Geriatric Lovers: Loss and the Nursing Intervention

SandandSandwiches, BSN, RN

My first job out of nursing school was at a long term care facility. It wasn't my ideal situation, in fact the ten-years-ago I would have never saw it coming. While I knew some of my classmates were holding out for that perfect job in labor and delivery, gracefully bringing new life into the world, here I was on the opposite end of the spectrum. I saw people at their hardest points in life, I watched people take their last breath, I spent Christmas night with people who'd otherwise be completely alone. It was hard, but as a new grad I needed experience, any experience because it wasn't easy to come by.

In that first year of employment, some days were smooth and other days were filled with unpredictable chaos, but one thing was always predictable reliable, and that was Bill and Sandy. Every day around 2pm as I entered the facility, mentally preparing for the shift ahead of me, I could always count on seeing the two wheelchairs, linked by hands. Sometimes you could stand by and hear the flirtation and giggles. It would remind you of your first love.

"You're pretty." He would say.

"Oh shut up" she always retorted with sass.

In the new employee orientation, we even had a special segment by the social worker dedicated to the two intermingling.

"Both of them have real spouses at home, and so you must keep an eye on them. If any family is coming to visit please separate them, and we don't let it ever go beyond hand holding."

Sometimes their flirtation got a little hot and heavy, causing me to blush and carry on. How awful I thought, to know that he is being unfaithful and had a wife at home. Though as the 50+ hour work weeks would come and pass I would see that his wife wasn't much in the picture. It seemed that she had a busy life that didn't involve Bill. Maybe it was because she knew about Sandy and that put her off, the reason remained a mystery but the one obvious fact was that Bill and Sandy were very much in love.

Maybe it was wrong, but when your life is in a facility, you would never be against two people bringing joy into each other's lives daily. So as the sun rose and the moon fell, Bill would be next to Sandy unless sleeping hours had struck. It was an everyday occurence to see them together at meals. But one day, I only saw Sandy sitting alone in the cafeteria.

"Where's Bill?" I asked my aide.

"Bill didn't wanna get up today, he seems really tired."

Hmm that's unusual, I thought. I popped into his room and he drowsily greeted me. His vital signs were normal, and so I carried out the rest of my hefty medication pass, sending the aide in to feed him dinner in his room.

A couple hours had passed as I made my evening rounds. I always hated night time meds, it meant waking up 20-30 elderly patients out of their beauty sleep to talk them into swallowing pills, usually always unpleasant and unwelcomed as you can imagine.

I was about halfway through the pass when Bill's aide came running down the hall towards me and I knew something was wrong.

"I got him up for the restroom and he collapsed, he's really out of breath and dizzy, his blood pressure is 180/100. His words are jumbled-"

With what felt like only seconds of an assessment I knew something wasn't right. It was so uncharacteristic of him to pass up a dinner date with Sandy.

"Send him out immediately" the doctor said via returned page. Sending out is nursing home terms for call the ambulance and have them handle it because this is serious. As I stapled together all necessary paperwork to hand off to the EMT, I checked on Bill who had his aide nearby for support.

"Bill, the ambulance is on it's way okay?" And usually defiant to any sort of fuss he replied "ok" shakily with obvious fear in his voice.

His roommate, an amputee sat up out of his sleep confused by the commotion, their beds only divided by a thin blue curtain.

As my heart felt its usual raciness in times of stress I couldn't help but think about Sandy. They always mentioned in school the "nurse's instinct". It was something, though new to me, that I was starting to develop. My nurse's instinct was proving itself right more often and I something inside told me that Bill would not be coming back. I thought about Sandy rushing out of bed the next morning, putting on too much rouge to meet Bill for breakfast and him not being there and us having to explain something and though she was old as hell she was sharp as a tack. That's when I made a split decision.

"Sandy. Wake up." I helped transfer her into her chair.

"What is this about! ?" She said with her always present attitude. I pulled her silk nighty over her legs. "You need to say goodbye"

And no further questions were asked as the staff far down the hall looked at me puzzled. I squeezed Sandy in her wheelchair to his bedside and went against all patient fraternization rules, nurse professionalism rules and scantily dressed patients being in the opposite sex room rules. Maybe this was too much, and highly inappropriate, I thought, but it felt like the right thing to do. So I rolled her to his bedside, and gave enough privacy to still be near enough to hear:

"I love you Sandy"

"Oh shut up" she said and gave him a single kiss on the hand.

I tried to keep it together. This reminded me of a scene from the Notebook or some equally heart wrenching romance flick. Only this love was real. I gave them a few more minutes together and before the paramedics arrived I had Sandy back comfortably in bed.

The "nurses instinct" proved right once more, and Bill didn't come back. He died the following morning of multiple organ failure. It was fast and unsettling, but I felt that I did my job in having his nursing home mistress there to see him off.

It took a while to get used to not seeing them together. She never once mentioned him to me, and I never brought him up to her. I was never mandated for what I did that night. I'm pretty sure no one of authority knows about it. Eventually his bed was filled with another elderly gentleman and we moved on with our lives. The nursing home was cold in that way. One trauma to another all fading into a distant memory.

So often in nursing we are bombarded with rules and beaurocracy and paperwork. So much that even the sweetest of souls becomes tired and desensitized. We need to take ourselves back, mentally to the initial drive and purpose of what our jobs are. The compassion part. We must follow the strict guidelines but every so often our heart makes an exception to the rules.

Geriatric Lovers: Loss and the Nursing Intervention

About SandandSandwiches, BSN, RN

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