Nursing the End of a Leash

Nursing extends to much more than merely pushing medications and providing education. It is can be easy to forget that there is so much more to what we do. Nursing includes being genuinely present--supplying a soothing balm to both body and soul. Being human is not a job requirement.

"Would you like a visit?"

You appear doubtful, hesitant and wounded on a level much deeper than physical as you, with quivering hands which flit like nervous birds, gather your blankets tighter around you and momentarily over your hair, tucking a few lose strands back.

You nod.

Your naked vulnerability is nothing new to me--I have seen a similar state in countless others. With but a moment I can sense your hurt. With but one snuffling huff I know all there is about the wound on your side, the medications dripping through your IV, the age of your NG tube and the state of your External Fixator. Your body language telegraphs a steady message of anxiety, despair, and pain pain pain.

But I am not here to judge.

My partner helps me settle on the bed next to you and offers you my business card. As you glance over the laminated cardstock, I nudge a little closer and you obligingly bring your arm up and around me, pulling me just that much tighter to you. For one moment we both sigh, content, before you thread one hand, no longer trembling, through my hair to fondle at one ear.

We sit in quiet. It is not my place to talk anyway. It is my job to be still, be present, and to listen.

You do not disappoint. After a few moments lost in a companionable hush, you pat my cheek to reassure me of your attention and doting before you begin to speak.

"I had one just like you. She was a bit smaller, though," you chuckle at the memory, your eyes going sad for a moment, ignoring my small look of exasperation at the comparison. It's not my fault I look this way. My body is much smaller than my covering gives me credit. "She was smart like you too. Beautiful." A fond sigh. I cock my head and regard you with pleased silence. Compliments always have a special place in my heart. "Are you always this calm and quiet?" I shake my head and nuzzle a little closer in answer, hoping my response coaxes you on. I'm relieved when you resume carding your fingers through my hair.

"You know, I'm all alone now. My children don't come to see me now that I'm out of the ICU. They have their own lives. And Ronnie...." A sob takes your voice as you curl closer. Your hand no longer caresses but clings. I don't mind it. "Ronnie's gone. My Ronnie is gone." Breathed into the crown of my head as a terrible, whispering secret. "I never got to say goodbye or I love you..." The nightmare of your heartbreak steeps into my hair with your tears. I close my eyes and lean, struggling to shoulder the weight of this burden, to ease it from you for just one moment so you may rest, so you may smile, so you may hope. In spite of my small size and compact body, I am much stronger than I appear.

It is a strange moment, the moment of spiritual transference when one's pain becomes shared and it can be overwhelming, stifling. But then your hand moves once more, patting, soothing, brought back to life and action as the tears begin to wane as you realize you are not quite so alone. I raise my face, offering up one of the few consolations I have as I dab your tears from your cheeks with my nose and am rewarded with a hesitant, watery smile and a weak laugh. We lock eyes and, keeping with my code of silence, I will you to see the truth.

Ronnie knows. He misses you. He loved you too. Smile. Heal. Resume.

You nod and bend to kiss my nose but I am determined you understand that this is not your moment to give love, but to receive it, without judgment, without desire for reciprocation, so it is I that kiss your nose.

I'm not a great kisser-- they tend to be a little slobbery, but you don't seem to mind.

You smile and resume your petting with greater enthusiasm, heartache temporarily forgotten. For the first time, I sense something different in your touch--perhaps it is the real you finally peeking through. You tickle my feet and quietly laugh as I tumble onto my back to offer my belly which you immediately scratch and pat. From nearby, my partner signals amusement as well as the warning that our time is drawing to a close.

Offering one last nuzzle and a lopsided smile, I allow my partner to guide me off the bed just as the nurse comes in to offer you more pain medication and something for anxiety. Your confident, calm decline of both makes my tail wag and as my partner taps a coded line of pleased praise with her fingertips along my leash, we respectfully take our leave.

From in the hall, we hear you call out to thank us not realizing that your smile and your time were thanks enough.

~~From the desk of Kid~~

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

Absolutely, the staff and handler benefit greatly. Before Kid worked to heal others, she first healed me. P.S. To those who asked, yes you may, of course, share any of my ramblings in any way you choose. It is always an honor and a pleasure.

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

Thank you CP well written and just so beautiful.xo

LOVED THIS!!! Yes, yes, animals are wonderful therapy!! My beloved border collie, is a wonderful therapy dog of sorts, as my paralyzed sister is in an ECF, which allows pets to visit.

so Buddy always comes with me, and he is most marvelous, allowing absolutely everyone to pet him and fawn over him, as we wind through the halls to my sister's room. We stop and visit all the people in their wheelchairs lining the hallway, and i always bring small treats that they can feed to Buddy.

Buddy even does tricks for them, which they all love and marvel over. (he has a pretty extensive repertoire of doggie tricks, hee hee)

and when we get to my sister's room, she LOVES seeing my Buddy. She lights up and becomes much more animated, alive. She can still move her hands a bit,

but usually gives up. BUT, when it comes to feeding Buddy treats, oh, she stays at it, and succeeds at picking up the treat, and handing it over to Buddy,

who somehow seems to sense, he must be very very patient for my sister to get him the treat, and takes it ever so gently from her.

Eventually, others who'd been in the hallway, meander in, to see the dog, which makes my sister feel popular, and increases her chances to socialize more.

great therapy, in many ways. THANKS FOR POSTING THIS, CHEESEPOTATO!!!

