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  1. spotangel

    What Just Happened?!

    Has an incident at work left you wondering if you were being helped in some shape or form? I am going out on a limb here to share my experiences and hope you are open to it even if you do not agree or believe. It took me 31 years to get comfortable with it myself. If you told me when I was a child, that I would see, feel and smell things that others couldn't, I probably would have run the other way and not joined the nursing profession! In nursing school, I remember how I felt being watched in the break room of the ICU and never feeling sleepy during my one hour break, no matter how tired I was. I heard veteran staff talk about someone sitting on their chest while they were lying down on the couch in the Nurse's Lounge! I eyed that couch with distrust and always sat bolt upright during my break, feeling eyes on my back! The first time, I felt something was in an old hospital in New York, while working a night shift. As a staunch Catholic, I always carried my rosary and felt protected. Pregnant then with my now 22-year-old son, and working the night shift, there was one room I never wanted to enter. Room 813 on that floor was always icy cold and I felt nervous entering that room at night. I had a patient, Linda, dying from AIDS and I tried keeping her company after my work was done. Sometimes, I would sit and hold her hand but my eyes would always stray to bed A by the door which was empty. I found out from two experienced older nurses that the room was haunted. Apparently, one time that room was empty, and Ms. James, a Jamaican nurse, went on her break to sleep on bed A. As she dozed, an old white guy woke her up and told her to get off his bed! Half asleep, Ms. James told him to use the other empty bed to sleep. He protested and told her, "But this is the bed I died in!" Ms. James shot up and took off! She went back to the nurse's station and told Ms. Joseph, an Indian nurse, that she was not taking her break, not telling her what had just happened! So Ms. Joseph, unsuspectingly, went to the same room and came running out 10 minutes later----! I was terrified now to go into that room and begged Ms. Chambers, the Nurse Attendant to come with me when I had to give 2 am meds to Linda. A few days later, Linda died. I am not sure if she joined the old man in that room and I did not want to find out! I always prayed not to get room 813 on my assignment! Leaving that per-diem job for a full-time position, I thought I would not feel anything strange or weird anymore! As I started working in an acute care hospital, on the telemetry floor, I noticed that I started smelling flowers where there were none. I smelt roses (felt like hundreds of them) and felt the presence of many peaceful beings (room felt packed) when one of my patients was dying. There was a sense of calmness and rightness and once the patient died, the smell and presence were gone in five minutes. None of my coworkers smelt it and the room was bare. I never shared that at work as I did not want them to think that I was strange! Death was something I was uncomfortable with and I did not want to have any part of it! Little did I know that I was going to get upgraded to a different smell! While still working on this telemetry floor, I started smelling a combination smell of flowers, incense and candles in certain rooms. This smell was familiar to me as back home we did not have funeral parlors. When someone died, the body was brought back home, washed, put in a coffin and placed in the living room or outside, under a makeshift canopy and surrounded with fresh flowers, candles, and incense for an all-night of prayers. The next day, the body was taken to the church with special church hymns sung for the dead and then buried after mass. I was now smelling this around patients that were dying or would have a sudden cardiac arrest on my floor. Even though I did not tell any of my co-workers, they soon caught on that I sensed something, when they would see me push the crash cart and park it outside the patient's room or check and make sure that the wall suction was working! We saved many patients and sometimes I used that sense of smell to gently nudge a family member to stay. One time, the daughter of my walkie-talkie patient watched me park the cart outside her mother's room and asked me point-blank if she should stay. Taking courage in my hands, I followed my instincts and I told her to get her sisters too! They flew in two days later and I got permission to stay overnight in the family lounge. I saw them when I came to work in the morning and there was so much laughter in that room. Four days later when I came back after the weekend, I heard that the patient arrested suddenly was coded, and died at 2 am surrounded by her daughters. The next month, I got a thank you card and flowers from her family, thanking me for their time together with mom as a family, during her last few days on earth. I still have that card! I soon started working in the ED and my senses went into overdrive. Sometimes, I would tell the patients things that made no sense to me at that time but made perfect sense to them. I remember telling this pregnant girl with a history of two