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Sunday, August 8, 2010
(I’m sitting on my deck drinking coffee and writing! Yes! It is cool enough to actually sit outside and breathe some air that doesn't feel like it was just blown out of a furnace. Just a little aside before I start my post. Had to share).
The New Nurse took things into her own hands. After working on a pain management manual at her desk for a couple of hours, she wondered when her manager was going to give her her marching orders for the day. Lavender Lane, the hospice where she works, was still in turmoil after moving into the new building.
She knew what the schedule paper said. It said that she was to spend the morning with either one of the chaplains or one of the social workers, but the morning was fast dissolving all around her. She was ready to get out of the office and see some patients.
The desk directly behind her is assigned to the night nurse, but since the night nurse was at home sleeping, Brenda, one of the social workers was using it. The New Nurse wheeled her chair around and asked, “What’s up with you today?” Teresa and I are supposed to be with one of you guys or one of the chaplains. Can we go with you?”
“I don’t see why not , but we won’t be back at the office until four this afternoon. You up for a long day?”
At that point, Teresa wandered into the new nurse’s space with a look of anticipation on her face.
“Aren’t we supposed to be doing something?”
Never having been accused of being shy, the New Nurse pulled herself out of her chair, which was a little deep for her, and strode across the hall to Katie’s office and, interrupting her, asked permission to go with Brenda.
Katie slapped her forehead and said, “Oh, shit! I knew there was something else on my plate. It’s just so full, I have to move everything around on it to see what’s there. Sure, tag along with Brenda. Hey, and thanks for being proactive. Go with my blessings” Then she returned to her conversation with another nurse.
The ride to Barnesville, mostly over country roads, was beautiful with deep green flora, recent heavy rains having produced a lushness in the landscape, unusual for these hot days of August.
The New Nurse tried to watch and listen as Brenda interacted with the family of the dying man. Having been admitted the day before, his family had only received his medication packet that morning. While Brenda’s voice began to sound like Charlie Brown’s teacher, the New Nurse could not take her eyes off the skeleton of a man in the bed. He was sucking for air and beginning to rattle. He had periods of apnea for as long as 30 seconds, followed by respirations as frequent as 30 in 30 seconds as he struggled to move air into his lungs. She held herself in check as long as she could.
No stethoscope or blood pressure cuff, no nursing apparatus at all, she interrupted Brenda, saying, “I must intervene her and be this man’s nurse.”
She explained to the family that their loved one was hungry for air, and that he needed some medicine to make him breathe easier and alleviate any pain he was having. He was nonverbal, so there was not way to assess just how uncomfortable he might be. She had the family look at his breathing, then opened the medication box, assembled the apparatus for delivering morphine drops under his tongue and guided the niece in how to administer it.
“But won’t morphine kill him, stop his breathing altogether? I don’t want to kill my uncle.”
The New Nurse took the frightened woman into her arms and whispered, “He is leaving us, and he knows it. We all know it. Your giving him morphine will make his leaving easier and more peaceful. By giving it to him, you are ministering to him, helping him along his way.”
Within five minutes, the patient’s breathing was less labored, though he was still having periods of apnea.
Then the New Nurse opened a tiny bottle of drops meant to dry the patient’s chest so the rattle would be less and maybe even go away. The niece was eager to give her uncle the medicine and was guided in doing so by the New Nurse.
They sat for a few minutes as the New Nurse guided the family through the signs of end of life, explaining that their uncle had some of them but not all. Though they had read the material on that subject given to them on the previous day, then remembered little of what they had read and needed gentle reinforcement.
On the drive back to the office, the lush countryside appeared even more verdant. New Nurse called the dying man's case manager and confessed to having intervened with her patient and was greeted with these words:
“Hell, Claudia, you’re a hospice nurse. You were just doing your job. We will write it up when you arrive. I am thankful you were there.”
synchronicity: the simultaneous occurrence of events that appear significantly related but have no discernible causal connection
I have long believed in synchronicity in the lives of people and what happens and does not happen in them, and I am certain in my heart that a powerful force in the universe - call it what you want - moved me to stick my nose in Brenda’s business and ask to go with her. It was an intervention outside of me and my spiritual capabilities that led me to that bedside on a hot August afternoon in Barnesville, Georgia.
ALL NAMES HAVE BEEN CHANGED EXCEPT MINE.