So my new years resolution with this blog was to write a new blog every month. Although, I don't think I actually told anyone that because I don't exactly believe in the term "new years resolution" but in my mind, that was my goal for the year. I've thought about blogging so much since my last post. There were several stories that brought me to this very spot where I started pecking away at a few keys. The only reason that stopped me from posting said blogs were that everything I blogged about seemed to be about death or dying. Here's my conclusion to that dilemma, I'm going to blog anyway. This year as a nurse, my reality has been death. My title at work as been "the Angel of Death" but I like to refer to it as "The Angel of Mercy." Seems a little less harsh on the ears. For whatever reason, I am coming to accept that God has given me favor with patients that are stepping into eternity.

This last week I had three patients pass away. One each day that I worked. (For anyone who is just reading this, please note that I work on a Medical/Oncology floor and that these patients, unless otherwise specified, were on End of Life care, they did not have a cardiac arrest or "Code Blue.") Since I started working at Madigan last June, I have had 23 patients pass away. Each one is different. Each patient passes away in their own way. Each family reacts differently from the next. I'm not sure there is any way to "get good" at being a nurse taking care of End of Life patients.

This month I was reminiscing on the past year and thinking about the different family members, friends and coworkers of these patients. There are some patients you just cannot forget. (Some you wish you could forget...) There is a handful of people whose stories will continue to live on. Memories of children weeping over their dead mother's body haunt me in my dreams. Their faces are so real, so tangible, I feel that I can still reach out a hand and touch them, put an arm around their bodies riveting from sobs. I see mothers crying over the bodies of their young sons. I see fathers, once tough and calloused, brought to their knees. I wonder if there is something I could have done differently, something I could have said to ease the pain, but in my heart I know there was nothing to be done.

The Family members become your extended patients and suddenly you go from having one patient to 6 patients. There is nothing more humbling, nothing more draining, nothing more saddening than standing by a husband or wife and showing them how to let their spouse go.

I always thought the kids were the hardest ones to watch when a patient is passing away. Their small world is crashing around them as they know it. This week I realized something - More than watching a small child cry, more than watching a mother or father weep at a bedside, more than watching a husband of 50 years hold his wife's hand as her heart of gold stops, above all of these heart wrenching scenarios is the moment when there is no one there. He came in as a train wreck and I overheard the physicians say they would be surprised if he even made it out of the ICU before he passed. He made it. Barely, but he made it. He came to our floor in the same train wreck condition, was listed as a "DNR/DNI" (Do not resuscitate/Do not intubate) and added to our growing list of "End of Life" patients. What I was expecting to meet, and what I did meet, were completely opposite. I was anticipating a patient that was unresponsive, I got a patient that was alert and oriented. Due to his condition and Diagnosis, making out the words he was saying became my mission. It was obvious that there were things he needed to say, and things he needed to be heard. One morning it took me almost six hours to figure out what he was saying. After many frustrating attempts to communicate, I decoded that he had some parts that were at Tyson Motors getting fixed and he would like me to call and tell them that he was sorry he didn't pick them up on Monday like he had told them he would do. I actually found it quite admirable. I learned that he hates country music with a passion and lives to hear classical. I learned he had an estranged daughter. I kept waiting for a family member to come to his side. A son, a daughter, a wife... but there was no one. He told me no one would be coming unless his neighbor stopped by. He was right. Spare from a neighbor stopping by, he was alone. Alone and dying. Dying yet still too aware of his surroundings to turn off his mind.

The last time I visited this patient in the hospice house that he had been taken to, the nurses told me he had been unresponsive since he'd been there. I went in to his room and I heard some ungodly country music playing from his radio at his bedside. I started laughing and I said, "Well no wonder they say you're unresponsive, Mr. Blank, they're playing the devil's music for you. Let's find you some classical." A small smile spread across his face and he simply said, "You're back."

It seems the more I see the end of life, the more I treasure the beginning of life. Each time I watch a patient pass away, I get to see the people that are surrounding them and the legacies they leave behind. It gives me hope and passion to live a life worthy of being mentioned. It makes me want to cherish the good times and forget about the bad. It makes me forget about tomorrow and relish in today. To capture the sun and dance in the rain. It makes me appreciate the little things, look forward to the larger things, and believe for the supernatural things.

The Privilege

I feel like the things I write about have a continuing theme of depressing. I don't mean this blog to be emo or depressing, but to simply share my point of view on death an dying.
This week I had another two patients pass away. I should start by telling you, they were expected to die... As in, they were on "comfort care" with DNR/DNI orders. Just don't want you all thinking I go around killing my patients! A fellow co-worker said something in passing that I started to ponder. She said, "Lambert I don't know how you deal with all that (waving her hand towards my patient's door who had just passed away.)"
I started thinking a lot about what she said and asked myself why it seems so natural? I think it all depends on your point of view. For me, the act of holding someone's hand as they step from this world into eternity, is a privilege. In many cases, the fear of dying is so great it's actually what keeps the patient alive longer. If you're reading this blog, you probably already know where I stand as far as my belief in Jesus and the reality of Heaven and Hell. No matter what someone believes before they encounter death, they will undoubtedly call upon Jesus in their last moments. There is always an opportunity to share the love that our Savior offers.
When I came on shift at 1900, I noticed that my patient was particularly odorous and I decided to make it my goal that night to give him the bed bath of a lifetime. :) Myself and another co-worker bathed said patient, put lotion on him, shaved him, scrubbed his hair and brushed his gums. This particular patient had been unresponsive for the past 4 days. After I finished bathing him, I was telling him how his wife wasn't even going to know who this spiffy young fella was lying in his bed in the morning. He turned to me, opened his eyes and shared the briefest smile with me before going back to his rough breathing. About 45 minutes later when we checked on him, he had passed away.
Most of the time I am able to stay emotionally detached, but this particular night warranted a single tear. I could go home from work that day knowing that I had done my job well and that knowledge was invaluable. To be able to give someone who is passing away their dignity back, regardless of how brief it may be, that is what it's all about.
So yes, it is an honor. Maybe giving someone a bath before they pass or performing post-mortem care isn't a glorified job, but it is dignified. Holding the hand of someone, It is a privilege.

