just a vent
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Okay, so I spent one shift with this fella who's dying. I love palliative care; it's like ER to me, a vacation. I don't think I could do it every day but it's enjoyable.
What I enjoy is the hands-on care, the little "common sense" things you do for the drowning chf'er, that help make them comfortable, and the family education. In a lot of cases it's possible to help both the family and the patient have a better experience by the time the patient dies. Plus it's nice that you have another small group of people out there who have a better understanding of nursing's role in palliative care.
So the patient's daughter is what my coworkers call "high maintenance," and what I see as common in the situation of watching one's parent die. Anxious, weepy, terrified of the term "hospice," afraid to touch or speak to the patient, totally out of her element. So by the end of my shift she has had some intensive education, and she's doing his mouth care, putting lotion on his arms, talking to him, etc. Woot!
Night two, still in our unit, much the same, different nurse though. We frequently shift assignments if it's emotionally draining. Night three, official withdrawal of pressors (he was already a DNR, sometimes things happen backwards), and a trip to medsurg to see what happens. His nurse tells me the daughter's driving her bananas. On my only break, I stick my head in his door to see how he's doing.
I've heard how he is, of course, and I agree with the other nurses. His lungs are about gone and he's going to go into his agonal breathing soon. But the rattle is gone, the grimace is gone, he's looking peaceful, and it's the most serene I've seen him. It's that nice place where he's not in pain but can probably still hear us, so this is the time when family, if they haven't already done so, can spend some good time with their loved one. What I'm seeing is a successful journey so far.
Then the daughter looks up and says, "I thought they were going to give him morphine." I tell her it's scheduled, the nurse will bring it on time, no problem. "Well I just wish he would hurry up and go. Can't we give it to him a little early?" The tone of voice from her is edgy and impatient. I thought, "who are you? Didn't I already explain all this to you?" I told her that he's not in pain, and he can hear you, so please just spend some time with him.
It would be nice if I don't ever see that woman again, it really would.