I used to think it was all about trying to imagine what it's like....trying to fathom how it would feel if it was me...trying to walk in their shoes.
But I'm starting to realize that it isn't...and I can't...and I don't.
Suffering and fear bring inner chaos. You see it in the eyes, and if you look closely, the hands.
Some days are all about finding the answers and tweaking the meds and trying all your tricks to reign in their chaos.
Sometimes there are no tricks left and 'being there' is all you can do.
Empathy is effectively communicating to another human being,
by words or touch or actions,
that their pain is real...and it counts...and it matters.
At least that's what i think it is today.
Thursday, September 10, 2009
Tuesday, September 08, 2009
evolution
me: "Hey, I'm here to see the Westins - is this a good time?"
colleague and friend: "Yea, I guess, but they're already pissed at you."
me: "What?! Why? I've never even met them!"
colleague and friend: "They've been waiting 2 hours for you. I told them you'd be here at 9."
me: "Why? I told you I couldn't be here until 11."
colleauge and ex-friend: "Oops...sorry..."
me: manage to express "thanks for nothing", "what did i ever do to you", and "you're buying me a coffee later" with only my eyes. it's a gift.
Okay, so this is not a good situation. I'm starting this one in a hole...a deep one. I consider donning chainmail and a helmet before entering the room, but realize i left them in my car. They are stressed out, don't feel well, are scared out of their minds, and now they think that some nurse is just taking her sweet time getting to them. Deep breath...
I enter, introduce myself, and just to clarify once and for all that there is such thing as a dumb question ask something like, "So, are you all ready for me?"
The Mrs. is armed. It's knitting needles and she is working those things so fast, I swear I saw a couple of sparks. The needles fly through her fingers, but she stares, okay glowers, straight at me as she does some sort of knit one, snarl two pattern.
The Mr. (the patient), arms crossed across his chest, speaks first saying, "Ready? We've been ready. Where the hell have you been?"
they are stressed out, don't feel well and are scared out of their minds
they are stressed out, don't feel well and are scared out of their minds
I apologize, mention that there was a misunderstanding about the time, apologize again, and start to set up. I have to teach the Mr. to give himself shots...2 of them a day. I quickly learn that the doctor told them it was only 1 shot a day. I resist the urge to use the term Shinola when explaining that the doctor is incorrect.
Eventually, we hit our stride. They read the handouts, handle all of the equipment, watch me demonstrate, and practice on the model. Then the time comes to do the real thing. He's so fast I almost miss it. 1-2-3-done. 1-2-3-done. The first two shots are in and he gave them to himself. They give each other a funny raised-eyebrow smile and it's like a fever breaking. Then the emotions come pouring out:
"I haven't been that scared in a long time"
"I really didn't think I could do it"
"That wasn't nearly as bad as I thought it was gonna be"
Their phone rings somewhere in there and they tell their daughter, "can't talk right now, we're working with our nurse". I smiled to myslef hearing the "our nurse"and yes, a small part of me thinks ha ha made you like me. Just a small part, I swear.
I go to leave and it's thanks and hugs all around. What a difference an hour makes.
The magic, for me, is in witnessing the evolution. To watch someone get it...understand...gain peace...explain it to their spouse like they've known it forever. To watch someone go from not knowing and fearing to knowing and accepting and doing right in front of you.
It's nursing distilled to its essence: providing direction, comfort, information, and hope to someone who really needs it. And I love it.
colleague and friend: "Yea, I guess, but they're already pissed at you."
me: "What?! Why? I've never even met them!"
colleague and friend: "They've been waiting 2 hours for you. I told them you'd be here at 9."
me: "Why? I told you I couldn't be here until 11."
colleauge and ex-friend: "Oops...sorry..."
me: manage to express "thanks for nothing", "what did i ever do to you", and "you're buying me a coffee later" with only my eyes. it's a gift.
Okay, so this is not a good situation. I'm starting this one in a hole...a deep one. I consider donning chainmail and a helmet before entering the room, but realize i left them in my car. They are stressed out, don't feel well, are scared out of their minds, and now they think that some nurse is just taking her sweet time getting to them. Deep breath...
