Aquarian Heart

Image by shadowlessPhoenix from Pixabay

One of my classes this semester is Nursing Care for the Older Adult. With all the pandemic stuff going around, we are unable to go to a clinical site for that portion of the class. We are making it work with having a clinical group online. For the past 3 Saturdays, I have spent 8 hours a day with 10 others learning about different ways to be mindful of working with the older adult population. I first got my nursing license in 2004 and spent just short of five years in various facets of long-term care. I worked in transitional care units, memory care units, long-term residential units, in an adult day center, and lastly, in a hospice unit. The hospice unit was my last direct nursing care job before I started with transplant in 2009. 

Our topic today was palliative and end-of-life care. I have a very concrete view of this area of care. Before I got sober, there were very few things about which I felt strongly. I had lost a lot of my identity in those years and just talked out both sides of my mouth. With hospice and palliative care, however, I knew and know where I stand. Those views were formed when my dad was ill for the last several months of his life, battling cancer. In those last months, it was nothing but an amazing honor to have been with him and there for him in a meaningful way. He died at home, surrounded by love and his family. This time of my life was very hard, of course, with losing a parent and being an early teen. However, the nurses I got to know when he was hospitalized were terrific. The family and friends that surrounded us for the months leading up to his death and afterward showed me how gracious the world can be in a time of sadness. What stands out most is that I was part of his care team and had these intimate moments of caring that not everyone gets to experience.

I shared a different story with the clinical group today. It's a story that I only share with select people. It's a patient that has stuck with me for over 12 years. I get emotional when I talk about her because the situation was so sad. I was working at Redeemer Health & Rehab, and I was on the hospice wing there. We had several patients pass during the eight months I was there. It's part of the job. It's challenging, but when I think of end-of-life care, I think of the incredible honor it is to care for someone and allow for a peaceful, comfortable transition to the next life. It was the first time in my nursing career (only really 3 years old at that point) when I felt like I was providing the kind of care that I wanted to provide as a nurse. It was incredibly difficult and incredibly rewarding. 

Our patient, D, was young. She came to our facility in her late forties with stage 4 breast cancer. She was visiting her family in MN (home was out of state) when she started feeling poorly and went to the ED at one of the local hospitals. She was immediately admitted and aggressively treated. She became so quickly deconditioned, she came to the rehab floor to get back on her feet. She was an incredibly neat lady. She was very anxious and terrified. She didn't like being with all these old people. She was a thousand miles away from home and wondered how her life ended up here. She was back and forth to the hospital for treatments and complications. One evening, I received a call from the nurse on the floor where she was at. "She is going on hospice care; her body has failed." I immediately advocated that she needed "to come home to us." The plan was to transfer her to a hospice floor at the hospital. Nothing against them, but she knew us. She should come home to us.

When she transferred back to us, her son came with her. He thought she was going back to rehab and was going to be OK. No one had the conversation with him that she was actively dying and only had less than a week to live. I finished my shift at 11:00pm that night and pulled him out of her room. I talked with him for nearly 2 hours about what was really happening. We were keeping her sedated because she would be in immense pain if we didn't. We were keeping her comfortable. He cried and wanted her to wake up to say goodbye. I had to rely on my experience with a parent's death and talk with him about things I had come to believe. "She can hear you. She knows you are there. I asked my dad to stay with us until I was done with something important to us both. He waited. I knew he heard me." 

D passed only a few days later. The aunt and the son decided to have her wake and funeral at our little chapel. "She received more love and care from you guys in the last 2 months of her life than she probably received in her whole life. We wanted for you guys to say goodbye." Many nurses attended the service. I said a prayer to her thanking her for having a significant impact on my life. I thanked God that she was free of pain now. I prayed for her son and family, who lost someone so quickly and so young. I walked back to the floor and started to care for my other hospice patients. I lost another patient that night who I had also come to enjoy. D has stuck with me for a couple of reasons. I advocated for something I truly believed in - something that rarely happened in those drunken years. She made me the nurse I wanted to be. She allowed us to take care of her at her most vulnerable time. She helped me to understand compassion. She was not always pleasant to us. She had a sharp tongue. However, I believe that our request to have her come home to us made a difference in the end. She passed comfortably in her sleep with love and her family. Her family allowed us to honor her and say our goodbyes.

I teared up a bit as I shared this story. If you talk to any nurse, some patients and situations just stay with us. I had the whole clinical group on the verge of tears too! I received all this beautiful feedback from the group via private messages. One of my classmates said, "What is your sign?" I am a full-fledged Aquarius. "Your Aquarian heart is going to change the world," she wrote. "Just don't forget to slow down and realize that you already have." Pretty wise advice from a person I have known for 18 hours of my life. I just stared at those words. Since getting sober, I have felt like I have something big to do. I don't know what it is. I feel like I can make this huge impact. Aquarians (or maybe it's just me) tend to think big. I want to make a huge impact. I want to be a motivational speaker that changes lives for the masses. I guess I can get sort of loss and pass over the differences I have made to people over the years. 

I still think my biggest accomplishment in my life was getting sober and staying sober. The empowerment I felt in changing my own life was so refreshing that I want the world to feel that way! I want to talk to people to let them know that they can do it too. I will never forget the darkness, and I will always remember who were the lights that help me find my way out. I suppose I could say I have a message that I want to share with the world. I am now working a job where recovery isn't an active subject, and there isn't a whole lot of reason to say anything about it at this point. I am in a school where substance use disorders are not the main topic (yet). It just made me realize that I have passions outside of recovery. It's not like I forgot about them; I have been just super focused on the recovery piece for the last six or so years. It is sorta nice to connect again with a few things outside of recovery that are important to me.

I tell people that I am not sure what I want to do when I grow up. That has to be pretty obvious as I am sitting here in school for the 4th time. Recovery is so important to me, so I keep thinking that a career related to recovery must be the place I need to go. What I fail to consider some days is that recovery is a part of everything I do. Today, I woke up in recovery so that I could go to school, get some errands done, and write this blog. Recovery has given me my passion for life back and a connection to the value system that is most important to me. So, should I become a mental health nurse or an ICU nurse, recovery plays a huge role. I have learned resiliency with recovery. After D's death, I went on a bender for a week or so. I didn't want to feel the emotions of her loss. Today, I shared the difference her passing made in my life. Being sober and resilient makes me a candidate for all sorts of options. Recovery is the foundation of it all. 

The last few weeks have been such a fun ride. I enjoy my work so far and engaging back in that technical nursing piece. I feel like all these experiences I have had in life (good, bad, or otherwise) have a new purpose through this clinical experience. I am actually enjoying that not everything is about recovery at the moment. Recovery will always be the most important thing for me because I will have nothing without it. I am starting to realize that maybe working full-time in recovery services is not quite the answer. One way or another, I will always remain connected to it, and it will always be a part of my perspective of things. There is no shortage of addiction issues in nursing in any specialty. I see it in transplant regularly. I see it in working with the older adult populations. I see it in mental health. I think I am coming closer to finding the balance.   

So, all in all, life is moving along. I am taking a moment to think of the people who have told me I made a difference in their lives. I am fortunate to have heard this more than once. These moments are changing the world just a little bit. A change of focus is never a bad thing. My Aquarian heart still has lots of love and compassion yet to share. Eventually, I will figure out the best place for it.

J