EDIT-----MANY ECFs ALLOW DOGS TO VISIT,

so if you have a loved one in an ECF, and if you have a very calm natured dog who TRULY loves and enjoys strangers of all types fawning over him, and can happily tolerate odd noises, odd gaits, odd smells, and being touched all over and loud talking humans,

(NOT all dogs do enjoy this)

then you might consider bringing along your dog to your next visit to your loved ones ECF. (if that facility does allow it and IF you know for a fact, that your dog DOES actually love all types of strangers touching him everywhere, etc)

I have worked at one facility that have specific pet visitation for the general population. I had an order once that stated...."Dog to visit stat!".....:D

When I could walk......I did pet visitation with my beautiful weimy. She was a huge hit at Childrens...... I do miss it.

Love it. Pet therapy is an awesome thing; but you have to "vet" (no pun intended) the dogs and the owners. There's a good deal of investment of time and energy into getting the required certification. (The Childrens Hospitals I know have very serious requirements.) I image any kind of facility would--lawsuits you know.

But it's a great idea. We just brought one of our dogs to see a dying relative, and he was so comforted and couldn't stop talking about her.

Dog to vist stat is GREAT.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I was owner and handler of a licensed therapy dog for 12 years. He was a big, brindled, boxer/hound mix. He passed away in 2009 after many years of service to SNF residents & kids with cancer. He was SO calm and SO quiet, one of my friends nicknamed him "Coma." He often fell asleep in patient's beds or on top of their feet. Nothing fazed him - seizures, call lights, code alarms, children trying to ride him or pull his tail, demented residents yelling, med carts rolling. He was absolutely calm and affectionate, always, and happy to lick away tears or put a paw on a shaky leg. Losing him soured me on owning another dog for a long time. Thank you for writing this. It's raining on my face.

I am so sorry for you loss. When my other dog died.....I was heartbroken....devastated. I did search and rescue, all over the country, with her......she was my best, my only, true friend.

It took me about 5 years to get another dog.......

Then came my "high energy breed dog" that everybody warned me about, my Weimaraner (pictured), who is referred to as Velcro dog and couch potato who mended my broken heart. She was the biggest hit for the children as the "Sesame Street dog".......I now have an auto-immune muscle disease......now she is my right hand girl and happily helps me around the house.

Someday you will love again.....it will be good for you. ((BIG HUGS))

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Love it. Pet therapy is an awesome thing; but you have to "vet" (no pun intended) the dogs and the owners. There's a good deal of investment of time and energy into getting the required certification. (The Childrens Hospitals I know have very serious requirements.) I image any kind of facility would--lawsuits you know.

But it's a great idea. We just brought one of our dogs to see a dying relative, and he was so comforted and couldn't stop talking about her.

Dog to visit stat is GREAT.

we actually had pet visitation hours. 10am til 2 PM and 4pm to 6pm.....on the weekends and 4-6pm during the weekdays. We had stricter rules about Peds and of course they weren't allowed in certain areas like the OR, PACU, NICU and special places were provided for those unusual pets like birds and reptiles. Plus the usual door closed on a leash.....I had to see them if it was the first visit (thank goodness I love animals) They had to have proof of vaccinations, be clean, be approved by the sup (me) ....blah, blah, blah.....get a "pass" ........extra work but worth it. I loved rounding on all the pets. I really miss that place....sigh.

The stat order was because it "wasn't pet visiting hours" and the patient wanted to see the pet (no one called and asked me of course) the Doc called raising Cain when I said....I never said the dog couldn't come........so the pet visited stat. I loved working

My best story however was having a Fallabella Pony (miniature horse) come see a patient....but that was another facility.

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

The loving bond with a pet is one that is irreplaceable, without argument. The bond formed with a service animal is nearly indescribable as it involves such a close working bond and hours upon hours of training and working together to learn and grow as a team. Every success and failure is shared. To lose that bond is devastating. To those that have felt such a connection and suffered its loss, my deepest sympathies.

The local hospice has a big yellow cat that owns the place. He visits everyone and keeps them all company prn. Yes, he seems to know when someone is about to die, and spends special time with them then. Gotta love it.

CP, you usually make me giggle and laugh with your articles and posts (in a good way!) but this one brought tears to my eyes (in a good way!).

My LTC has a facility 'pet'. We rescued him from a local kill shelter. He is the most loving, sweet dog ever! He patrols the halls looking for a wrinkled, shaky hand to pet his soft smooth coat or an arthritic leg to rest his block head on in turn acting as a heating pad for that painful joint. He's been smacked by demented pts, has had things thrown at him (and occasional his been hit by it), had his tail run over by wheelchairs, scooters and yes, I have to admit..a med cart :( (that was me) and never once uttered a sound, never growled, snippped or made an indication he was going to hurt someone. When he's had enough or he feels the residents have had enough of him, he goes to the elevator door and lets out a yip. We push the button for him...press both 1 and ground..and from there he takes his ride to the floor of his choosing. He has been our 'security' when a few visitors became unruly, he's been 'attacked' and hurt by visiting dogs who are far, far smaller than he, and his been the 'safe' place a nurse can bury her face when the tears come due to a much loved residents passing.

Did I mention, our facility dog is a Pit mix? ;) And he was attacked and badly hurt by a visitors little fee-fee yip-yap lap dog! Our boy is a good hearted kind old soul..a former 'bait dog' with many a scar to prove it. Luckily for him he didn't have a mean bone in his body and didn't do well in his former life so he was dumped off and abandoned. He tucks his tail between his legs and cowers when an aggressive dog comes to him, or if he hears voices raised in anger. Again, never showing any indications of aggression.

He's much older than we were lead to believe (per the vet) and has some hip and leg arthritis, he's slowing down these days and needs occasional shots of cortisone for the pain, his face is almost as grey now as the resident's heads...and sadly I think the time will approach soon that we will have to 'retire' him from the facility and give him to the ADON, who has offered to be his 2nd forever home until its his time to go to his 'final' eternal home.

Thank you for this beautiful piece!

"Dictated but not read"...really? :lol2: