For My Mom Whom I Miss Dearly

[Swgfan]

My mother always raved about my writing and at one time I did have the ambition, but as life would have it, God had other plans for me. I do enjoy the occasional short story once in a while and as my wife is now in the final year of nursing school at NSU I am learning all about the specialties a nurse can enter into after graduation. One particular field of study that she was considering was Palliative care. Once I researched it to find out more I was honestly against the idea. I could imagine how heart wrenching it would be to go to work everyday and work with people who are dying. It takes a special person to do such a job and it inspired me to write a short story about such a profession.

I am trying to steer my wife towards anesthesiology At LSU upon graduation and she informed me this week that she is also considering Psychiatric Nursing as well. Either one would suit me far more than Palliative care, although I am sure it is a rewarding career for the right person.

Here is my short story dedicated to Mom, who always encouraged me to write. Hope you enjoy, and remember, all names, situations, etc are make believe and come only from my imagination of the profession.

I saw that look on Judys face again tonight, she is worried. Not about the kids or the rent payment, nor the bad tire on the car or the larger note on the boat we just purchased. No, she is worried about Mrs. Fuentes, a person not even related to our family and one that was virtually unknown to us 2 weeks ago.

It has now encompassed our lives it seems even though my wife tries to act like everything is ok and she forces that big smile when I look at her and asks me how my day went. We've seen this look in my wife before, in fact it happens many times throughout the year as she moves from patient to patient. It gets really bad when she juggles 2 at a time which is technically not supposed to happen but with shortages at hospitals and budget cuts it happens from time to time.

You see Mrs. Fuentes is a patient at the Hospice center where my wife works and my wife is the assigned RN or should I say ACHPN which stands for Advanced Care Hospice and Palliative Nurse. A designation she went back to school to earn and was so excited to recieve. We were excited too on that day as we had no idea on just how hard her life would be in the future. We actually thought life was getting easier now that all the schooling was finsihed and the money was gonna come pouring in.

Oh how we needed that extra money as we had 2 kids reaching the teenage years and getting into all sorts of activities that require extra money like football, dancing, baseball, and of course just going out with friends to the mall. Seems every time I turn around one of the kids has got their hand out, "I need $20 bucks dad for the movies", "I need $10 for a lab fee at school", "I need $75 for a field trip and $55 for new athletic shoes." I think you get the picture, we were relying on her boost in income to cover the gaps in life and hopefully make our lives better in the long run.

It's been a long day and my wife is out of the bathroom and ready for bed. A longer day tomorrow and I kiss her goodnight and reach to turn out the light. In the darkness I settle in under the warm covers and place my hand on her hips to give her a gentle caress and tell her I love her. I slip my arm around her and just hold her tight and wait for the sleep to envelop me but it doesn't happen.

I can feel her tension and I can tell something is bothering her as she keeps moving every minute or so like she is trying to get comfortable. She can't sleep and that makes me alert and sleepless as well. The thing is I need to sleep as I have 2 different construction jobs going on this week and I can't afford to botch either one. I'm already behind schedule on the Lalanne house and the Petermans offered me a bonus if I can get their bathroom finsihed by the weekend. A bonus we could definatly use with all the school loans and such.

But the mental state of my wife worries me more than anything as she is my soul mate and the reason I take every breath. She is the foundation of our household and keeps this band of pirates together and on the straight and narrow. Without her, chaos would ensue and we'd all fall apart. I'd be an empty shell just going through the daily motions. So it is important to me, to try and comfort her in anyway I can.

In the darkness I tell her I know something is wrong and she of course says it's nothing. Trying to hide her work from us and protect us from the gloomy environment she drives to everyday, but she should know we see it in her eyes when she gets home and we feel it in her unattentiveness. I ask her if it's Mrs. Fuentes again and she sighs a big long sigh and turns slowly over in my arms. She finally opens up and tells me about her day.

