Unwanted Wages

Yesterday was a busy day to say the least.I had five patients at the beginning of the shift in IPU. Three discharges planned, one of them to go home with crisis care. By the end of the day, two patients were discharged home, one remained, one died and between 1830pm - 1845pm another patient died and two new patients arrived by ambulance to be admitted. During the day I felt like a gymnastic athlete and each patient was an event to achieve with excellence. I maneuvered the floor routine doing back flips and somersaults to make each step count. By 1100 the first patient was out of the door and I finished my routine with a pirouette. Onto the next challenge, the vault, a quick run to get the next patient out of the door by 1230. Chosen to be an Olympic nurse it is expected to attempt the parallel bars at the same time. Meds are given and comfort provided to the families of dying individuals. Bottoms wiped and foleys inserted. By 1330 the next patient was positioned into the ambulance. The delayed arrival of the ambulance gave me time to comment on paper on my performance. I mentally graded my delivery of care. I gave myself 9 out of 10 for compassion, 7 out of 10 for technique and 2 out of 10 for style. I swallowed 2 chocolate chip cookies as a substitute for steroids. I moved to the balance bar. Nursing is a lot like gymnastics it requires physical strength, flexibility, balance and grace. It is also a team sport and we depend on other disciplines around us to support the action. Without their help I could not do what I am gifted to do. At the end of my shift I was exhausted but satisfied that I had done my best and I could not have done more than that. No gold medals awaited me but food sounded good. This was the last day of a 3 thirteen hour shift and I was looking for a movie and calories. I chose "The Confessions of a Shopaholic" and stopped at Jack in the Box for curly fries, a coke and a spring roll as an added treat. I had stopped at Krogers but I was not in the mood for chocolate, my favorite winning medal. I had consumed the fries during the last five miles home. The hot bath with smelling bath salts was not on tonight's menu. Adrenaline was still surging my veins so I threw of the nursing leotard and put on my leisure outfit. The french fries were forgotten now and the spring roll was not enough to satisfy a mouse. I pulled out the chips and dip. Still not enough so I made cheese on toast. The whole time I was watching the confessions of a shopaholic. The binge stopped when Hugh Dancy, (he is English by the way) asked Isla Fisher why she did it. She said "it makes the world seem better so I shop and I feel better, then it stops and I have to do it again". I thought about why I had to eat when I get home, why it comforts me. Perhaps it is the cortisone increasing my appetite but mostly is makes the stress of the day go away for a while. Alcohol gives me a headache and smoking is not my drug of choice. The shear idea of going out to exercise makes me want to vomit. No answer yet, I am sure counseling might help but the expense of it make me hungry. A support group seems promising with people that can understand.

Symbolic Loss

As I was studying for Grief Counseling I learned about Symbolic Loss. I had not heard the term before but I was aware that people expericence grief in other situations other than related to the death of a love one. Symbolic Loss and grief is experienced in reaction to divorce, unemployment, moving from a neighbourhood, and having an empy nest. I believe hospice nurses and staff experience symbolic loss as we move from one family to the next. We have lost a relationship, the investment into their lives, we also lose a routine that we are familiar with and we are forced to create a new bond with another family. We just move on without taking the time to look at the loss. We are not at a check out register passing items across a scanner and placing them into a plastic bag to be taken home. People pass through out hands and our hearts and are placed in a coffin to go home. I believe that we have to take the time to acknowledge our loss so that we can regroup and equip ourselves to move on. Perhaps we can find unique ways to acknowledge the transition without going to McDonald's to mourn.

How do you show 'your' grief?

A couple of Saturdays ago I decided to trim the yard with a weed-whacker. As I was pushing in the plug I did not realise that I also had my fingers on the start button so when the plug was completely in the stupid thing went to work as it was suppose to. The wire attacked my feet and shins and I did the maniac dance. My husband tried to help but I needed to find that place of calm for myself. Once I was pain free I went back to work but I was in too close a proximity to my husband and began to shower him with dirt and stones. He was not at all pleased and in response I threw the weed-whacker on the ground and went crying into the bathroom. My tears were so intense and so out of proportion to the silly event that just happened. As I sat there on the toilet seat weeping into toilet tissues I asked myself what on earth was going on. I realized that I was releasing the grief that I had buried and ignored. The was a lady at work who was dying and her husband never left her side. When I asked how he was doing, he said "it is not about me, it is all about her." I explained that we cared for the whole family and he was grateful. He still did not leave her side and he only slept for two hours at a time. His love for her was so magnified in those last days and I could not deny the grief. Once I acknowledged my own sadness I could release the pain. I went on and defeated the weed-whacker and the yard.

What frustrates you the most?

I trained in England to be a nurse and my vision was to be like Florence yourself. I wanted to put on bandages and cool clothes onto feverish heads. I wasn't sure about vomit and bowel movements but there are ups and downs to everything in life. I certainly did not become a nurse to journal every moment of my day. Does a plumber or a mechanic have to stop and document every screw applied and in what fashion he did it. Nurse Aides are the real Florence Nightingales of today the trouble is they probably get paid as much as she did then. What I hate really is giving the time to documentation that I would rather be giving to the patient and their families. Does electronic documenting really help? When I get a report from an RN using a computer she has to go from screen to screen to get any info I ask for. It is not just at her fingertips like they promise.

So what do we do? I believe that verbalizing and acknowledging our frustrations provides stress relief. Talking with people that can relate makes me feel better. They understand my pain. Life grief it is not something that can be fixed but we can journey together and just knowing that someone is walking beside me provides comfort.

The Lesson of a Fall

A year ago on Father's Day I put three grand-daughters on the church bus for summer camp. The four year old grand-daughter was too young to go so we went home and put a tent up in the spare bedroom and planned to have summer camp at gramma's house. While my sweetheart swept out old leaves from the tent I went up to the attic to get a exercise mat to make a soft bed. Once up in the attic I remember very little, I certainly do not know how I fell eight feet down the ladder. I was sent down town by life flight. I had fractured my skull and had suffered a sub-dural hematoma. By the grace of God I recovered completely and was back at work in eight weeks. I mention this to share that never in my life did I think of my life ending from a fall from the attic at nine o'clock in the evening. Since that time I do not take a single day for granted. I do not bring the future into the present and I do not poison the day with regrets and pain from the past. I multi task less because it dilutes each individual activity. At work I do what is placed before me knowing that it is impossible to be in several places at the same time. I do the best that I can and I trust the rest to God. I can stress or I can trust.

Welcome to the opening of REST. This is the first time I have looked at a blog let alone open one. I will need a lot of help. You are invited to journey with me as we try to acknowlege our struggles in helping others as we travel towards death. I really want to help others find an environment where they can talk about death. Our job is not good conversation over the dinner table and at BBQs the place goes silent when we say what we do. So who do we talk to? Well lets talk to one another.