I enter, introduce myself, and just to clarify once and for all that there is such thing as a dumb question ask something like, "So, are you all ready for me?"
The Mrs. is armed. It's knitting needles and she is working those things so fast, I swear I saw a couple of sparks. The needles fly through her fingers, but she stares, okay glowers, straight at me as she does some sort of knit one, snarl two pattern.
The Mr. (the patient), arms crossed across his chest, speaks first saying, "Ready? We've been ready. Where the hell have you been?"
they are stressed out, don't feel well and are scared out of their minds
they are stressed out, don't feel well and are scared out of their minds
I apologize, mention that there was a misunderstanding about the time, apologize again, and start to set up. I have to teach the Mr. to give himself shots...2 of them a day. I quickly learn that the doctor told them it was only 1 shot a day. I resist the urge to use the term Shinola when explaining that the doctor is incorrect.
Eventually, we hit our stride. They read the handouts, handle all of the equipment, watch me demonstrate, and practice on the model. Then the time comes to do the real thing. He's so fast I almost miss it. 1-2-3-done. 1-2-3-done. The first two shots are in and he gave them to himself. They give each other a funny raised-eyebrow smile and it's like a fever breaking. Then the emotions come pouring out:
"I haven't been that scared in a long time"
"I really didn't think I could do it"
"That wasn't nearly as bad as I thought it was gonna be"
Their phone rings somewhere in there and they tell their daughter, "can't talk right now, we're working with our nurse". I smiled to myslef hearing the "our nurse"and yes, a small part of me thinks ha ha made you like me. Just a small part, I swear.
I go to leave and it's thanks and hugs all around. What a difference an hour makes.
The magic, for me, is in witnessing the evolution. To watch someone get it...understand...gain peace...explain it to their spouse like they've known it forever. To watch someone go from not knowing and fearing to knowing and accepting and doing right in front of you.
It's nursing distilled to its essence: providing direction, comfort, information, and hope to someone who really needs it. And I love it.
Thursday, August 20, 2009
results
i'm glad i know
how hard it is to wait.
it can only make me a better nurse.
slightly more crazed and frayed, maybe
come to think of it though
that's how i'd describe some of the best nurses i know.
the hell of waiting for results
where against all psychic counsel, your heart rate rises and your breathing is shallow
and your bowels churn, threatening your comfort, as only they can do
you've done the emotional math
what's the worst they can find?
what's the best?
what will we do if....
you sit there making small talk
waiting for them to come deliver
your family's fate
in the form of scan results
on a piece of paper
a piece of paper that you know someone is probably carrying in their pocket right now
as they deliver the guy's fate next door
will this day be remembered?
will it be the start of the big sadness?
or will it be forgotten altogether
i will myself to the conclusion that whatever it is, we can handle it
we're close. we love each other. we take care of each other.
my non-zen alter ego whispers 'blah...blah...blah' in my ear.
alter ego knows the truth
the truth is that the thought of watching cancer strip my dad of his life, his pleasures, his limited body fat, makes me want to run from the building screaming.
sure, i can handle it
but i don't want to handle it
and just as i think i might implode from feigning casual
the nurse comes in with the results
and they're good
as good as they could've been, at least
my dad takes the paper
and my mom exhales
and my heart rate slows
and i give my bowels the 'as you were' nod
we hug
and make a few calls
and wave farewell to that bullet that just whizzed by
as we make an appointment to do it all again in three months
i could swear i felt my bowels roll their eyes
how hard it is to wait.
it can only make me a better nurse.
slightly more crazed and frayed, maybe
come to think of it though
that's how i'd describe some of the best nurses i know.
the hell of waiting for results
where against all psychic counsel, your heart rate rises and your breathing is shallow
and your bowels churn, threatening your comfort, as only they can do
you've done the emotional math
what's the worst they can find?
what's the best?
what will we do if....
you sit there making small talk
waiting for them to come deliver
your family's fate
in the form of scan results
on a piece of paper
a piece of paper that you know someone is probably carrying in their pocket right now
as they deliver the guy's fate next door
will this day be remembered?
will it be the start of the big sadness?
or will it be forgotten altogether
i will myself to the conclusion that whatever it is, we can handle it
we're close. we love each other. we take care of each other.