Mrs Fuentes is dying of course, as is all of her patients she is assigned to. Also, like many of her patients the family has a big involvement in what's going on and are usually at the hospital 24 hours a day. They have set visiting hours in the patient room but towards the end they move them to a special living facility where my wife works and the family are allowed to basically stay around the clock. They do limit 2 in the room at a time but that is a rule rarely enforced.

The problem isn't Mrs. Fuentes she explains, but her daughter and the stepdad. They don't like each other and they tend to get in arguements a lot which upsets the rest of the family there. It's got to the point where some of the family is now taking sides and it's very disturbing to the nurses and Doctors trying to care for the patient. The daughter thinks the stepfather who has only been married to Mrs Fuentes for 6 months, was so demanding and hard on her, that he drove her to the weakened physical state that she is in and thus caused her medical problems. Her stepfather is 20 years younger than her mom and she feels as if he only married her for her money.

Like every story there are two sides to this. The stepfather thinks that the daughter and other family members who had little contact with Mrs. Fuentes over the years, are only now coming around and taking an interest in her life because they are seeing dollar signs. It got so bad today that apparently the 2 divided groups of family started shouting as my wife was in the room trying to turn Mrs Fuentes on her side so she would be comfortable and not develop bed sores. They got loud and then started talking about getting lawyers involved and sueing each other. My wife who had been caring for this patient for 3 months had grown to really like her and been one of the last people to speak to her before she got so bad that she could not talk anymore. Mrs. Fuentes had told her many stories of her life and childhood and had always been nice to my wife when she entered the room. Even at times when my wife was coming in to take more blood or switch meds and Mrs. Fuentes was already feeling bad and knew it wasn't going to be pleasant. She still maintained a smile and and always had a kind word for her. The staff and nurses were amazed at her stoic spirit and will to fight all the way to the end.

Now, here these greedy and selfish family members were ignoring their sick loved one altogether and bickering right next to her bed. It was all my wife could take and she burst out and told them they ought to be ashamed of themselves. She went on to describe how she had cared for her for the last 3 months and she told them about her stories and how she said she loved her family. She described her will to fight and keep a smile on her face even as it got down to the end and she was losing her ability to function. She told them even though she could not speak she might be able to still hear them fighting. It shamed the family of course and they stopped and looked guilty. Several shuffled out of the room and my wife went about her duties.

Later that day, she got called to the Director of Nurses office, but she thought it was just something routine. Although when she got there, she found not only the head nurse there but the Doctor assigned to Mrs Fuentes, the Physcologist on the Palliative care team, and the Grief Counselor. It immediately occured to her that something was wrong, and that was confirmed as the Doctor asked her to have a seat and she saw in his hands her personell file. She was then informed that a couple of the family members had lodged a complaint against her. Basically saying that she had screamed at them and interrupted them as they discussed family business. They asked to have her removed from caring for their loved one and went so far as to ask if there was a procedure for lodging a formal complaint.

This complaint was to be reviewed by the team assembled here and she was being given a chance to explain herself. She told them exactly what had been going on and the reason she finally was pushed to say something that day. She insisted that she cared for Mrs. Fuentes and had only her best interests at heart. In the end however, she was somewhat scolded by the Head Nurse and Doctor and informed that her job was to care for the patient and adhere to the familys needs, but to never ever give an opinion on their ideas or problems. If she thought they were being unruly or putting undue stress upon the patient then she should have gone to her supervisor and let them know. This way the decision on how to proceed from that point would not have come back on her shoulders as it is now. A formal complaint had been lodged and they had no choice but to put a copy in her file along with their findings and disciplinary actions.

They wrote in the complaint that they did not think she acted with any malice or ill will towards the family or the patient, but that she did fail to notify supervisors or the care team as to any potential problems. As a result she was also being re-assigned to another patient at the far end of the floor to prevent as much as possible any future contact with Mrs Fuentes or her family.

My wife is one of the most loveable souls you'll ever meet and this crushed her spirit and broke her heart. She truly cares for these patients and wants nothing but the best for them as they take their last journey in this life and go on to the next. She really felt that the family was out of line but in the end it came back to bite her because she was the only person brave enough to say something. Other nurses, techs, and staff had come into the room from time to time and observed the same things but no one had a backbone to take up for the patient.

