It was another one of those insidious but powerful dreams that roused me from a deep healing sleep. The last four days have taken its toil on my physical and mental system as I worked three different halls at the nursing home and faced death and dying; unrelenting demanding patients and family members; tired, irritable co-workers and those never-walked-in-my-shoes – administrators and managers.
I've lost count of how many times I silently told myself in the last four days that I’m just too old for this. In fact, I think that I deserve some of the same kindness and loving care that I try to provide not only to my sick patients and concerned family members, but also to the co-workers who don’t always share my high expectations.
So, about 5 a.m. this morning I was standing beside Jim on a tall mountain ridge looking toward the west as the edge of the horizon was rising and falling in great upheavals. Entire cities were being tossed into the air and bouncing down deep into the earth as the disastrous landscape came closer and closer to where I stood holding Jim’s hand in silence.
Suddenly, I was all alone as the land started vibrating beneath me. Jim was gone. He had calmly told me that the landslides and earthquakes would not cross the large massive river that flowed between us and the disappearing earth, but instantly I knew he had been wrong.
As my body was thrown to the ground and I thought I was going to be buried deep within the huge mountains of rushing earth - it was over! I found myself standing alone next to an earthen roadway looking for Jim and feeling absolutely all alone. No Jim. No Sheba. No children. No Sandy. Nothing!
But in the next moment, I saw many people running past me carrying with them, tucked under their arms (of all things) TREES. I knew I would not follow them – perhaps to safety and a new life – because I would always wait right there for Jim and those I’d lost to come back and find me – if they ever did…
Just as quickly – I woke up? Wide awake and trembling slightly, I lay there thinking about why I would have such a weird dream. Perhaps my four intense days on the job were somewhat like that dream. In my work, I often feel overwhelmed and alone with the constant demands and unrelenting challenges of working with a usually great team of people, but often caught in the middle between patients, families and staff.
On Saturday and Sunday, (while Ohio State won and the Steelers lost). I had almost 30 patients and I didn’t know most of them! But they had to get their massive amounts of pills in a two-hour window of time, and I needed to ask the other staff who each patient was before I could give the pills.
In the dining room, I walked in and said, “Where’s Frances? Raise your hand.” The aide passing trays yelled at me.
“She’s sitting right there. Don’t you know that?”
I replied that no, I didn’t know all the patients yet and didn’t want to give the wrong medicine.
“You’ve worked enough day shifts to know these patients,” she said tartly.
“You can drop that attitude,” I responded even more tartly.
The third day I worked on another hall with a supervisor who I’m sure would never vote for me as Employee of the Month.
Her attitude is a bit of a mystery to me. She’s intelligent, funny and organized. But, somehow she and I hit it off on the wrong foot from the very beginning when I started on her hall as the night nurse. She has left many notes in my file that I call "her famous notes" about situations she completely misunderstood (instead of asking me what happened). She officially wrote me up with the first written warning I’ve even gotten – and it was something she was totally wrong about. She looks at me with the word “why?” in her eyes when anything goes wrong….I could go on and on, but it’s personal, I know.
I’m a people-pleaser so it’s awfully hard to work on her hall constantly trying to please her, only to have it backfire in my face! I often kick myself for even trying, but hope to someday gain her trust and confidence.
So that was Monday. I have to work that hall EVERY Monday for the rest of my life – or so it seems.
But yesterday, I thought the shift would finally be somewhat easier. It’s the hall with the fewest patients.
They had been short three nurses on the schedule (Devil's Night), so I picked up the extra day. Not that I WANTED to work so many hours in four days, but it was one of those times I didn't, 'just say no' fast enough!
By yesterday's shift, I figured I could stay ahead of the game. I’d take a nice lunch break and put my aching feet up on a chair and eat a warm dinner Jim would deliver about noon. Then I’d be ready to leave on time at 7 p.m.
As I was setting up early morning meds for the first room, I heard a strange but familiar moaning coming from another room. My almost 40 years of nursing hasn’t all been for naught…. I recognized the sound of dying!
Nothing had been said in report about anyone near death, so I was puzzled. But then in report I was told that the man in Room 104 had been given Tylenol for a toothache and he had been discharged two days ago!
I asked the aide if the patient usually sounded like that and she said the patient had been moaning like that since yesterday and was more confused and seemed “really sick”.
I dropped everything and went in to assess the patient from head to toe. To protect confidentiality and to make a long, long day’s story short, she had taken a change for the worse. I started what I call the ‘death watch protocol’ with many calls to the doctor, STAT labs, STAT x-ray, every 2 hour pain meds, comfort care, total care, family calls and conferences, supervisor updates, and of course, constant charting to keep it all recorded and legal.
It was also the Halloween Party Day and all my diabetics needed extra insulin. Some patients got diarrhea from all the sweets handed out at will. Others became irritable and upset and all the unusual activity. A few were actually afraid of the outlandish costumes that only devils day brings out!
Family members screamed in my face because call lights were not answered quickly. Doctors did not return my repeated calls. Managers were out in force supervising areas they knew little about. “Why DIDN’T you answer that call light?”
While I couldn’t take time for that 30-minute lunch break I had anticipated, I too divulged in some chocolate sweets someone left at the nurses station, and it was the sweetest moments of the last four days!
I finally clocked out late last night and limped to the car.
Hey where is my car? It's been such an intense last few days, I can't remember what my car looks like or where I parked it! Clicking the key thing several times, the headlights lights flash on and off, "Welcome back, Linda".
Nope, in almost four decades of nursing I’ve never been made Employee of the Month. That usually goes to the sweet, meek, non-earthmovers of the group! I’m sure I don’t qualify.
Jim is working for one week at the old job, and we’re passing like ships in the night but delighted that he has work for a few days.
He drives most of the night so he’s sleeping in this morning. Sheba is sleeping with my slipper under her nose and Samantha cat is napping on her heated blanket.
I’m off work for one day but return on Thursday. Back to the hall with 30 patients, most of whom I do know by name. I know if I need to crush the pills and put it in pudding or in applesause. I know if there's a chance they will spit the pills back onto my white uniform, or if I have to use words like, "Your son said to take these pills".
Most of all, I'll always smile to each one and say, "My name is Linda and I'm your nurse today."
Take Care on the Journey,