Birthdays and Transitions
On the morning of November 16th I started my 48th year..
I started my day just like any other walk the dog, feed the dog, coffee, checking overnight messages for my patient statuses and head out to see patients before out bi-weekly meeting with the hospice team.
According to the over night RN one of my newer patients was put on Continuous Care, this means the patient is declining and will be transitioning soon. Of course no one knows how soon but soon enough that someone is stationed with the patient 24/7 for comfort care and support.
I had only spoken to the patients spouse on the phone so I was thrilled she was already there and bedside with her husband. She had been upset during out previous conversation, she was struggling with his rapid decline. Since they were 19 she had been taking care of him, being his wife, mother to his children and making sure he had everything he needed including nutrition.
It is hard for people to see their loved ones slow down, slow down doing the things we do everyday without really thinking.. like eating and drinking. People think that if they can just make the patients favorite meal, snack or a glass of their favorite beverage they will miraculously recover. I had this difficult conversation twice this week and it is always hard on loved ones. For them to hear the patient is telling us something by doing this.. telling us he doesn't need it, telling us my body can't handle it and telling us they have free will to say no.
I walked into the room, the patient was in bed and his wife was at the foot in a chair just staring at him. She got up to greet me with a hug and a "its wonderful to see you and put a face to the kind voice on the phone." I asked the LPN present how the patient was doing but it just took a minute for me to be bedside to see/hear/feel for myself. He was slipping away..
He was breathing/gasping every 2 minutes or so and just barely holding on to this life.
I found a wash cloth, wet it with cold water and placed it on the patients forehead. He was not feverish but warm. I pushed the cloth back over his his hair line to lay the hairs down, ran the cloth down his cheeks over his nose and back to his forehead so he felt something cool. I held his hand with one of mine, placed my other on his heart and hummed something that came to mind nothing specific just soft. I bent to his ear and whispered his name, told him it would be okay and that I knew he was tired.
His wife stood up, stood bedside me, she put her hand on top of mine so that our hands rested together on his heart. In a soft tone she said she was stepping out to use the restroom..
I moved the washcloth from his forehead, kept my hand on his heart and closed my eyes.. he took his last breathe.
He slipped away with his wife out of the room but not alone.
She came back in, our eyes meet and she knew. She asked if he was gone, a soft yes came out of my mouth and a tear rolled down her cheek.
We stood bedside for a few minutes as the LPN checked vitals, there were none to be found.
She said "thank you for being here, thank you for showing him love and thank you for being strong."
I thanked her for the privilege, thanked her for the gift her family and her husband had given me. That is was my birthday, that I wouldn't want to be anywhere else and that it meant the world to be to be present.
After she left the room to make calls I slipped away, slipped away to the team meeting and the rest of my birthday. It was a day of transitions, celebrations and mourning but the best gift because it was a real present.
I started my day just like any other walk the dog, feed the dog, coffee, checking overnight messages for my patient statuses and head out to see patients before out bi-weekly meeting with the hospice team.
According to the over night RN one of my newer patients was put on Continuous Care, this means the patient is declining and will be transitioning soon. Of course no one knows how soon but soon enough that someone is stationed with the patient 24/7 for comfort care and support.
I had only spoken to the patients spouse on the phone so I was thrilled she was already there and bedside with her husband. She had been upset during out previous conversation, she was struggling with his rapid decline. Since they were 19 she had been taking care of him, being his wife, mother to his children and making sure he had everything he needed including nutrition.
It is hard for people to see their loved ones slow down, slow down doing the things we do everyday without really thinking.. like eating and drinking. People think that if they can just make the patients favorite meal, snack or a glass of their favorite beverage they will miraculously recover. I had this difficult conversation twice this week and it is always hard on loved ones. For them to hear the patient is telling us something by doing this.. telling us he doesn't need it, telling us my body can't handle it and telling us they have free will to say no.
I walked into the room, the patient was in bed and his wife was at the foot in a chair just staring at him. She got up to greet me with a hug and a "its wonderful to see you and put a face to the kind voice on the phone." I asked the LPN present how the patient was doing but it just took a minute for me to be bedside to see/hear/feel for myself. He was slipping away..
He was breathing/gasping every 2 minutes or so and just barely holding on to this life.
I found a wash cloth, wet it with cold water and placed it on the patients forehead. He was not feverish but warm. I pushed the cloth back over his his hair line to lay the hairs down, ran the cloth down his cheeks over his nose and back to his forehead so he felt something cool. I held his hand with one of mine, placed my other on his heart and hummed something that came to mind nothing specific just soft. I bent to his ear and whispered his name, told him it would be okay and that I knew he was tired.
His wife stood up, stood bedside me, she put her hand on top of mine so that our hands rested together on his heart. In a soft tone she said she was stepping out to use the restroom..
I moved the washcloth from his forehead, kept my hand on his heart and closed my eyes.. he took his last breathe.
He slipped away with his wife out of the room but not alone.
She came back in, our eyes meet and she knew. She asked if he was gone, a soft yes came out of my mouth and a tear rolled down her cheek.
We stood bedside for a few minutes as the LPN checked vitals, there were none to be found.
She said "thank you for being here, thank you for showing him love and thank you for being strong."
I thanked her for the privilege, thanked her for the gift her family and her husband had given me. That is was my birthday, that I wouldn't want to be anywhere else and that it meant the world to be to be present.
After she left the room to make calls I slipped away, slipped away to the team meeting and the rest of my birthday. It was a day of transitions, celebrations and mourning but the best gift because it was a real present.
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