my non-zen alter ego whispers 'blah...blah...blah' in my ear.
alter ego knows the truth
the truth is that the thought of watching cancer strip my dad of his life, his pleasures, his limited body fat, makes me want to run from the building screaming.
sure, i can handle it
but i don't want to handle it
and just as i think i might implode from feigning casual
the nurse comes in with the results
and they're good
as good as they could've been, at least
my dad takes the paper
and my mom exhales
and my heart rate slows
and i give my bowels the 'as you were' nod
we hug
and make a few calls
and wave farewell to that bullet that just whizzed by
as we make an appointment to do it all again in three months
i could swear i felt my bowels roll their eyes
Friday, August 14, 2009
journey
it was only a few months ago when they got the news
when the months of nausea and strange pains and swelling made sense
when it appeared that nothing will ever make sense again
so begins the journey
the journey they never wanted to be on
their season tickets to the theatre are traded in for hospital parking tickets - lots of them
cue alison krauss and robert plant singing...
oh my darling
my darling
my heart breaks as you take your long journey
they'll come 2, sometimes 3 times a week.
and sit in the window seat
he'll get her water
and stroke her hair
he'll read to her
sometimes from the newspaper
sometimes from the bible
i'll offer him coffee, juice, a pillow
he'll say no thanks
maybe because he doesn' t want them
or maybe because he feels he's on duty
he'll watch her as she sleeps
i'll watch him look up, breathe deeply, then grab her hand and lower his head
oh the days will be empty
the nights so long without you my love
and when god calls for you i am left alone
but we will meet in heaven above
they'll come week after week
she'll get smaller and smaller
we'll get the call one morning from the hospice nurse
that she died overnight
those of us who cared for them will take a minute
just a minute in the back room to let it sink in
maybe to hug a little, maybe to swear a lot
god's given us years of happiness here
now we must part
and as the angels come and call for you
the pains of grief tug at my heart
there will be people and flowers and prayers and casseroles
all intended to apply pressure to that emotional hemorrhage
one journey ends and another begins
i hope there is someone there to get him water
and stroke his hair and read to him
as he embarks on his odyssey of grief
when the months of nausea and strange pains and swelling made sense
when it appeared that nothing will ever make sense again
so begins the journey
the journey they never wanted to be on
their season tickets to the theatre are traded in for hospital parking tickets - lots of them
cue alison krauss and robert plant singing...
oh my darling
my darling
my heart breaks as you take your long journey
they'll come 2, sometimes 3 times a week.
and sit in the window seat
he'll get her water
and stroke her hair
he'll read to her
sometimes from the newspaper
sometimes from the bible
i'll offer him coffee, juice, a pillow
he'll say no thanks
maybe because he doesn' t want them
or maybe because he feels he's on duty
he'll watch her as she sleeps
i'll watch him look up, breathe deeply, then grab her hand and lower his head
oh the days will be empty
the nights so long without you my love
and when god calls for you i am left alone
but we will meet in heaven above
they'll come week after week
she'll get smaller and smaller
we'll get the call one morning from the hospice nurse
that she died overnight
those of us who cared for them will take a minute
just a minute in the back room to let it sink in
maybe to hug a little, maybe to swear a lot
god's given us years of happiness here
now we must part
and as the angels come and call for you
the pains of grief tug at my heart
there will be people and flowers and prayers and casseroles
all intended to apply pressure to that emotional hemorrhage
one journey ends and another begins
i hope there is someone there to get him water
and stroke his hair and read to him
as he embarks on his odyssey of grief
Wednesday, March 11, 2009
news
sometimes it's simple:
your insurance just approved this treatment
your cultures are negative
your x-ray is clear
then there's the other kind. the kind that changes everything.
and as the nurse, you know.
you know the result because you've been checking for it compulsively
you know the doctor told her he would call her today with the result
you know at this moment that she is trying to casually fill the minutes of her life until he calls, checking occasionally to be sure that the phone is working, and that the ringer is on
you know that at this moment that doctor is skiing on another continent and won't be calling
you know you have to call
calling with bad news strips you of all the tools you need to humanize it. you can't lock eyes or lay a hand on a shoulder or hand a tissue. words are all you have and they are just usually not enough.
