Friday, September 26, 2008

not really chronologically correct

so when i started this blog i wanted to tell my story from the beginning but now something has happened that i feel i must share.

I am a nurse and i love my job. i know God led me to do this through experiences in my life that i will share throughout this blog, i am sure.

So the other night i get to work, expecting that my direct boss would have called out sick (she called out the previous 2 nights and at my job if you call out 3 times in a row it equals one call out) she was there. Then seeing that many new nurses were scheduled for work that night i figured i would be put in the district with some of the newer ones (we generally do that), i was not. Then i figured since i was the more experienced nurse i would have the more difficult patients, but i did have one easy one.

Or so i thought.

This patient is one that we have often. he has had a myriad of health problems over the years and we have cared for him multiple times. he has an amazing family who are at his side 100% of the time. Not one of those families that comes out to find you each time the patient needs to be turned or have their blankets pulled up or whatever. One of those kind of families who turns, cleans, dresses and feeds the patient before you can get there.

like i said amazing.

Now it comes to my turn to care for the patient. I know his mom well, i have seen his sister many times. They are there and they are sad. As it turns out, this patient will not be getting better. His body has begun to shut down. His organs are failing. he is struggling for every breath he takes, literally drowning in his own fluid.

His mom and sister know they dont want him to be on a ventilator. they know they don't want us to do CPR on him. But beyond that, they aren't sure. Death is inevitable, but they aren't quite there yet.

Not one, not two, not even three but FOUR doctors have talked to them about putting him in a nursing home. Let him die there. it will be easier. Four doctors have tried to convince them to put him on a morphine drip and let him drift away. One social worker has tried to speak with them about insurance limits and hospital bills. Put him in a nursing home, it is easier and cheaper.

They are angry. they are hurting. they dont trust anyone.

it is now 2 am.

i have made him as comfortable as i can. i have given him pain medicine. He is on a bipap. he can only maintain 90% oxygenation. (we need 92% or greater to live)

his sister wants to go outside to smoke. I offer to go with her. (we aren't allowed to smoke at work but i think oh well, it can't hurt, something is telling me to go with this girl)

She is 27. her brother is 25. Their mom had their sick brother (the patient) when she was highschool. She dropped out to care for him. She made a commitment to care for this patient with downs syndrome for his whole life. And so she did. When she had the following two children(the afore mentioned 27 and 25 year old) they all participated in his care.

she tells me over and over how much the patient is loved, all of the sacrifices they have made for him, how much this whole thing hurts and how angry she is.

she tells me how she has to be strong for her mother, for her brother.

she tells me that no doctor and no social worker seems to understand, they don't care about the money or the bills. her mother has cared for this patient for his whole life, why would she put him in a nursing home to die?

she tells me story after story about this patient and his life, their commitment to keep him happy and active. to take him to school, to the park, to church. to give him a life that counted.

I feell overwhelmed. I feel the need to share with her. i tell her about my son, about our struggles with his health. i tell her all the times i cried, and was scared. I tell her that i don't believe in accidents. I know God has a plan and that He will show us what it is if we listen. I truly believe it in my heart.

And so does she.

She drags me into her brothers room when we get back upstairs, she wakes her mother up and makes me tell her mom what i just told her.

it is now 3 am.

The patient's oxygen is now at 88%, I get a respiratory therapist to give him a treatment. he remains at 88%.

I talk to mom about options. I applaud her for not wanting to put him on a ventilator. i take her to 2 other patients rooms who are on ventilators to show her what it looks like. (this is against the rules but it is 3 am, who's watching?)I ask her if that is what she wants for her son. She shakes her head.

We sit together, the mom, the sister, the patient and i.

thankfully one of my other patients is a vegetable ( well i'm not thankful for that, but thankful that i have the time to spend with this patient) and the other is sound asleep.

it is now 4 am.

the patients oxygen is now at 82%. i call the doctor. he tells me what i already know.

i go into the room, mom on one side and sister on the other. I stand with them. i am quietly searching for the right words.

"i talked to the doctor"

they are silent.

"mom...." (why am i calling her mom?)

" he is suffering. look at him and see how hard he is working to breath."

i grab the stethescope and let mom and sister listen to his lungs. they are 2/3 full of fluid. they hear it.

"there isn't anything else i can do for him. he will continue to work harder and harder and suffer more and more until he dies. you know (patients name) has always done things his own way, he is telling us no nursing home, no hospital bills, no more suffering. " ( i can't believe i am being this blunt.)

"i can help him. I can give him morphine and take off his mask and we can be here with him while he goes to heaven."

i leave the room so they can talk for a while.

it is 5 am.

the brother gets there. sleep still in his eyes he goes into the room.

i wait.

i go into the room and they all look at me and mom smiles." i don't want him to suffer. give him the medicine and take off the mask."

i tell her to get family together while i call the doctor. he comes immediately and signs the papers.

it is 6am.

the extended family arrives and begins to say their goodbyes. i give him the morphine.
sister asks me to go for one more smoke.

when we get outside, she turns to me and i am afraid of what she will say...

she thanks me for being so honest. she tells me no one else was so honest. she tells me she is grateful that i gave it to them straight. and she tells me she trusts me because she can see how much it is hurting me to say the things i've been saying. we hug and head back to the room.

it is 6:30 am.

i go to the room. the family is crowded around and mom is sitting at the bedside holding the patients hand. she looks up at me and says you can take it off, we're ready."

i look at her, i look at the sister. i ask them" are you sure? do you understand that when i take off the mask there will be no miracle (though i do believe in miracles) he will die"

they nod.

i walk to the patient, squeeze his hand one last time and....

take off the mask. he opens his eyes for the first time that night and looks at his mom. i turn off the breathing machine.

i go to the machine measuring his oxygen level, it says 60%, and i turn it off.

i stand there with his family, crying for him, praying for him (Lord, please let it be quick). three minutes later, he died.

he was 29 years old.

i never thought about this when i got to work that night. i had no idea God would use me in this way.

He did. me, unworthy sinner. He used me and my sorrows to help this family when no one else could.

thankyou Lord for continuing to amaze me. i wasn't strong, but You were.



Kent, Jodie and Asher said...

that was an amazing Jineen. It is neat to see how God uses people.
(I hope you didn't mind that I found this blog)

Heather said...

This is the blessing of being a nurse.

Being able to help people come to terms with the stark reality of the fact that we are all going to die. The only choice we have (sometimes) is to face death with dignity and compassion, or fight it tooth and nail (and lose).

God put you with that patient at that exact moment for that very reason.

Amazing, isn't it?