Sadly this is just one bump in the long road with the career my wife chose. This is not the first time a family has gotten her upset with their selfishness and lack of caring for their own family member but it is the first and probably the last time she will ever stand up and say anything about it. I hold her tightly in my arms and kiss her on the forehead and I tell her, that I think she did the right thing, no matter what the Doctor and Head nurse said. I was proud of her for standing up for this dying lady, that I personally have never even met, but I had learned to care for through the stories she told my wife and her repeating them to me late at night as we lay in bed.

She meets her new patient in the morning, a Mr Jack Eland, 57 years old, and in the late stages of brain cancer, according to the file she was given this afternoon to read over. As I kiss her goodnight and tell her everything will be o.k. and how tomorrow will be a better day, I turn over and wonder what Mr. Elands family will be like and what stories he will tell my wife of his life, before he loses his ability to speak. I guess I'll find out soon enough, and before I drift off to sleep I say a silent prayer for my wife and I also ask God to watch over Mrs. Fuentes as she comes to join him soon.

[HouTx, BSN, MSN, EdD]

You have a wonderful talent, but I think you may be missing the mark on Palliative care. Nurses (and other health care professionals) who choose to devote their careers to end-of-life care are not caught up in the sadness of death. Instead, they ensure that their terminally ill patients are able to 'live' the totality of their lives rather than allowing their remaining time to be consumed with the demands of futile care. These nurses are some of the most fearless, funny, positive and optimistic of our colleagues and have a profound effect upon the patients and families with which they work.

In the words of Jim Morrison, "No one gets out of here alive". My hope for all of us - a great palliative care or hospice nurse will be there to advocate for us when we need one.

[roser13, ASN, RN]

" Once I researched it to find out more I was honestly against the idea. I could imagine how heart wrenching it would be to go to work everyday and work with people who are dying. It takes a special person to do such a job and it inspired me to write a short story about such a profession.

I am trying to steer my wife towards anesthesiology At LSU upon graduation and she informed me this week that she is also considering Psychiatric Nursing as well. Either one would suit me far more than Palliative care, although I am sure it is a rewarding career for the right person."

FWIW, you might consider encouraging your wife to make her own decision about what suits her. It is not your career but hers, about which you are expressing your opinions and "trying to steer."

After all, who are you to say that your wife is not the "right person" for the rewarding Palliative career? Perhaps you could be inspired to support your wife's choice and not just inspired to write a story.

[nurseprnRN, BSN, RN]

Good writing, but assumes facts not in evidence but which are erroneously accepted as fact by many lay people. :) Hospice and palliative care are not about death, they are about life. The nurses there do not go around with grey clouds over their heads all the time-- most are the happiest, most alive people I know.

You need to spend some time talking with real, not hypothetical, hospice nurses to get a better idea.

Oh, and it totally doesn't matter what "suits you." Unless you have a deal with her that she gets to tell you how to live your life and work your profession, you don't get to take over that responsibility for hers.

[FieryPsychRN, BSN]

Well written, and I know your Mom is proud of you. It sounds like you care for your wife very much, and I understand we as nurses carry our work with us in our hearts, which sometimes reveals itself on our faces, in our actions, etc. It is hard for our families to see us this way. However, your wife does need to have autonomy to choose the field she would like to pursue. The great thing about nursing is if she doesn't feel it is a good fit for her, she can move on to something else. Palliative care and hospice nursing is a specialty that can be rewarding, but not all nurses are meant to be in that field. The key is for you to be as supportive as possible to your wife. If she doesn't pursue it because of your apprehension she will always wonder. I think we are called to be nurses, and once we find our niche it is that much more rewarding. It is those like Mrs. Fuentes out there that touch our hearts in a way that remind us why we chose to become nurses in the first place.

Best of luck to you and your wife!

[chopwood carrywater]

My experience as a hospice nurse has been rewarding beyond measure. As several posts have stated, there is a great deal of joy to be found in this job. There are so many moments of meaningful interactions between pts, families, and friends. Yes, there have been a few 'Jerry springer moments' but it worked out okay, and they are far outweighed by the rest.