that feeling...that feeling of dialing, slowly, wishing you could be doing just about anything else, quickly sorting through in your mind what to say and how to say it, knowing your tone will be read in the first hello, knowing this call will be remembered, knowing you just have to spit it out. ugh.
it starts out well and you say hello, and state the facts , and tell her how sorry you are. all too often you then decompensate into some adrenaline-mediated mish-mash of apology or silver lining or offer of hope intended to soften the blow. it's really hard not to even though you both know the score. it's hard. it's hard to demoralize someone. it's hard to know that their life has just changed course down a path they never wanted to be on. it's hard to know that whatever we did didn't help.
after a few quesions, she'll say, 'thank you for letting me know'. and you'll say 'you're welcome', as dumb as that sounds.
soon enough it's over and you're moving on to the next chart, the next note, the next patient, the next call.
at the same moment, she's making calls too - to the people who love her and she's saying, 'the nurse called. it's not good news'.
your insurance just approved this treatment
your cultures are negative
your x-ray is clear
then there's the other kind. the kind that changes everything.
and as the nurse, you know.
you know the result because you've been checking for it compulsively
you know the doctor told her he would call her today with the result
you know at this moment that she is trying to casually fill the minutes of her life until he calls, checking occasionally to be sure that the phone is working, and that the ringer is on
you know that at this moment that doctor is skiing on another continent and won't be calling
you know you have to call
calling with bad news strips you of all the tools you need to humanize it. you can't lock eyes or lay a hand on a shoulder or hand a tissue. words are all you have and they are just usually not enough.
that feeling...that feeling of dialing, slowly, wishing you could be doing just about anything else, quickly sorting through in your mind what to say and how to say it, knowing your tone will be read in the first hello, knowing this call will be remembered, knowing you just have to spit it out. ugh.
it starts out well and you say hello, and state the facts , and tell her how sorry you are. all too often you then decompensate into some adrenaline-mediated mish-mash of apology or silver lining or offer of hope intended to soften the blow. it's really hard not to even though you both know the score. it's hard. it's hard to demoralize someone. it's hard to know that their life has just changed course down a path they never wanted to be on. it's hard to know that whatever we did didn't help.
after a few quesions, she'll say, 'thank you for letting me know'. and you'll say 'you're welcome', as dumb as that sounds.
soon enough it's over and you're moving on to the next chart, the next note, the next patient, the next call.
at the same moment, she's making calls too - to the people who love her and she's saying, 'the nurse called. it's not good news'.
Friday, February 20, 2009
back
...to work...sigh.
alarm goes off
make sure baby is breathing
baby is
take shower
listen for baby
dry hair
listen for baby
get dressed
drink coffee
baby cooing
get baby out of bed
take long slow swig of warm baby neck
watch baby's delight that his feet are still there
feed baby
burp baby
take long slow swig of warm milky baby neck
attach baby to hip
set out jeans and t shirts for big boys
remember it's gym day - excavate sweatpants out of basket - replace jeans
get big boys out of bed
ask boys to get dressed
set out breakfast plates
slice apples and artfully display on plates
ask boys to get dressed
decant breast milk into bottles
gather breast pump parts into handy travel bag
ask boys to stop jumping rope and get dressed
safety pin strap of handy travel bag that breaks with the third use
realize i'm starving and eat artfully displayed apple slices
baby crying
change baby
suction giant boogies out of baby's nose
take long slow swig of warm baby neck
sniff ears while i'm at it
baby cooing
come down to find boys miraculously dressed
and making themselves toast
review facts with 8 year old for quiz on Brazil
remind 7 year old to take completed project to school
wrestle drum, sticks, and music stand into ill fitting drum bag
inlaws arrive
kiss everyone
drive away
drink breakfast
arrive at work
turn on computer
check messages
erect breast pump
go see first patient
document
see patient, see patient, see patient
document, document, document
spend 30 minutes looking for 1/2 gallon of urine that patient has lost somewhere between car and waiting room
break it to doctor that urine is lost and tests can't be run
doctor to me: 'did you look for it?'
