loss

Contemplations on Mourning & Why I’m a Nurse


I’m really horrible with dates, whether birthdays, anniversaries, or whatever, but when I was talking to my mom this morning she reminded me that exactly three years ago today my dear uncle Robert died.  I never knew my grandfather on my dad’s side of the family & because Robert was considerably older than all of my other uncles & because I spent a lot of time with him & my aunt Katherine, I always thought of him more like a grandfather than just an uncle (no to disrespect to uncles of course). special date

In any case, as soon as my mom reminded me of his passing, floods of memories came pouring to the surface.  Most intensely of course I remembered that day three years ago when I saw Robert for the very last time.  The circumstances under which that occurred were really quite significant.  Allow me to explain.  Robert had been in & out of the hospital for several months at that point, & the nurse part of me of course knew that his prognosis wasn’t very good.  I had seen him a few times here & there, but as it turned out that weekend I was scheduled to go to a Zac Brown Band concert in Roanoke, VA with a close friend of mine, so I was hoping to tag on a visit to him as well.  It just so happened that both NC & VA were subjected to a great deal of snow & ice that weekend, but I was determined to make it to VA.  So, quite foolishly I suppose, I left Raleigh in some of the worst freezing rain I’ve ever encountered.  It was so bad that I had to stop more than once to scrape the ice off my windshield just so I could see to drive!  After about an hour on the road it became clear there was absolutely no way I could safely make it to the concert in time.  My friend wasn’t so sure she could make it there either, & thankfully she was able to transfer our tickets to some folks who could go. freezing rain

Anyway, once I realized I couldn’t make it to the concert, I decided I would still go home & visit Robert & the rest of my family.  There was just a part of me that knew that this might be the last time I’d ever see Robert alive, so even though the roads were horrible & I drove by quite a few accidents, I was determined to make it home safely so I could see him.  What is normally just shy of a three hour drive turned into over a five hour drive; I don’t think I hit more than 40 mph the whole trip!  But my husband’s trusty little Chevy Cavalier, hardly the best vehicle for such dangerous wintry driving conditions, got me home in one piece, & I was able to visit my uncle in the hospital the next day.end of life quote

I still remember very clearly entering his ICU room & seeing him lying there intubated.  It hit me like a ton of bricks that, yes, this was definitely going to be the last time I ever saw Robert alive.  I’d been a nurse long enough at that point to know that this was it.  Even though it was a Sunday we were fortunate to have a palliative care doctor available to us, & I remember helping my aunt discuss various things with the doctor (e.g. whether to continue tube feedings).  In short, the decision was made to proceed with comfort care only, which was what I & the rest of us felt was best & what he would have wanted could he have spoken for himself.  When it came time for me to leave, I went over to the bed & looked my uncle in the eyes, & even though he was still intubated & fairly sedated at the time (the ventilator was actually off but the ET tube was still in place), he turned his head & opened his eyes & looked at me.  I kissed him on the forehead & told him I loved him but it was ok for him to go if he needed to.  I hugged the rest of my family & left that room knowing I would shortly receive the news of his passing.

As it turned out, it was just about an hour later that one of my cousins gave me the news that Robert had passed away peacefully.  I had to be back at work the next night I believe, so I was already back on the road to Raleigh at the time.  I will never forget pulling over on the side of 460, somewhere around Altavista, where I watched the sunset, a gorgeous one I might add, & cried.

I was put in mind of these events this past Fall when my grandfather was ill & the nurse part of me knew that he was dying as well.  For sake of time I won’t elaborate too much, but essentially the exact same scenario happened, minus the missed concert & the winter weather.  I’ll never forget kissing him good-bye & telling him I loved him but he could go if he needed to, then walking out of that hospital room knowing I’d truly just said our final good-bye.  I also distinctly remember driving home to Raleigh the next morning & pulling over somewhere in Charlotte County to watch the sunrise & cry.

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The sunrise I watched in Charlotte County, VA on the way home from seeing my grandfather for the final time

Now I’m fighting back tears of course, but I’m writing all of this to say not only that I miss these dear men very much but also that I like to think of a lot of my nursing care as being in honor of them.  Let me explain.

I’d only been a nurse for a few months when it became very apparent to me that I have a special place in my heart for palliative care & hospice.  Even though I was all of 22 when I became a nurse I seemed, even then, to have a particular affinity for working with patients & their families at the end of life.  Like many others of course, I got into nursing largely with the idea of saving lives. But it didn’t take much experience for me to realize that even with all of the advanced medical care available to us today, that doesn’t mean every life can be saved every time.  Furthermore quality of life is at the end of the day so much more important than quantity of life, at least in my mind, though I’m sure the vast majority of people would agree.  Even as a young nurse, I remember advocating for palliative care & hospice for several of my patients who clearly needed & desired that type of care to allow them a peaceful death.  I quickly realized that helping them achieve that goal & assisting their families in that process was, though difficult at times, the most rewarding part of my job.  Over four years later I still agree with that sentiment one hundred percent.hospice

In the past four, now closer to five, years of nursing, I’ve called families countless times to inform them that their loved one was in the process of dying & they needed to come see them if at all possible.  And countless times I’ve called families to say their loved one has in fact passed away.  It’s never easy, but it doesn’t scare me anymore either.