miscarriages, who had abdominal pain but no bleeding, that she was going to have a boy and not to be so worried. A year later she came in to see me with a little boy to say thank you! Another time I was helping another nurse who had a hard stick with a crusty uptight older lady who warned me that I had one shot to get "bloods"! I thanked her and got her "bloods" in one shot and joked that I thought she was going to send me to Alabama if I missed! She stared at me and then burst out laughing as she was from Alabama! I had no idea! I also heard my angel whisper in my ear if my patient in the ED took a sudden turn for the worse when I was with another patient. As soon as I went I would find that most of the time the patient was having an acute episode of bradycardia, hypoglycemia, hypotension, or Altered Mental Status. I would always thank my angel Providence and would ask him and my other guardian angels to watch over all of us in the ED and in the hospital! One time, a patient walked in with her son and my angel told me she was not going to make it. Turns out that she was septic, got intubated and died on Christmas eve! Just before she died, I was catching up on my notes in the ED during my "break" and heard my angel clearly say, "It is time"! I immediately got up and went to her side, pulled up a chair, and sat next to her, holding her hand. She had been made a DNR. I said the Lord's Prayer and as I finished, she flatlined and died. She didn't die alone thanks to my angels! All throughout these years, I felt uneasy with my "gifts"! I moved away from acute care to Long term care(LTC) after a layoff. In 2012, I was in a bad accident with my entire family! Our car was totaled but we walked away without a scratch. That same year, I remember getting stuck for three days at a Pediatric LTC where I worked, as we were snowed in and relief could not come in. Finally, when I was leaving to go home, I walked into a chapel within the building, to thank the Lord for three safe days. I told him that I was worried about my commute home being that the accident was recent and my other car was old with slippery wheels. I asked him to send the chapel angel whom I saw when I walked into the chapel as a brilliant pillar of light, as soon as I opened the chapel door. Initially, I was nervous about the light but soon got used to it. After my prayers, I left, dug my old van out of a three-day snow pile, and drove 10 miles an hour with my flashers on. When I reached home, I locked the door and started walking up the stairs. I realized that I had the car keys in my hand and so turned to walk down the stairs to hang the keys by the door. I stood transfixed as there was a big ball of light shooting back out of my door. The chapel angel had kept me company and was leaving back now that I was home! Talk about a quick answer to prayers! Another time I was rounding in a room of a pediatric patient. The child was around one with a tracheostomy and sleeping peacefully in the crib while I was talking to his mother, Crystal, who was taking classes to become a nurse. This was a double room and there was a new admission (mom and child) also sharing the big room. The curtains were pulled around the sleeping child's crib and I was next to the crib. The lights flickered three times and I thought that the other mother was checking the lights. It was around 9.30 pm and the room was bright with the lights on. All of a sudden all lights went off and I instinctively checked on the sleeping baby in the bright moonlight. I gasped as on the other side of the cradle stood a familiar figure in a nun's habit, Elizabeth Ann Seton, whose statue was in the lobby of this center! The lights came back on and there was no one there. I checked the other bed. The new admission and his mother were not in the room. So who turned off the lights? "Did you see that? What just happened?", I said. I couldn't believe what my eyes had just seen! "What did you see? I always felt a peaceful presence in the room but have never seen someone!", Crystal said. "Just know your son and you are protected by Mother Seton!", I told her as I walked out of the room, shaken. I had heard other staff at the LTC talk about seeing or sensing others in the children's rooms but had never experienced it myself! I felt reassured that the children had loving eyes on them always! After two years there, I left to work in a larger LTC with 750 patients and around 200 staff. This LTC was extremely busy with active codes, dialysis patients with hypotension, admissions, hospital transfers, discharges, missing or wandering patients, along with sick calls, staff issues, supplies issues, and a huge narcotic count and distribution to the units. Sometimes I would see big house flies come into certain patient rooms and they would die within the week. I remembered that I'd seen that happen in the hospital too! There were times when I needed help, prayed and help would come miraculously. I would be pulling my hair desperately, trying to even out staffing based on acuity on days with a large number of callouts. Staff would wander in that were not on the schedule and tell me that they thought they were on to work or I would get unexpected calls from the staff offering to stay or come in for overtime. On