Wednesday, August 29, 2012

For several weeks when Leslie was in the ICU, she literally had tubes coming from all over.  Then on top of all the tubes, she had the ventilator, which while it wasn't breathing for her, it was protecting her airway, which obviously is very important.

I remember when Jay's Grandpa was dying of brain cancer.  From diagnosis to death, we're talking months.  I remember we were on out way to a birthday party and I told Jay I felt we should stop by to see him one more time, as he was inevitably close to death.  When we arrived, he had the "death rattle", meaning secretions were building up in his mouth, throat, and lungs and just rattling around in there with each pathetic breath.  His arms were so swollen they were shiny, and when you touched them, it caused an indent that never fully rebounded.

I also remember when Jay's aunt was dying from diabetic kidney failure.  We were all there.  We were in the process of moving her from the recliner to the hospital breaths when she did those awful "fake"breaths....where her chest rose and fell, but there was no air exchange.  Just like that, she was gone.

Last story was my Uncle Frank's funeral.  He was in his coffin and was on day 3 of the viewing.  I touched his arm. Rock hard and cold.  It made me quietly yelp and back away, and also caused me to vow to never touch a deceased loved one again.

Back to Les.  When people were around, I kept the touching to a minimum.  Maybe hold her hand or brush her hair.  I was comfortable enough in the hospital setting to know that each bleep and bloop of the machines did not necessarily mean something bad, but for my parents sanity, I kept the touching to a minimum.  What they DIDN'T know, was that when everyone was gone and I was on night duty, it was a regular ol' Jane Fonda session all up in that ICU hizzouse.  I'll be damned if my sister recovers from sudden cardiac arrest but then has months and months of PT related to foot droop.  Or worse, she recovers, then becomes septic due to bed sores.  Nope!  Not on my watch.

I remember one particular bad night.  She was in full blown paranoia mode, fully believing someone was going to break in to our "apartment".  Not only that, she was having a horrible reaction to a drug and had hives head to toe.  She didn't get the concept of scratching the itchiness, so she just moved.  A lot.  She still had tubes in, this time we were down to heart monitors, a catheter, and a PICC line.  She'd go to grab at the PICC line, and as you gently pealed her fingers away, she was already plotting on attacking the foley straight on.  As you carefully told her that it will HURT if she pulls that out, she has already detached herself from all the heart monitors and is handing them to you so sweetly as if to say, "here, I think you misplaced these!"  It was nonstop, all night long.  I was tired.  Finally?  I said "Screw it!" to my empty bed and climbed into her bed.  I rolled her to her side and got the foley anchored tightly between her legs.  The PICC was covered by her gown now, so it was less distracting, and the heart monitors were on their own, meaning:  she was still plucking them off left and right.  Anyhow, I got her situated and positioned myself behind her bottom, in the crook of her knees and gently blew some cold air on her backside with one hand while using the other hand to gently rub over her entire body to relieve the itching.  It was then that she finally fell asleep.

Her paranoia ceased because I was physically touching her and calming her; as well as distracting her from other things that were bothering her (the itchiness) which she did not have the mental capacity to put the two together.

This is just a specific example of touch.  My hands were on her constantly.  Rubbing her shoulders, scratching her back, stroking her legs and arms.  I couldn't do much, but I could let her know with a gently touch "I AM HERE."

My current nursing role is very hands off.  Sure, I get to talk to my patients and develop relationships with them.  It's been amazing.  But I miss the hands on part.  I miss being able to assess a patients general well being by simply listening to heart and lung sounds, as well as bowel sounds.  To assess the status of a wound by removing a dressing, comparing previous assessments, and then redressing the wound.  Of having a delicate, bony arm around my waist as I shuffle an elderly patient to the bathroom.  Of hugging the wife of the man who just passed away. Of rubbing lotion on the elderly patient with no family to visit, who winks at me as I leave as his way of expressing appreciation.

I miss it.  Literally speaking, I'm not going "home", as it is a new health system with people I do not know.  To ME, though...I am absolutely going back "home".  Home is where your heart is...isn't that what that cliche little plaque says that you can usually find for 25 cents at a garage sale?  It has so much truth, though.  I'm so read to go back.  Back to what I refer to as "home".

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