Just Another Statistic

....is what the number-crunchers will call it. Just another 80-something female who had a ground-level fall and fractured a hip, came out of surgery worse than when she went in, and then transferred to a skilled facility for rehab. What no one knew at the time is that this was the beginning of the end for a noble lady, loved by all who had the privilege of knowing her. She was my co-worker's Grandma, and she was one of my favorite residents. Nurse Forums Announcements Archive Article

Just Another Statistic

It had been a good weekend, full of sunshine, relaxation, great food, and even better companionship, and I was still in a cheery mood when I walked through the door at work this morning. In fact, I was even whistling as I put my lunch in the refrigerator and nosed around the break room for stray notes with resident names or room numbers on them, which is a write-up for the offender if I find one. Satisfied that there were no potential HIPAA violations afoot, I proceeded to the med room, which is almost always my first stop of the day.

Then I saw the stack of pill cards on the counter next to an empty chart and my heart plummeted into the depths of my stomach, for it could only mean one thing.

Ellie* was gone.

As I looked through the chart notes describing the manner and time of death, I wondered stupidly why I hadn't gotten a phone call when she passed. The staff ALWAYS calls me when a resident dies, no matter what the hour, because they know I want to know. Our night shift med aide is new, however, and I made a mental note to speak to her about it at our next staff meeting.

I'd known things were going to go badly for Ellie the instant I laid eyes on her, as she was being settled into bed by the hospice nurse and aide. You can't be in this business as long as I have without knowing the "look".....unless, of course, you are related to the patient. And all it took was one glance at my friend and co-worker, Hanali*, to know that she had no idea whatsoever that her grandmother was literally at death's door.

They say that love is blind, and never was it more true than of Hanali that morning. She's worked in assisted living for years and seen many residents off on their final journeys, but she didn't see the gray lips, the sunken eyes, the labored respirations. She didn't see the furrowed brow or hear the tremor in Ellie's weak voice as she tried to follow Hanali's animated chatter. All she saw was the grandmother she had loved all her life, the woman who had nurtured her when her own mother couldn't, the "Grammy" who treasured their weekly outings and visits from her large family more than anything.

No, Hanali never saw how ill Ellie was until last Friday evening, when she took a sudden nosedive and began the active dying process. It was with a heavy heart that I noted the blueish cast to Ellie's nail beds......the cognac-colored urine in her Foley.....the obtundation. Hanali was officially on vacation, but when I called to update her on Ellie's declining condition, she was at the facility almost before we hung up the phone.

That was when she finally saw the truth in Ellie's heavy-lidded eyes: death was on its way, and there was no bargaining with it or delaying it. The only question was when......and as Hanali wept, it was all I could do not to break down right beside her, for Ellie was one of my favorites and I knew when I walked out of that room that I'd never see her again.

You know how you just know this stuff? This was one of those times I wish I didn't. Because in the end, Ellie will wind up as just another statistic: the one out of five women who die within a year of fracturing a hip. Who she was to the people who cared about her won't matter to the people who collect those numbers, let alone the state's medical assistance program that just paid out thousands upon thousands of dollars for her surgery, anesthesia, hospital and rehab stays, medications and so on. A pathetic end to a life that was so well lived.

But I don't care about any of that right now. I'm too tired and too sad to allow my emotions to wander along paths better left unexplored. Maybe I'll be more rational about all of this tomorrow, or the next day. But tonight, a much-loved resident is gone and my dear friend is hurting.....and statistics be damned.

*names changed to protect privacy

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VivaLasViejas

About VivaLasViejas, ASN, RN

Long Term Care Columnist / Guide

I'm a Registered Nurse and writer who, in better times, has enjoyed a busy and varied career which includes stints as a Med/Surg floor nurse, a director of nursing, a nurse consultant, and an assistant administrator. And when I'm not working as a nurse, I'm writing about nursing right here at allnurses.com and putting together the chapters for a future book about---what else?---nursing.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Viva Las Viejas - I've been so sensitive about stories like this since my mother died two years ago that I've avoided reading them. Something prompted me to read this one,though. I'm so glad I did. It reminds me of the kinship of grief that binds us together as fellow human beings, whether we are nominally placed in the role of a professional, a friend, a family member or some sort of mosaic of all of that, and while it's sad, it's comforting to read through your words that you truly understand.

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Specializes in Sleep medicine,Floor nursing, OR, Trauma.

Dear Viva--

I am so sorry you are hurting and heart-weary. Sadly, there are no words to soothe this ache...nothing I can offer to act as balm or virtual hug.

But know that your empathy, your powerful heart, make you an amazing advocate, nurse, friend.

This too shall pass.

Kindest regards,

~~CP~~

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Specializes in Medical Oncology, Alzheimer/dementia.

I worked in LTC for 6 years. This is familiar and touching. You have a beautiful way with words.

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Beautiful, Viva. Deeply personal and an experience that is certainly unique to nursing, told in the fluent tongue of an excellent nurse and human being. Many thanks for this one, my friend. I think we can all relate.

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Specializes in Corrections.

Well written. The comment about the "writeups" puts a hard edge on an otherwise heartfelt story, IMO. I don't mean to sound obnoxious, but it jostled me a bit. And are we required to add APA citations after we post? Just curious.

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

No, we don't have do that unless we're using outside resources, which we don't usually do for articles like this one. :)

You know, I thought about the write-up comment after I posted this story and realized it did sound pretty hard-nosed. We have a big problem with the staff leaving notes and 'brain' sheets lying around that contain sensitive information, and I've had to come down on a few repeat offenders. But I don't actually look for trouble, and I HATE writing people up so I don't do it very often.

That said, I wrote this in about 45 minutes out of raw emotion and sorrow, so it's a little rough around the edges and I didn't give it my usual polish. Thank you for your comments.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

:hug: Beautiful Viva as usual. I took the looking for brain sheets description as how you start your day. As managers we realize that sometimes our jobs aren't pleasant and it is necessary sometimes to make the staff realize the seriousness that their compliance is necessary.

But in the typical mundane routine your heartfelt sorrow at the loss of this resident reminds me why we became nurses to begin with.....thanks for another heart felt personal experience to eh=enhance our lives.

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Specializes in Corrections.

Please don't apologize for writing from the heart....some of my best work comes from the same place. You have a powerful writing style, and I appreciated reading it.

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Specializes in Certified Med/Surg tele, and other stuff.

(((hugs)))

QUOTE=VivaLasViejas;6935861]It had been a good weekend, full of sunshine, relaxation, great food, and even better companionship, and I was still in a cheery mood when I walked through the door at work this morning. In fact, I was even whistling as I put my lunch in the refrigerator and nosed around the break room for stray notes with resident names or room numbers on them, which is a write-up for the offender if I find one. Satisfied that there were no potential HIPAA violations afoot, I proceeded to the med room, which is almost always my first stop of the day.

Then I saw the stack of pill cards on the counter next to an empty chart and my heart plummeted into the depths of my stomach, for it could only mean one thing.

Ellie* was gone.

As I looked through the chart notes describing the manner and time of death, I wondered stupidly why I hadn't gotten a phone call when she passed. The staff ALWAYS calls me when a resident dies, no matter what the hour, because they know I want to know. Our night shift med aide is new, however, and I made a mental note to speak to her about it at our next staff meeting.

I'd known things were going to go badly for Ellie the instant I laid eyes on her, as she was being settled into bed by the hospice nurse and aide. You can't be in this business as long as I have without knowing the "look".....unless, of course, you are related to the patient. And all it took was one glance at my friend and co-worker, Hanali*, to know that she had no idea whatsoever that her grandmother was literally at death's door.

They say that love is blind, and never was it more true than of Hanali that morning. She's worked in assisted living for years and seen many residents off on their final journeys, but she didn't see the gray lips, the sunken eyes, the labored respirations. She didn't see the furrowed brow or hear the tremor in Ellie's weak voice as she tried to follow Hanali's animated chatter. All she saw was the grandmother she had loved all her life, the woman who had nurtured her when her own mother couldn't, the "Grammy" who treasured their weekly outings and visits from her large family more than anything.

No, Hanali never saw how ill Ellie was until last Friday evening, when she took a sudden nosedive and began the active dying process. It was with a heavy heart that I noted the blueish cast to Ellie's nail beds......the cognac-colored urine in her Foley.....the obtundation. Hanali was officially on vacation, but when I called to update her on Ellie's declining condition, she was at the facility almost before we hung up the phone.

That was when she finally saw the truth in Ellie's heavy-lidded eyes: death was on its way, and there was no bargaining with it or delaying it. The only question was when......and as Hanali wept, it was all I could do not to break down right beside her, for Ellie was one of my favorites and I knew when I walked out of that room that I'd never see her again.

You know how you just know this stuff? This was one of those times I wish I didn't. Because in the end, Ellie will wind up as just another statistic: the one out of five women who die within a year of fracturing a hip. Who she was to the people who cared about her won't matter to the people who collect those numbers, let alone the state's medical assistance program that just paid out thousands upon thousands of dollars for her surgery, anesthesia, hospital and rehab stays, medications and so on. A pathetic end to a life that was so well lived.

But I don't care about any of that right now. I'm too tired and too sad to allow my emotions to wander along paths better left unexplored. Maybe I'll be more rational about all of this tomorrow, or the next day. But tonight, a much-loved resident is gone and my dear friend is hurting.....and statistics be damned.

*names changed to protect privacy

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I'm gonna go cry now...♥

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Beautiful words.. I'm truely sorry for your loss.. My facility lost one of our most loved residents on my shift about a month ago.. I cried that whole day- ran into the bathroom, every time so I could collect myself and focus on my other 24 residents. Every staff member on that day walked in and paid their respects, I cried and held the family members as if they were my family, even the city fire department shows up to pay respects to a well loved retired fire fighter. I still think about him during mde pass (he was always one of my first on the shift), I'd ask him for a finger to check his 02 sat and he'd flip me the bird as a joke. All my some of the other nurses say you will get used to it and it'll get easier.. I'll learn and be prepares but I will always show emotion. I wish the best to you and the family. Take care!

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