those days, I knew I was getting heavenly help to maintain safe staffing and keep our staff and patients secure and safe during their shifts. This trend continued when I moved to a job closer to home to work in a clinic. Now I am inspired in the clinic to ask my patients what really matters to them. Many of my patients request me to pray with them and I do. I am surprised at their priorities which have at first glance, nothing to do with health. Some of their priorities are: "I want to be independent as long as possible." "I want to see my children." "I want to stay in a home that I won't get kicked out from." "I want to not forget my family. I am losing my memory." "I need money to buy food and medication." "I don't want to go to the hospital again!" Since I work with an immigrant population that has 70% illiteracy, multiple comorbid conditions, social determinants of health, poverty, and transportation issues, it is challenging to say the least! I try my best and utilize the help of our health team to coordinate their care. During the recent COVID pandemic, I got deployed back to a medical-surgical unit in my hospital from the clinic. The enhanced smell of death returned but this time most of these COVID patients were DNR/DNI and I used it to pray with them, give them comfort and strengthen them in their last days. Many times, I called their family on Facetime on the phone and had them talk or see each other. These encounters brought them comfort and for most of them, it was the last time they would see or speak to each other. Last August, I was inspired to write a book entitled Sightings After Death (SAD) about 25 true stories that dealt with death and hope. At that time I did not know why I was writing this book in the middle of a fulltime job, doctoral studies, and being a wife and mother. I self-published it in December 2019 on Amazon. Looking back now, I know why the Lord was so insistent that I publish it before the end of December 2019. I realized that He wanted people not to be fearful of death and in His tender mercy and grace wanted me to write hospital-based stories that offered solace during these times. I hope this book helps at least one person. The COVID experience hit the pause button in my life and made me re-evaluate and reinforce my priority list of God, family, work, school, and everything else. I have learned to appreciate my family, blessings and be present in the moment, fully. I am thankful that none of my family or immediate coworkers have died from COVID. One nurse that I knew from a previous job, died from COVID. In her memory and all the other staff, patients, and family who have died, I will continue to use my "gifts" to better mankind. In the meantime, I am just grateful for another day and an opportunity to be a nurse!
  2. I have worked all my 24-year nursing career in the state of Alabama. According to the Pew Research Center, Alabama is currently ranked as #1 (tied with Mississippi) as the most religious state in the U.S. Religion is a strong thread in the cultural fabric in this state and a key consideration in providing culturally competent nursing care. I considered religion and spirituality as interchangeable throughout many of my nursing years. In 2016, I found myself in spiritual distress eventually- leading to a deeper understanding of spiritually competent nursing care. In May 2016, I checked into an inpatient facility for treatment of alcoholism. I don’t think anyone enters detox without having to experience a significant degree of negative life consequences- such as loss of job, relationships and sense of self. Through my drinking, I did a great job of isolating myself from all the people, places and things I held most dear. After 10 weeks of inpatient rehabilitation, I realized I also lost my sense of spiritual connectedness. My treatment team would frequently to assess my spiritual condition by questions similar to these: -Who or what provides you with strength, hope and peace on a daily basis? -What is helping you through this experience? -How do you express yourself spiritually? -What personal spiritual goals do you hope to reach during treatment? Important note: Our spiritual journey is unique to us- just as our patients’ spiritual journey is unique to them. The intent of this article is not to provide a “right or wrong” path to spirituality because it is different for every individual. To care for an individual in spiritual distress simply requires a nurse to support individuals in their own spiritual growth. Prior to my spiritual crisis, I had inner laced religion and spirituality. I felt I was competent in supporting another’s spiritual needs but had little self-awareness of my own spirituality. I am certain living in a state where 53% of the population reports affiliation with a specific religion shaped my own perception of spirituality. In order to provide truly competent spiritual nursing care, I had to first understand the differences in religion and spirituality. The Difference in Religion and Spirituality Religion and spirituality are not the same, but the two often overlap. Spirituality reflects an interconnectedness with something bigger than ourselves and the search for life’s meaning. Christina Puchalski, MD, Director of the George