Reality.

I thought about entitling this blog "Life's a Bitch" or "Life sucks sometimes" or "Some things just aren't fair." They all still seem fitting, but in an attempt to not be completely mellow-dramatic, I'll come up with something lighter. Yesterday I spent the day with a good friend of mine. It wasn't a 'going to the park' day or a walk in the forest, it was simply sitting there. Sitting and just being there. Nothing about yesterday seemed fair. Not the pain, not the hopelessness, not the sadness, the lack of sleep, the dozen invasive devices. I wouldn't be honest if I didn't say I don't question the reasonings of things sometimes. Maybe that's the beauty of our relationship with Jesus. He doesn't ask us to be perfect, but to be real. So as I drove home last night, I was real. I cried and asked him why. I think I must have asked it at least a few dozen times. Maybe I don't have to understand his reasoning or timing, maybe I just have to believe in the "bigger" perspective. The last two years seem to be a constant attempt to see the "bigger." Can we call life out for what it is sometimes? Shit. Sometimes life is just shitty and unfair. Death seems so final sometimes.

I opened up my computer this morning and I was greeted with the desktop photo of the sunset on the Oregon coast last weekend. The sun will still rise every morning. We will still get out of bed, put one foot in front of the other. Each morning we will get dressed and remind ourselves to keep breathing. And eventually, eventually we won't have to remind ourselves to breathe anymore. Mountain tops or valleys, He is faithful even when I can't always feel Him. "And the Pain of the World is a burden, And it's my cross to bear, I stumble under all the weight, I know you're Simon standing there, I KNOW you're standing there." (Caedmon's Call lyrics - Love Alone)
Maybe the beauty is in the reality. The Reality that this is temporary and Jesus is eternal. Pain, whether emotional, physical, spiritual, it's temporary. The Love of Jesus is real and everlasting. So today I am choosing to cling to the reality of the Eternal.

Well, today is January 12th... and I'm officially writing in 2010. What's this blog going to be about? I have no idea. That's what's so exciting about this whole blogging business. You don't have to have a massive event occur before you can write. :) Happy. To be honest, I'm using my blog as my outlet for me tonight. I'm sitting here on CQ (Charge of Quarters... if you don't know what that means, don't worry about it... it's pretty lame anyway) watching people walk in and out of the barracks. What does this job entail? Two things: One, don't let the giant building made out of strictly bricks, burn down. And Two, don't let any pedophile come into the building. It's pretty serious stuff. I do have this awesome nasty 80 year-old-widow-smoker's-cough right now, so most people run away when I start coughing... It works out well. Anyway, I have been checking things off of my lists all night. I'm doing well so far. Yesterday I wrote a list of lists. My list of lists contained 8 lists. I wrote six of those categories on my whiteboard and wrote the list of things to be done under each one. One thing I have learned lately - I cannot function without lists. I am a list guru. I live and die by lists. In fact, I think I shall write a list of things that need to be done in the event that I die. Funerals are so much easier if they're already planned out. Okay, I'm way off-topic now. Wait, I have no topic. Beautiful. Oh, right, back to the "outlet"... what I meant was, I am involved in way too much right now. I guess that's good because it keeps me out of trouble. I was thinking in October how I needed to get more involved in things... and now I'm overly involved and committed to way too much. Tonight I have successfully written my budget, finished the cleaning roster for the next six weeks, balanced my checkbooks, finished a spread sheet, and caught up on facebook gossip.
I mean, let's be real, that's pretty much what a Facebook Newsfeed is... everyone putting their business out there for the world to read. Speaking of Status Updates, it always cracks me up when people write just enough to keep you wondering exactly what they're talking about. I know you all know who I'm talking about... those Facebookers who are just desperate for someone to ask them what they're referring to so they have a reason to write another three paragraphs about their lust lives... ahem, I mean, love lives. Oh, and then there's the "over the hill" population... they have the tendency to think you actually WANT to know what happened in EVERY moment of their day. Their SU are so long you have to click the "read more..." hyperlink to see the small novel they have written about going to the grocery store. Yes, you're laughing now because you can just picture exactly what I mean. There's always a handful of people who only put a verse are their SU. Don't get me wrong, I ain't tryinta hate on no Jesus talk, but it's a STATUS UPDATE... Meh, whatev. All of this to say, I caught up on the small novels of the grocery store, the lust... ahem, love lives, and the daily verses tonight. I feel very informed, thank you Facebook.



Well, I'd love to stay and play a bit longer, but the need to cross something off one of my lists is just overwhelming me. Unfortunately "Write a blog entry" was not on any of my lists, so this doesn't count for anything. However, maybe I could write it in just so I can cross it off and feel that sense of accomplishment... ;)