Now I’ve said all of that to finally say this:

Yes, I’ve been told by plenty of folks that I’m “smart enough to be a doctor.”  And, yes, I agree one hundred percent with that sentiment.  But let me tell you why I am so, so glad I chose to be a nurse instead.nurse pic

In case you didn’t know, doctors don’t round at night (& even during the day they usually only see each patient once or twice).  There are doctors on call at night of course, but they are there to handle admissions & emergencies.  Otherwise it is completely up to us as nurses to monitor our patients & advocate for them when the need arises.  If your loved one’s condition is deteriorating, believe me, the doctor isn’t coming around every hour to check on them.  That just isn’t feasible.  But the nurse is doing exactly that.  It is up to our eyes & ears & critical thinking to manage those patients & to know when to call the doctor & what to ask for when we do.  I can’t tell you the number of times I’ve quite literally saved a life by intervening on the behalf of a patient who had acute hypoglycemia, A Fib-RVR, SVT, acute respiratory distress, or any number of other life-threatening conditions.  Knowing I’ve been part of such efforts is of course incredibly rewarding.

smart nurse

But the most rewarding thing of all to me is when I help someone achieve a peaceful death.  I know that may sound very bizarre but it’s just the truth.  Though none of us likes to admit it, the truth is we’re all going to die someday, & I think all of us hope that when our time comes, it will be peaceful & as painless as possible.  So when I can be a part of making that happen, I feel like I’ve accomplished something truly meaningful in this world. hospice 1

Of course there are situations when patients & families are contemplating comfort care/hospice but haven’t quite made a decision yet.  And of course sometimes things change drastically overnight & suddenly that decision cannot be put off any longer.  Especially overnight when the doctors aren’t rounding, it becomes up to the nurse to advocate for that patient.  Though it is challenging, multiple times I have been the one who has called a family member to say that a choice needs to be made.  I have facilitated conversations between family members & doctors so that a choice for comfort care could be made official & we could begin to work towards a peaceful passing.  Yes, ultimately the doctor is the one giving the orders, whether it’s for comfort care or otherwise, but believe me, even the best doctors are relying very heavily on us as nurses to guide them.  This is especially true at night when we are quite literally their eyes & ears.nursing quote

Anyway, maybe this all sounds morbid & strange to you if you aren’t part of the healthcare field (or perhaps even if you are).  But when I care for patients & their families at the end of life, I think about my own loved ones I’ve lost.  I remember Robert & PawPaw (my grandfather) & Granny & their suffering & the relief I could see in their eyes when they heard us tell them we loved them but we could let them go if they needed to.  And I remember the nurses who cared for them during their last days & made them as comfortable as they could be. end of life

Yes, I’m sure I could have been a doctor & to some people maybe I’m “not living up my full potential” by being a nurse.  But the folks who say/think that have no idea what I do on a daily basis.  They have no idea the difference I’ve made in the lives of countless patients, both those I’ve helped to save & those I’ve helped to achieve a peaceful death.  As I’ve said, I’ve long since lost count of the number of times when I’ve been the one who has intervened for a patient & made a tremendous difference in their life, again whether it was helping to save them or helping them achieve a peaceful passing.  Particularly when the situation is the latter, I often remember my own loved ones who’ve passed away & I like to think I am serving others in honor of them.

In summary, yes, nursing is frequently stressful, overwhelming, & emotionally & physically taxing.  But every night that I work I know I make a meaningful difference.

And that, my friends, is why I’m a nurse.

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Processing Grief During the Most Wonderful Time of the Year


A week from today is Christmas so I know I “should” be writing some kind of joyful, uplifting post about how this is the most wonderful time of the year.  And in many ways it is.  But I work in a hospital so whether I like it or not I’m confronted with the fact that Christmas can actually be a very sad & difficult time of the year for many people because of sickness, accidents, mental illness, drug abuse, and of course death.  My own family has lost several members over the past year & this will be our first Christmas without some very special people.  I don’t mean to be depressing, but I just feel like I need to address this subject because I know I’m not the only person who is feeling very conflicting emotions at this time of year.  Part of me loves all of the decorations, parties, Christmas music, & general “cheer” that the holidays bring.  But part of me also feels the weight of grief in knowing that this Christmas will be a bit different than those of the past.  This leads me to a greater topic that I want to address.

grief

A friend of mine recently posted something on Facebook about how sad she thought it was that some religious people believe that grieving, even at funerals, is wrong because the focus should be on the loved one being in Heaven.  I was very struck by that post because I too have witnessed this sad phenomenon.  I have been to lots of funerals in my life and over and over again I have heard the same basic phrases: “She’s better off now.  She isn’t suffering anymore because she’s with Jesus in Heaven.  Don’t despair.  You’ll see her again someday.”  To be perfectly honest, until my grandmother died five years ago I was quite guilty of saying some of these things myself to other people whose relatives or friends had died.  However, when Granny died I realized how completely unhelpful such things are.  I know that people mean well when they say these things, but standing in the line at the visitation the night before Granny’s funeral, I realized that the only words that really comforted me at that time were these: “She was a wonderful person.  We all loved her so much & we will miss her forever.  I’m so sorry for your loss.”  I needed people to recognize that, yes, this WAS a major loss.  And I had every right to feel sad, depressed, and even angry at the fact that she was gone.  (To be honest I’d worked through a lot of these emotions even before she passed away because of her being on hospice for quite some time, but even so the pain of losing a loved one is never easy.)  I remember going to her funeral and wanting to cry so badly but feeling like I couldn’t.  Now, this is largely my own fault I suppose for not feeling comfortable enough to cry in front of my own family.  How ridiculous is that?  My sister wasn’t afraid to cry, but I was.  I never once cried in front of my family when Granny died.  I only cried when I was alone or with my now-husband (then boyfriend).  There are a lot of underlying reasons for why I only felt comfortable enough to cry in front of him, and I am still working through those reasons even now.  But I can’t help but feel one of those reasons was that for so much of my life I’d been inundated with the never-explicit but always strongly implied idea that grief was somehow sinful, somehow selfish.  I don’t know exactly where this idea came from and I am blaming no one in particular for it.  It was just there.  Maybe I made it up, but I don’t think so.

When I was a junior in college one of my OB nursing professors told us a very personal story about her own miscarriages and the eventual birth of her first child who was either stillborn or died within a few hours of birth.  The point of the story was that there was so much grief involved with losing this child and that she had to learn to work through it.  She learned that no matter how much she tried to just “move on with life” and push it away, the grief was still following her.  I’ll never forget that lesson.  I remember so strongly sitting in that class, thinking about how it had been a year since Granny’s death and I had done everything I could to run away from that grief because I was busy with nursing school and just didn’t want to deal with the grief of her passing.  I just didn’t feel like I had the stamina to process it so I kept pushing it away.  And just like my professor said, the grief kept coming back.  It kept haunting me.  It wasn’t until I heard her speak about how she finally learned to confront the grief, to handle it, to honor it, to accept it, to process it, that I realized how much I needed to do the same thing.

My professor was so right.  Grief is a process.  It isn’t something that goes away overnight.  For some losses, the grief will never totally disappear, but no matter how much we feel like we can’t handle dealing with our grief for whatever reason, it will never go away at all until we start to process it.  Indeed, grief will haunt you forever until you learn to really work through it.  This can mean so many different things for different people (and can be different even for the same person depending on the nature of the loss).  I think it’s fair to say that most people process grief at least partly through tears.  I know there are exceptions to every rule, but the majority of people do cry when they’re sad.  But sadness is just one part of grief.  There’s so much more to it than that.  Grief can encompass anger, frustration, and so many other feelings because whenever we experience a loss in life there is a part of us that wants to shake our fist at the sky and ask “Why?  This is so unfair!”  And quite often it is unfair.  And there is nothing wrong with feeling that way!  It’s just part of human nature, of experiencing life.

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So my challenge to myself and to anyone reading this is to really think about the losses you’ve experienced in life, especially any unresolved grief that might come back to haunt you at Christmas, this time of year when memories can seem stronger than ever.  And instead of trying to just forget it or push it aside, really confront that grief.  Begin to process it.  Sometimes we think we’ve moved past a loss only to realize months or even years later that the wound is as fresh as ever.  And that’s ok too.  We just have to find ways to process our grief.  For some of us that means listening to music or reading a book or writing a poem or song.  For some it means seeing a therapist or counselor.  There’s no right or wrong answer here.  The point is that we need to be honest about our grief.  We can’t try to hide it or deny it.  As families and friends we need to support each other and not be afraid to show our “weaknesses.”  If this is your first (or second or tenth) Christmas without a loved one, don’t be afraid or ashamed to cry or just not be as “jolly” as perhaps you usually are.  It’s ok.  Just be honest with yourself and your family and friends about your grief.  You never know who else may need your encouragement to process their own grief as well.

I hope this post wasn’t too depressing but it’s something I’ve been thinking about a lot this year and felt like I needed to write for my own sake as well as hopefully to encourage others.  Merry Christmas & Happy Holidays to all my lovely readers!

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