September 1, 2006, 2:35 am

Hanging On For Dear Life

docbox

Nurses!

Are you bothered by unsightly, unwanted ER patients?

Tired of feeling like the Narcotic Nanny?

Well, help is on the way!

Now available to your patients: the latest upgrade in medical accessibility!

The new, 2007 edition of “Doc In A Box”!

Patients simply open the box, remove the physician and get all the narcotics they want.

When they’re done, they return the MD to the box and store in a convenient location.

It’s that simple!

Available wherever nurses are employed.

(Use as directed. Reader takes all responsibility for any perceived insult to any physician or patient. Void where prohibited.)

******************************

Your father was ninety-nine years old.

You were the youngest of twelve children he raised while residing in Mississippi.

And god, you were a pain.

Pushy, continual questioning, repetitive requests and into the ER at least every other week with the same complaint for your father.

In you would come. Always with one of your dad’s caretakers in tow.

One of three full-time caretakers. He had the same caretakers for ten years while he lived in your home.

Ten years!

They did a great job.

But your dad was old. Very old.

*****

The staff thought you were crazy. They didn’t even want to get near your dad’s case.

So they assigned him to me.

Each time for the last six months.

I “had a way” with you, they said.

No I didn’t.

I just gave you the attention you seemed to crave so badly. I answered your questions.

Repeatedly.

But most of all, I listened.

*****

The turning point came when you suggested a treatment for what you thought was wrong with your dad.

What you asked for could not hurt, so it was ordered to appease you.

And it worked.

Dramatically.

Damn! I said, for once not watching my language in front of a patient.

I couldn’t believe my eyes as your father became alert and interactive.

Such a simple thing.

But you knew.

*****

After that, when he would come in, you and I would look each other in the eye and nod our heads over what was happening.

I got to know your dad and how he responded. What looked right and what did not.

You had even taken steps to decrease the number of ER visits by arranging to have his ongoing issue addressed on an outpatient basis.

And it worked.

For awhile.

*****

One night I came back from break to find you and your dad with his caretaker in one of my assigned rooms.

Something was horribly wrong.

One look and I knew.

Knowing your dad’s venous anatomy like the back of my hand, I inserted an IV in a most unusual spot, but I always knew that’s where I’d find access.

Your questions came fast and furious and I answered all of them. For once I was glad to be in a multi-bed room because I could be available consistently to answer your questions and I could watch your dad the entire time.

And he needed watching.

He was dying.

*****

You didn’t like the doctor who gave you the news that this could be “it”.

You looked like a deer caught in the headlights. You couldn’t spit the questions out fast enough. You said something about your dad not being a “throw away”.

You didn’t process a single answer.

Except that you asked me directly how bad it was.

It was bad, I said.

Very bad.

You looked right at me and started to sob.

And then just as abruptly pulled your emotions right back in.

*****

But it was too late.

I had seen the facade crack.

You weren’t crazy.

You were scared.

And in that one brief moment of emotional release I saw you as a human being who did not want to lose their parent. Not a controlling, off-the-wall family member who could drain you dry of energy in minutes.

You were a child who was afraid that your dad would be written off and that your obserations would be ignored.

And you fought for him. For you.

After all those visits in all those weeks…months…years, I realized your affect in the ER was a defense mechanism built after years of dealing with nurses and doctors who distanced themselves from you and would not listen or respond to what you said or what you wanted.

For your dad.

To keep from having to deal with what you were faced with right now.

Your dad was ninety-nine years old and dying.

And we had taken away the one thing that gave you stability.

We had taken away your hope.

*****

You said he was tough, that he had fought before and he would fight again.

I acknowledged that, indeed, one does not make it to ninety-nine unless they are tough.

Things were actually better by the time your dad was admitted, with his caretaker at his side. He drank some ice water. He spoke some words and seemed less lethargic than before.

I prayed that for your sake you would have more time.

*****

I learned after a couple of days off that you had one more day with your dad.

I wondered how you were doing.

And if I’d ever see you again in the ER.

And I learned to listen more actively when families (or patients) seem difficult or feel they need to push hard to be understood….or respected.

To appreciate the observations of someone who would know their family member much better than I would ever know them.

Sometimes you drove me crazy.

But it was an honor to be able to care for your father.

And you.

12 Comments

  • unsinkablemb
    unsinkablemb

    September 1, 2006 at 3:55 am

    Excellent post! Gave me goosebumps…


  • Mother Jones RN
    Mother Jones RN

    September 1, 2006 at 6:51 am

    Kim:

    You MUST submit this to a nursing magazine. Call me.

    Signed, Mother Jones RN, or She Who Knows Wrting Talent When She Sees It.


  • marachne
    marachne

    September 1, 2006 at 7:35 am

    OK, you’ve hit on one of my pet peeves. Professionals who won’t listen to patients/family members (even when they drive you crazy). An incredable nurse-researcher and all around incredable person named Pat Archbold, and her partner in reserach Barbara Stewart, came up with a wonderful paradigm: Local Knowledge and Cosmopolitan Knowledge. Cosmopolitan Knowledge is what you and I have — the technical/experiential/professional knowledge. Local knowledge is that intimate knowledge that a person who lives with fraily and disease comes to develop about themselves or the person they take care of — they know their bodies, their baseline, their habits. And we don’t listen to them, and respect their knoweldge at risk to not being able to give appropriate care.

    Thanks for illustrating that, as well as all the emotional complexities of these kinds of family relationships.


  • Susan
    Susan

    September 1, 2006 at 8:24 am

    This is beautiful, Kim. Thank you.


  • Kelly
    Kelly

    September 1, 2006 at 9:13 am

    Thanks for writing something that helped this “difficult relative” not feel so self-conscious—for even just a little while 🙂


  • difficultpt
    difficultpt

    September 1, 2006 at 11:11 am

    Thanks, Kim . . .


  • Gail Rae Hudson
    Gail Rae Hudson

    September 1, 2006 at 12:49 pm

    Well, my dear Kim, you have reduced me to tears, which are flowing freely because you have, as well, opened my eyes, as a caregiver to an Ancient One, to what my inevitable, final experience with my mother will be from “the other side of the curtain”.
    I was wrong. You hadn’t written “that post”. Now you have. Thank you for perserving, with me, with all caregivers to Ancient Ones, with the Ancient Ones themselves…just, you know, thank you. I hope, when my mother and I reach this part of her journey, I can persevere with you, in your role, with as much grace and acuity as you have with me, my mother, and our roles.


  • Gail Rae Hudson
    Gail Rae Hudson

    September 1, 2006 at 12:51 pm

    P.S. I’m going to establish a link to this post from my journal. As well, loved the “Doc in a Box” add! What a creative mind you have!


  • Nurse Hells
    Nurse Hells

    September 1, 2006 at 5:27 pm

    🙁 That was so good to read. My Pappa just passed away and I think every nurse in the home he was in was like that. They gave a crap and the listened.


  • Russ
    Russ

    September 1, 2006 at 9:52 pm

    Nurse Kim,

    You have one heck of a gift for writing.

    Russ


  • Lance Mannion
    Lance Mannion

    September 4, 2006 at 8:39 am

    A blogger’s crisis of faith and the miracle of the non-political blogs

    When it comes to blogging, my guru Tom Watson sometimes sounds like a parish priest out of Graham Greene novel who’s lost his faith but keeps saying mass every Sunday in the hope that going through the motions will re-inspire him one day. I say someti…


  • jillbryant
    jillbryant

    September 5, 2006 at 12:17 am

    This did make me cry. It also made me very glad your grandmother gave you Cherry Ames – and I hope there are a lot more like you out there.


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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