Tears Trials and the Importance of an Open Heart

Sometimes we find ourselves in unexpected places doing things we never thought we'd do. It is like we make a rule in our head about who people are, how we are supposed to do things, and why we do the things we do. I love rules and when it came to my nursing career I had two I never intended to budge on. The first was that I would never let anyone see me cry and the second one was I would never practice as a hospice nurse, EVER. But then one day... Nurses Announcements Archive

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Specializes in Chief Nursing Officer.

The sky was a clear and bright blue as I turned the wheel of my truck onto the small dirt road. The trees were not yet turning from green to gold but the air held a smell of changing seasons. As I pulled through the circular drive a little lady with white hair piled in a curly bun and wearing a bright red gingham apron stepped out on the porch to greet me.

She was drying her hands on the bottom of her apron and coming down the wide steps toward me as I reached for my nursing bag and paperwork.

"Oh, you must be our nurse! We are so happy you're here!" I remember her saying. She reached me and engulfed me in a generous hug and I noticed she smelled of fresh coffee and pie.

As a hospice nurse, I'd never been greeted with such warmth and happiness. Usually, when people needed me they were grief-stricken, frightened, sometimes angry, and often overwhelmed. They counted on me to bring peace, compassion, wisdom, and relief. They saw me as a professional who could help them, but this soft and smiling grandmother had greeted me like a long-lost friend.

"Come in! Come in," she said with a wide smile as she looped her arm through mine and escorted me up the stairs and into their little farmhouse. The smell of still warm bread wafted through the air and with it I noticed a tinge of cherry pipe tobacco.

"Papa, look and see who I found!" She called, and around the corner came a tall lean man wearing faded but pressed denim overalls and a red flannel shirt. His hair was snowy white and his eyes a bright blue that crinkled at the corners as he smiled at me. Across his cheekbones and under his nose I noticed the clear tubing and the nasal cannula.He greeted me as warmly as his wife had and asked if I'd like some pie and coffee. Before I'd even had a chance to respond I was pointed to the table where a steaming cup of coffee had been set beside a slice of peach pie. I have to tell you that it was positively delectable! Sweet plump peaches suspended in a velvety filling. It was so good I closed my eyes as I took the first bite.

As we sat around their table and I got to know them I almost forgot why I was there. They, (let's call them Papa and Ma) had been married over sixty years and he had raised cattle and cotton his whole life. Before I'd even put my stethoscope to his chest they owned a large piece of my heart and I was a goner.

Over the course of the next several months, Papa's health seemed to improve. That often happens when hospice gets involved. I think it is an absolute tribute to what a positive difference we as nurses make in the lives of our patients. I remember walking through the door one day as they sat finishing their breakfast and Ma told me she was glad I was there because she needed help setting Papa straight that he could not go to town and have barbecue and take a drive to the lake!

I agreed that he should not be driving to which Papa informed me that their grandson had offered to do that. After a thorough assessment and a long conversation, I told him he was a hospice patient and not a hostage and I thought the outing might be good but suggested he choose one or the other to conserve his energy. A compromise was reached, I made arrangements for a portable oxygen concentrator, and his grandson picked up the barbecue for them to enjoy at home before taking a drive.

On another occasion, I'd walked in as they were having a conversation about what heaven was like. As I filled his pill box and checked on supplies I was soon roped into the debate. Ma spoke long and eloquently about flowers and golden streets and being greeted by loved ones long since missed. I still smile at the memory of her shining eyes and her rosy cheeks as she spoke with wonder and delight as to what she thought was waiting. Pa chewed on his empty pipe as he listened to all his wife had to say on the matter. (I'd insisted he give up his smoking of it with a long lecture of smoking and oxygen use). When she was done she sat back in her kitchen chair, cupping her coffee cup and wearing a satisfied smile.

Papa said he didn't necessarily disagree but that he certainly had his own idea! He stated simply and matter-of-factly that he thought right before it was time for you to "cross over," the heavens would roll back like a scroll and you'd hear the angels singing and you'd see "all of glory" revealed before your eyes. He told us that he felt sure he would "see the Lord" and in the "blink of an eye" he'd be there in heaven with him and that would be that. I realized when they were each done speaking that they were both looking straight at me to settle the matter! I don't recall exactly what I said but it was something akin to how I didn't know for sure but I knew one day the mystery would be solved.

My visits stretched from fall through winter and deep into the spring and one day, just as I knew she would, Ma called the answering servicing requesting they tell me to come right away. I was on call so I had clothes laid out just in case and in less than ten minutes I was on my way. As I arrived it seemed every light in the house was burning bright and Pa's sweet speckled mutt met me on the porch. He looked up at me with what seemed like solemn eyes. The "wap wap" of his tail was slow and soft instead of its usual happy and quick. Opening the wooden screen door I heard Ma's slippered footsteps coming down the hall. She motioned for me to come back to their bedroom where Pa lay silently and labored slightly for breath.

As I started my assessment I asked about level of pain and all the normal things any hospice nurse would ask. I noted the marked mottling of his skin from his knees to his toes and observed that his fingertips also bore a definite bluish tone. As I took care of his physical needs Ma asked me to pray for them and then she busied herself making a pot of coffee and rolling out biscuit dough. I stayed beside my much-loved patient, constantly assessing, constantly keeping watch for any discomfort or any need.

The house soon filled with sons and older grandchildren. One by one or a few at a time they came to the bedside of the man they all loved and respected deeply. Some wept quietly, some were stoic, all of them kissed his cheek or forehead or hand. I'd just finished a set of vital signs and knew his life on this side of heaven was about to come to a close so I stepped into the kitchen and motioned for Ma to come to the bedside. She and I had been sitting together for the last several hours and she'd just stepped out of the room to stretch her legs and refill her coffee cup.

Entering the room he seemed to be peacefully resting but when Ma reached to stroke his hand he began to whisper something over and over. She was leaned over as close as she could get and I watched a tear roll down her cheek as she told me she could not quite make out what he was saying. She moved over to suggest I lean in and as he repeated the words over and over it was hard for me to make sense of them too. Suddenly I realized what he was saying and as the recognition came my tears began to spill one after the other from my eyes.

"It's true," he whispered, "it's true, it's true, it's true..." the words came over and over.

"It's true," I said as I looked from him to Ma. She bent and rested her cheek on his and as her tears fell across both of their faces she said, "Heaven? It's true about heaven?" To which we both saw the corners of his mouth turn slightly up into a weak smile. After Papa's funeral, I made a stop to check in on Ma. She was doing well and of course, poured me a cup of coffee and cut me a slice of pie. We drank from our cups and she told me that she would be meeting with a realtor about maybe selling their land and how their oldest son wanted her to move closer to him. It was a good visit and afterward she walked me to the porch and as I turned to leave she asked me what I thought about Papa whispering about it being true over and over. She was wondering if I thought he was telling her, it's true-you were right, or did I think he was saying, It's true-he was right? I hugged her and smiled and told her that I didn't know but either way it sounded pretty wonderful.

So often it is easy to see our patients as a to-do list. We think of the IV that has to be restarted, the labs that must be drawn, the antibiotic that needs to be hung, and the dressing that needs to be changed. As nurses, our lists can seem endless and our work thankless. I know there have probably been more shifts where I felt that way rather than feeling a human to human connection.

I never wanted to be a hospice nurse. Babies and pediatrics and education are my nursing loves. My jam, as my millennial children would say. How I ended up in hospice is still kind of a mystery to me but the years I practiced in that specialty made me a better nurse and grew me as a person.

I've cried buckets of tears over my patients-young and old-but I never let it interfere with my first priority which was safe, compassionate, medical care. There is a fine line there, yes, but I urge you to never stop allowing yourself to be human. Keep an open mind to your area of practice or specialty and an open heart to your very human patients. Who knows, you might have a Papa and Ma just waiting for the touch of your hand and the knowledge you own to make their lives better.

1 Votes
Specializes in LTC, assisted living, med-surg, psych.

This story made my eyeballs all sweaty. I was never a hospice nurse, but I worked with hospice patients in long-term care settings and learned a great deal about end of life issues. I've seen people drift away in peace and comfort; I've also seen them staring with frightened eyes at sights I couldn't see. I even watched my own dear husband leave this earth, reaching out for me with his hand as he took his last breath. It was the most precious moment of my life.

You sound like the kind of nurse I would have wanted for him, and for anyone I care about (including me). Good job!

Specializes in Hospice.

Thank you for your article. I have found that I have received so much more from my patients than I have given them.

Specializes in Chief Nursing Officer.

Cardiacfreak, RN, and I bet you have given much more than you ever realized. I have no doubt you are such a blessing to your patients.

Thank you so much for taking the time to leave me a comment. It encourages me so much and I appreciate it more than you could know. :)

Specializes in Chief Nursing Officer.
This story made my eyeballs all sweaty. I was never a hospice nurse, but I worked with hospice patients in long-term care settings and learned a great deal about end of life issues. I've seen people drift away in peace and comfort; I've also seen them staring with frightened eyes at sights I couldn't see. I even watched my own dear husband leave this earth, reaching out for me with his hand as he took his last breath. It was the most precious moment of my life.

You sound like the kind of nurse I would have wanted for him, and for anyone I care about (including me). Good job!

I've read some things you've written and your words in the comment mean so very much to me. I cannot tell you what an honor it would have been to care for your precious husband and how reading how he reached for you absolutely touched my heart. What a wonderful gift that was. I cannot imagine how much you miss him.

Your encouragement means so much to me, VivaLasViejas, bless you and thank you truly.

Specializes in Family Nurse Practitioner.

"...never stop allowing yourself to be human." These are powerful words to live by for EVERYONE in healthcare. When I see that so many of our biggest challenges in healthcare today can be traced back to a fundamental denial or denigration of what it means to be human, it does my heart and soul an infinite world of good to read articles like this. Thank you for inspiring me today.

Specializes in Chief Nursing Officer.
"...never stop allowing yourself to be human." These are powerful words to live by for EVERYONE in healthcare. When I see that so many of our biggest challenges in healthcare today can be traced back to a fundamental denial or denigration of what it means to be human, it does my heart and soul an infinite world of good to read articles like this. Thank you for inspiring me today.

That means more to me than you could ever know. Thank you for your words of encouragement Lane.

Specializes in Psych (25 years), Medical (15 years).

JS McCabe, RN- here:

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Now: you give me a tissue!

Specializes in Chief Nursing Officer.

I appreciate that encouragement so much Davy Do, thank you, thank you, thank you, sir.

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

This is one of the best articles I have read in a long time. I have experienced such love for my patients that have been under my care and I have allowed myself to cry right along with the family as they are ushered out of this life and into life everlasting.

As nurses, we have an awesome responsibility and privilege to make a positive difference in the lives of patients and families that we care for in sometimes unexpected and almost unbearable life and death experiences. In certain situations, expressing genuine emotion can be a sincere way to provide emotional support. Sometimes.......nurses cry......

You are an amazing writer.

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