I've wanted to be a nurse for as long as I can remember. I don't know why - I wasn't classified as a sickly child to have the aura of nursing invade my young mind. I remember being very little (about 5) and having my tonsils out, and tossing my "pinky" (soft toy) through the cot bars then buzzing for help and having this wonderful nurse come and give me pinky back and not ONCE did she get cross. I remember having my appendix out as a teenager, but all I wanted to do was go home. I wasn't interested in staying. So, no, no real immersion in the medial side
I remember being told at school that I would never be a nurse because my maths was too poor. I remember my pleasure at becoming a medical secretary! I was close! And I remember my glee when I was hired as a patient liaison when Nuclear Medicine first came out in Australia.
But always, in the back of my head ... "I'm not a nurse ...". Sure, I did some geriatric nursing as a teen, but got too involved, too emotional .. it was not the right time. Not then.
But here I am now! I made it!
And so, I began my new job in a flash private hospital, chuffed that they thought me clever enough to hire me (regardless of the nursing shortage, and knowing they hire anybody because they're desperate) here I stand. I am going to make a difference! I am not a tired, jaded nurse. I am here, doing the job I have wanted to do for so long, and I am going to do it with empathy, understanding, education, and love.
My first patient loads weren't too mind-boggling. I'm too new to be given anything terribly complex just yet, but keeping on top of the meds and obs is enough in the early days with the odd dressing (I hate dressings ...) thrown in. I'm not allowed to play with the pumps, so I have to find an RN to do the tricky stuff, so really, my job, right now, isn't taxing enough.
I had one gentleman, and I will call him Frank. A funny fella who would spit his upper dentures out constantly! He was a mess! His bed was a mess. His PJ's were a mess. He had food in the bed, on the bed, under the bed. He had tissues that had been shredded and mangled in the bed, on the bed, under the bed. I tossed him in the shower, cleaned up his room with the help of the domestic, and with fresh linen on the bed, hauled him out of the shower, put him back to bed, and in less than 2 minutes, he was a mess again!
He was swollen and leaking fluids. His skin was so dry it was cracked and bleeding. He was on a fluid restriction and was miserable about it. He was hard to understand because of the lack of teeth, but he did have a jolly sense of humor. I dressed his dry and cracked skin. Sat down and found a happy balance in his fluid balance chart, wrapped his leaky legs up, and gave his wife comfort when she asked how she was going to cope when he came home. I discharged him a day or so later, knowing he was headed home, happy with a Fluid Balance Chart he could comply with, knowing home nurses were going to come in twice a day, 5 days a week to bath, dress and keep an eye on him, giving his wife a bit more peace of mind as well.
4 days later, he was re-admitted. Swollen up like a balloon. Apparently sneaking into the bathroom and getting more water doesn't count when on a fluid restriction!
I sat in with him and the doctor when the doctor said: "your kidneys are failing". Frank shrugged and said, "So, give me a kidney transplant". The Doctor patiently explained that Frank's heart wasn't so good either, surgery wasn't really an option, and sadly, it's now only a matter of time before you die" Frank shrugged again and said, "look into other options doc, it ain't my time". The Doctor smiled and said, "not a hope, sorry".
I was aghast. Frank obviously didn't want to go, but his body was failing him, yet he appeared unworried at an outcome the doctor made quite clear. The Doctor knew this patient well enough, to be honest with him and the expected outcome. "You won't be going home".
2 days later, Frank was on his way out. The children had been called. The wife was doing a bedside vigil. She was distraught. Frank was not expected to see the night out, and yet there were more children to come from far away. Frank wasn't given the palliative med's that would ease his discomfort. At last, in the early evening, the children and wife by his bedside, the vigil continued. Frank was having some alert moments, but fewer and farther between. As I tended to Frank, his hands made a movement towards his mouth. I laughed, and my colleague said "Whatcha laughing at?" and I said, "He's having a beer!" Yes, Frank was somewhere lovely in his head, having a nice cold beer. He was chugging away at a non-existent bottle, and loving every drop! I went out and told his family, and the boys immediately went and bought some cold ones. I gave them a sponge, and they lovingly wiped a beer-soaked swab around their Dad's mouth, and boy-o-boy did he suck on that!
The next morning, I came on duty to find the man in the next bed had passed away, but here was Frank .. still gurgling and battling on. The wife was beside herself. Begging Frank to stay. To get better. She didn't know what to do if he left. Frank kept breathing but was more and more non-responsive. Moving him to hurt him. He was drowning in his own fluids. I was based with other patients, but this one touched my heart, perhaps because I wasn't there when my own father died suddenly, and I felt a bond with Frank and his family. I don't know, but I do know that I walked past his room and the wife came flying out to me, flung herself in my arms and said: "Oh thank God you're here, don't leave me". I was lucky enough to have a light patient load, and the nurse looking after Frank didn't mind the extra help, so I helped out as much as I could.
Often, we would find the family in our handover room, nurturing their distraught mother. One daughter would come to be and we would discuss the hereafter as she doesn't 'do the God thing terribly well'. Another daughter wanted to pray constantly. The boys wanted Dad's peace. The wife? She wanted her husband back.
There came a time when I said to here "You need to tell him it's time to go" and she looked at him, looked at me and said, "I can't do that, I can't let him". The kids rallied beside her and all agreed. It's time for Dad to go.
"Not yet ... a little more time" she begged.
By the next morning, Frank was, by all accounts, no longer with us. His body was functioning, but there was no response other than pain when moved. I dragged the whole family into a room and sat them all down. I held the wife's hand and said "Now c'mon .. what would Frank want? You know him best of all, what would he say?"
"Let me go" she sobbed. The kids rallied around her. I noticed the doctor outside motioning for me to come over.
"It's his pacemaker that's keeping him alive, and we need to turn it off. The family need to agree and understand"
And so, in my first month of nursing, I sat the family down and explained to them a process I have never witnessed (or knew about at that stage!!).
The children immediately said "Do it!" the wife, however..." not yet ... a little more time" she begged. The children sat her down and 15 minutes later she finally said: "yes, he's had enough".
The doctor came 3 hours later, and the family was having a breather. They knew why the doctor was there and what was going to happen. We didn't know exactly what would happen when the pacemaker was turned off. Franks heart might go into its own rhythm for a little while, it might stop straight away ...nobody could give me a straight answer either.
So, I held Frank's hand, while the doctor put the pacemaker machine's mouse on top of the pacemaker. He pressed a few buttons, and I could see a perfect rhythm on the monitor. He pressed a few more buttons, and it flatlined. As it flat-lined, Frank took a deep shuddering breath, flung his arms out and at that moment, a daughter walked in saying "should Mum be here?" I looked at her and said "errr .. yeah" knowing that as Frank relaxed on the bed, he was gone. He had a few more gassy breaths, but for all accounts and purposes, he was gone. It was that quick.
It was an honor to be there. It was an honor to hold this man's hand while he passed over. I felt shocked, relief, horror and love all at one time. The family thanked me for my support, they dealt with their grief rapidly and were gone in 30 minutes after Frank had passed away. I fell apart after that, and an older nurse came up, handed me wads of tissues and said: "Be thankful you still have a heart ...."
I still love being a nurse. I'm doing exactly what I was supposed to do, heartbreaking as it can be, this is what I am meant to do.
I AM A NURSE. PROUD.