me to self: 'why didn't i think of that?'
run to office
pump breastmilk while returning phone calls
tell people i'm calling that i don't know what that strange noise is
forage in desk for nuts and berrries: find nuts, no berries
down nuts
see patient and document
repeat x 4
return to office
call husband who says, 'if you leave now, you'll be home in time to feed him'
leave now
arrive home
greet all
lucious baby grin quickly fades to a 'where you been, Missy?' wail
feed baby
the next few hours: attend to the feeding, watering, bathing, and educational needs of various small people
tuck in said small people
read to said small people
take deep breath
find husband who i have pased in the hall several times in the last few hours
kiss husband
watch episode of The Office with husband
laugh ass off
shirk various domestic responisbilities
go to bed.
thank God i'm only working part-time
it's the stage of parenting that i'd crave if i didn't have,
mourn if i lost,
and will too soon be over.
but it takes stamina
which some days you have and some days you don't
i'm pretty tired.
note to self: get some laurels
so i can rest on them
alarm goes off
make sure baby is breathing
baby is
take shower
listen for baby
dry hair
listen for baby
get dressed
drink coffee
baby cooing
get baby out of bed
take long slow swig of warm baby neck
watch baby's delight that his feet are still there
feed baby
burp baby
take long slow swig of warm milky baby neck
attach baby to hip
set out jeans and t shirts for big boys
remember it's gym day - excavate sweatpants out of basket - replace jeans
get big boys out of bed
ask boys to get dressed
set out breakfast plates
slice apples and artfully display on plates
ask boys to get dressed
decant breast milk into bottles
gather breast pump parts into handy travel bag
ask boys to stop jumping rope and get dressed
safety pin strap of handy travel bag that breaks with the third use
realize i'm starving and eat artfully displayed apple slices
baby crying
change baby
suction giant boogies out of baby's nose
take long slow swig of warm baby neck
sniff ears while i'm at it
baby cooing
come down to find boys miraculously dressed
and making themselves toast
review facts with 8 year old for quiz on Brazil
remind 7 year old to take completed project to school
wrestle drum, sticks, and music stand into ill fitting drum bag
inlaws arrive
kiss everyone
drive away
drink breakfast
arrive at work
turn on computer
check messages
erect breast pump
go see first patient
document
see patient, see patient, see patient
document, document, document
spend 30 minutes looking for 1/2 gallon of urine that patient has lost somewhere between car and waiting room
break it to doctor that urine is lost and tests can't be run
doctor to me: 'did you look for it?'
me to self: 'why didn't i think of that?'
run to office
pump breastmilk while returning phone calls
tell people i'm calling that i don't know what that strange noise is
forage in desk for nuts and berrries: find nuts, no berries
down nuts
see patient and document
repeat x 4
return to office
call husband who says, 'if you leave now, you'll be home in time to feed him'
leave now
arrive home
greet all
lucious baby grin quickly fades to a 'where you been, Missy?' wail
feed baby
the next few hours: attend to the feeding, watering, bathing, and educational needs of various small people
tuck in said small people
read to said small people
take deep breath
find husband who i have pased in the hall several times in the last few hours
kiss husband
watch episode of The Office with husband
laugh ass off
shirk various domestic responisbilities
go to bed.
thank God i'm only working part-time
it's the stage of parenting that i'd crave if i didn't have,
mourn if i lost,
and will too soon be over.
but it takes stamina
which some days you have and some days you don't
i'm pretty tired.
note to self: get some laurels
so i can rest on them
Friday, November 07, 2008
no words
there are no words
for the sensation of pushing a new life into the world
the life that you have cared for the last 9 months
the life that kept you awake some nights and alive some days
and there he is
the face you recognize from the sonogram
the warm bluish limbs flailing around on the very belly in which he resided 1 minute before
there is a swirl of activity and noise and cheers and tears
and all you can say is thank you. and welcome.
there are no words for the feeling of adding another member to your family
for watching the big brothers race in, throw down book bags and race to hold him
for the colossal sweetness that is newborn
for the head of thick black hair
for the general lusciousness of it all
that's a lot of words considering i said there were none
love will do that to you
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