I think one reason for the saying 'hospice nursing isn't for everyone' is that in this country, so many people are removed from death and dying; we don't know what or how to talk with the dying and their families. One does not become cursed when 'exposed' to the dying.

There is laughter and love and tears too; but they all have meaningfulness behind them.

If your wife does get a job as a hospice nurse, I hope you will be supportive and I also hope that you too will gain insight into what hospice is about.

[nurseprnRN, BSN, RN]

Hey, OP, whatever happened with your wife's job search?

[TammyG]

There are several factual errors in your story, which is wonderfully written but does not describe a realistic hospice setting. (Getting asked by a family to be removed from a patient's care, for example, wouldn't even raise an eyebrow among the supervising nurse. Moreover, it would take an act of God to get the doctor, psychologist and grief counselor in the same room.) Like others who responded, I do not find hospice work depressing at all but rather very uplifting that I could help a family have a good death.

And I too want to know what your wife decided!

[Swgfan]

Hey all, my wife graduates in August!! Only about 4 months left and she is still undecided but she is getting closer to a decision. She is considering working ICU or Med/Surge for the first year. If she goes back to college to specialize, we noticed a lot of schools prefer at least a year of experience in one of those areas.

Also rest assured I am NOT gonna push her into any direction, I took your advice and will let her decide. After all, I'm not the one who has to go to work in that profession every day. I fully love and support my wife in all that she does and I always will. I'm still not keen on the palliative care profession as I've seen a lot of death already in my lifetime and I personally have problems with dealing with it so I try to avoid those situations. My wife is made of a different substance so she has always been able to handle it better. In fact she feels good when she helps someone who is sick and dying and knows in her heart that she is giving them some level of comfort.

She has also been talking lately about working at a VA hospital for the first year. She is gonna do some rotations there during her final semester and see if she likes it. They have some good benefits and we do plan on moving away from Louisiana eventually so with the VA, she'd have the ability to transfer to any other VA in the country as long as they have an opening and there are a lot of VA hospitals. About 1700 of them I think I read, lol

I'll let you know what she decides soon, I told her with only 4 moths left, she really needs to think it over but I also told her she could just work in a hospital for a year and then see what she wants to specialize in.

Also, on one other note, I know my story was not factually correct but it wasn't really meant to be. It's just my imagination running wild that I jot down. I'll keep you informed, she's graduating from Northwestern here in Louisiana!!

[roser13, ASN, RN]

" I took your advice and will let her decide"

I hope, for the sake of your marriage, that you apply this principle to every aspect of your life and your marriage. No doubt you will continue to struggle with your control issues, but it is good that you are aware of the issues and are working to correct them.

[Nascar nurse, ASN, RN]

Depending on your location, you both may be very sad to find that she will end up taking the job she can actually find as opposed to some specialty that she decides she wants. It's a pretty rare situation these days for a new grad to just decide she wants to be in a certain specialty and then actually get hired in that department.

As a side note, I have been a nurse since 1986. I have been a hospice nurse since August 2013. In all of my nursing career, I have never felt like more of a nurse or felt like I have made more of a REAL difference in people's lives than I have in the past several months. I'm so sad that it took me all of these years to discover the real reason I entered this profession at the young age of 19.

You're correct, these patients as well as their families make a tremendous impact on my life - as well as I do in theirs. There are sad moments but there is much more love and laughter. To be accepted by these family members & patients in their greatest time of grief, to have their respect and to have the ability to sooth some of the physician and emotional pain is the greatest feeling of satisfaction. It's a REAL difference & I get to do it every day.

I recently had my 47th birthday. My first birthday since becoming a hospice nurse. My younger brother began the usual teasing about my age. I smiled and said I was a lot smarter this year. I now really understand how precious each birthday is and how every year (every day) above ground is a gift. I love & cherish life. I'm certainly not walking around in a funk...I've got far to much to accomplish before I need a hospice nurse.