Dearest Woman,
When I handed you a lozenge for your scratchy throat you grabbed quickly at my hand. With your pale fingers and almost translucent skin, an oxygen saturation monitor dangling from your index digit, you encircled my wrist squeezing as tightly as your sapped strength would allow.
“Thank you,” your shaky voice said, and honestly I was reminded again how to me you resembled the elderly Rose from the Titanic movie with Kate Winslet. Your voice had that same musical quality, with undertones of knowledge accumulated over a full life lived.
Your soft eyes, wrinkled at the corners, gazed up at me, and you continued, “it’s the little things, you know?”
You took the lozenge from my hand with gratitude I didn’t feel I deserved, and then you stopped me in my tracks.
“You’re a good nurse,” you said. You smiled brightly, and then you turned back to your forensic television show.
I stood there motionless for a moment. One, two, three. The seconds passed as I tried to absorb your compliment. But I couldn’t. I certainly didn’t feel like a good nurse, and definitely not the one you deserved.
Your “ticker,” as you called it had just got tired of ticking. The plumbing to your main pump was all clogged up, and even our best of the best couldn’t unstop it.
When faced with cases like yours I am often at odds. The ICU nurse inside me comes head-to-head with my Hospice nurse heart, and they mentally battle over what’s best for you.
I usually am given a reprieve in my ethical dilemma as loving family offers their wishes, but you’re special, aren’t you?
Even as your heart rate races madly, and your blood pressure plummets your mind is as strong as the day you turned twenty. In your lucid clarity after absorbing each of the facts all eyes turn to you, but you turn your eyes to me.
“Whatever you think is best,” you say. And you give me that sweet smile again, the one that somehow makes your hazy eyes glow.
I struggle for you in my heart, and in my mind knowing that “do not resuscitate” doesn’t mean “do not treat,” and I waggle back and forth between interventionist and advocate.
As I stand at your bedside trying to accept in my heart the compliment you have given, I am kept from it by memories of your cries.
The cries as we inserted various, large needles and lines into major veins and arteries to care for you best. Best for you physically that is.
Working fervently, as we health professionals frequently do, to fix the acute problem even as the chronic cause is a disaster beyond our control.
And now as you sit here somewhat stable I am conflicted in my soul. I don’t feel like a good nurse, and that’s all I want to be. For you.
“I’m ready to go home,” you say, and I pat your hand wanting to wail, I’m sorry I hurt you! I only want to help.
And that’s what it all comes down to my dear, sweet lady. I only want to help you, but sometimes we hurt you instead, and I wonder for what end.
Even though it’s crazy, as I stand at your bed with these thoughts racing through my mind, suddenly that old Kenny Roger’s song comes to me.
I guess sometimes we have trouble knowing how to play our cards right. We’re unsure when to hold ’em, and when to fold ’em.
You just want to go home, and I just want to help you, to not cause you any undue pain. To fix what I can, but know when to stop fixing, and just hold your hand.
I’ll always hold your hand. After all, it’s the little things. You know?
Sincerely,
Your Nurse
kristy hopkins says
THis is one of the most moving blogs I have ever read. I occasionally read yours but tonight showed me how you are the definition of a true nurse. I pray for this patient and I know she will be in the best of care at MRHC with you as her nurse.
brieann.rn@gmail.com says
Thank you so much. I appreciate your comment.
Martha says
I appreciated what you said in your blog tonight. I help take care of my father who is elderly and have to wonder about a lot of things also, about what’s the best thing to do to take care of him
brieann.rn@gmail.com says
Thank you for commenting and sharing. It’s so hard to know. I pray peace for you, and clarity to hear God’s voice as He leads you daily on this endeavor. One day at a time.
Denise says
Brie… Your writings are always so full of God and love… And this is what makes you an outstanding writer and nurse. You have the blessed ability to balance love of God and nursing as you practice and touch the life of so many people. In my opinion, you are the finest example of what every nurse should be at all times. Thank you, as always, for helping us all to be better people and nurses.
brieann.rn@gmail.com says
Thank you so much Denise. As always, your words of encouragement really lift my spirits. I’m so thankful we became connected through this blog. God bless you my friend.
Denise says
Awwww.. What a beautiful way to start my cold and dreary, “back to life after the holidays”, MONDAY. You made my day Brie.. Thank you!!
JoEllen says
That was an awesome post! I, too am an ICU RN (33 years)! Well said!
brieann.rn@gmail.com says
Thank you so much!
Anyone is free to share.
Jane Lemaster, RN, BSN says
I simply sat here and cried when I read this, I have lived this over and over as a practicing professional, and more recently when my husband with his cervical cord injury sustained a year ago, from which he has never fully recovered, made himself a DNR at our family physician’s office. I know in my heart he has made the best decision for him, but oh the dilemma when he passed out on the back pew of the church two weeks ago and the physician who responded wanted to send him to the emergency room! I had to advocate then for my husband who needed to get his pressure up with fluids but who I knew did not want needle sticks or any interventions anymore. When he regained conciousness, I poured water into him just to be able to get him home where he truly wants to be. Life can be so difficult, sadly, we have too many options in health care anymore, patients can be made to come back to more potential suffering just because we can do it. You so clearly articulated how hard this struggle is, to keep doing it day after day. I am retired now, but this saga continues. I hope to God there is a special place in heaven for those of us who have struggled and suffered with the inner pain of knowing we should let go of people and when it is time to do that. Thanks Brie, I’ll wipe my tears now and keep on truckin’.
brieann.rn@gmail.com says
Thank you so much for commenting and sharing your own struggles. You’re in my thoughts and prayers.
Nitashia says
Well said. Well said. I often wondered if I was the only one who thought that way or if there are others….now I know.
brieann.rn@gmail.com says
Thank you. You’re not alone.
Leah Bivins says
Great article! Have you ever considered hospice nursing?
brieann.rn@gmail.com says
I did for over two years. Loved it. Only stopped because I have young children and the call doesn’t agree with that.
Connie C. Renfrow (retired rn) says
Sometimes, as I am sure you know, when a patient, especially an elderly patient says they want to go home, it is their heavenly home they are talking about. I heard a very wise physician say once, “sometimes the hardest thing to do is nothing”. So true