Washington Institute for Spirituality and Health defines spirituality as “the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience connectedness to the moment, to self, to others, to nature and to the significant or sacred”. Both religion and spirituality refer to the belief systems and philosophies of people and are often used in similar contexts. Belief in a religion may be very spiritual to an individual. However, an individual may be spiritual without affiliation to an organized religious system. Characteristics of religion include: A formal, organized system of beliefs with practices, activities and rituals to facilitate closeness to the sacred or transcendent. Being a member of a group and following the teachings of others Interconnectedness linked to church, temple, mosque, synagogue, etc. Teaching and philosophies often based on the past Belief in a religion may be very spiritual to a person Characteristics of Spirituality: A sense of relationship with believing in a power greater than ourselves Subjective and individualistic Spiritualism is a feature of the individual, not the group About finding one’s own path Inwardly directed Less formal and emotionally oriented Not authoritative May be spiritual without affiliation with a religion The Experience of Spiritual Distress I experienced spiritual distress when I was unable to find sources of meaning, peace, strength and connectedness. I felt as if I was in a deep and dark hole and lost all hope I could get out. I am now more aware when other individuals are having signs and symptoms of spiritual distress. A person may ask questions about the meaning of life, their belief system or pain and suffering. They may also suffer from feelings of sadness, depression, anxiety, anger and depression. A sense of isolation, emptiness and feeling alone is common with spiritual disconnect. Meeting Spiritual Needs It is important to be aware of your own spirituality to support another experiencing spiritual distress. As nurses, we must meet patients “where they are” and not where we think they should be. By projecting our own beliefs and ideas about where the patient should be spiritually, we could potentially inflict more suffering. This can be challenging for healthcare providers in a highly religious state or area. Here are a few guidelines when providing spiritual care: Don’t assume you know what is best for the patient and do explore what or who can help in reconnecting (meditation, prayer, journaling, art, nature etc.) Don’t give empty reassurances (“it will be alright”) Don’t debate religion or impose your own views Don’t try to “fix” your patient’s spiritual problems or answer “ unanswerable” questions Actively listen to the patient Ask “Who or what provides you with strength, hope and peace on a daily basis? Ask “How do you express yourself spiritually and what is helping you through this experience”. Do you think nurses fall short of addressing patients spiritual needs? Does the culture in your area impact the spiritual care you provide? Additional Information: Spiritual Distress Patient Education
  3. jaelpn

    A Changed Heart

    Late nights usually accompany me with the television on low as I randomly read through a magazine or book, once I am in my soft pajamas. I fall asleep quicker when I take a few hours to unwind. Then I turn on the fan, close my eyes and cuddle in my bed with warm blankets surrounding me. This is the typical night for me; nothing exciting. ....and then there are those thoughts that I just so happened to think about as I heard on the commercial about starving children. About those poor dogs that need homes. Kids without running water, a decent education. Barefoot in 30 degree weather. I couldn't imagine a life so horrible. Here I am- a 27 year old who has the rest of my life in front of her. I'm disgusted with myself. While I am a nurse and do take care of my residents and do my best in this life, why am I not taking a stronger pride in humanity? Where is my compassion? I have never wished hell on anyone. Those people who are out on the streets because they are down on their luck- wouldn't just a little part of my check give that person a heads up? Wouldn't just a little bit of friendship or conversation make for a different emotion? Why can't the world see this? Why do we look down on the people who need us the most? No one is perfect- no one deserves to be bullied, or even talked down to. We are all living life with the greatest of struggles. We need to be more kind and deserving of others. Be patient- walk in their shoes for a mile and you will realize that not everything is peaches and cream. I cry myself to sleep many nights thinking that I wished I had more to give, I wish that my heart could pour out to these people that need to hear what needs to be said. God never meant for anyone to suffer, not in the ways that we do. Suffering emotionally and spiritually is enough to make even the boldest person break down in tears. God loves each and every one of us, no matter what we have done in this life. We have the choice to either ignore it or embrace it. For just one day- I am going to give it my all, in hopes that what I will have in return is a changed heart.

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