get used to it.

I’ve spent six months learning so many apps, and programs, and things to chart (and not to chart), and all kinds of new technology to help me take the best care possible of my patients, and make sure they have perfect care plans, and all of their medications delivered on time.

But do you know what?  There is NOTHING, and I mean absolutely nothing like the touch of another human soul.  You can store all of the photos you want on your phones, your laptops, and your ipads, but there is nothing quite like a good old fashioned family photo album – the kind that little treasures fall from when you turn the pages, like notes from the tooth fairy, or locks of hair from a child’s first hair cut.  I’ve sat with an elderly couple on their sofa and watched these things turn tears into laughter.

So I’ve slowed down.  I’ve made sure I touch every single one of my patients.  An arm around their shoulders, or just holding their hands for a good while – it is making all the difference for them (and for me!)

I won’t forget the man who thought for months I was his daughter.  It comforted him that I was able to visit (she was not allowed).  I just let him believe it.  I hugged him, and told him the kiddos were doing just fine when he asked.

Today I learned that charting, “the patient has not fallen in a week,” is similar to saying “Wow!  It sure is quiet today!” in the ICU.  I didn’t get a mile down the street and he was flat on his face.  “Don’t chart that ever again!  You jinxed us!” my friend said.

Sometimes, a patient lying on the floor face down, questioning and crying out to God, is perfectly acceptable.  And sometimes, the best nursing practice you can give is to get right down on the floor with them, and just sit there and listen.

I used to think as an ICU nurse that anything a hospice nurse could provide, I could do in the unit.  I really believed that.  We had the equipment, the knowledge, the medications, etc.  We could turn on soft music, call the Chaplain, or even find a therapy dog.  But there’s nothing quite like entering into the home and the world of someone who is living out their last days.  It’s such a privilege to see their wedding photos, and watch them beam with pride as they point out each of their grandchildren in picture frames on the walls.  And never, ever in the hospital would I have ever had the rare opportunity to hear a couple laugh so loudly together that they ran out of breath – as he danced around the kitchen in a head-to-toe apron, singing in Italian while making breakfast for his wife of 70 years.

A young lady who works at a nursing facility loves her patients so much that when they pass – she cries really hard.  And, she gives them a little kiss on the cheek and thanks them for the privilege of taking care of them.  She reminds me that this “job” I have is a gift.

One young man told me last week that his Dad got up every single day and went to work because providing for his family was the most important thing to him.  And when there was no work, he got up anyways, and he went looking for work.  He’d knock on people’s doors and ask if they needed anything fixed.  “He was a good Dad,” his son told me.

Cancer sucks.  It just does.

And while I’m at it – so does dementia.

Today, a gentleman told me about his father living through World War II in Europe.  When he came to the United States, he owned an ice cream shop in Detroit, and provided a good life for his family.  He even took a bullet once when he was robbed at that shop.  He was a good Dad – still is.

COVID is real.  It really kills people.  You really don’t want to get it.

But isolation will kill people as fast as the COVID virus will.

Human touch is powerful, and crucial, and necessary, and healing.

We were meant to live in community with one another.

Smiles are infectious, unless they are behind a mask.

Music is very therapeutic, and even if you don’t sing well – you ought to just do it anyways – as loudly as you can!

When someone is dying, it’s so very similar to when someone is being born.  What a privilege it is to be in a delivery room when a baby is born.  We should never underestimate just exactly how much of a gift it is to hold the hand, or even be near someone who is taking their last breaths this side of eternity.  We’re not invited yet, or allowed to go where they are going.  But – we get to hold one of their hands while God holds the other one in that sacred space.  “One-on-one time with Jesus,” I call it.  Because – He is just that very merciful.

I don’t think there’s a more sacred moment in all of life.

And yeah, I’ll say it again and again.  I waited way too long to do this.

 

Jesus said to him, “I am the way, and the truth, and the life. No one comes to the Father except through me.