Today I received a letter from Susan, the resident I take care of with ALS. I didn't even know she thought twice about what I shared with her about the death of my friend Holly, which I blogged about last time.
Here is what she wrote:
"And I'm extremely sorry to you and Joe having lost Lady Holly, but try to remember the past 17 years you enjoyed having her, because all I had for the past 17 years was Lou Gehrig's disease and that has been helpful in some ways. It taught me how to be more patient, otherwise it was hell watching my beautiful body disintegrate around my marvelous brain. Death is inevitable. But I love my Marilyn."
What an unexpected treasure. I went into her room and told her I would place this letter in my scrapbook to cherish forever.

Susan

One of my residents is a 56-year old woman with ALS, or Lou Gehrig's Disease. Like Stephen Hawking. The muscles waste away but the mind remains intact. She cannot speak, but she can mouth words and also uses a special computer with a remote mouse attached to her forehead like an Indian "dot." I have taken care of Susan for several years. We have a special bond, being that we are only a year apart in age. We consider ourselves aging hippies. She loves Steven Tyler, I love Gordon Lightfoot. But anyway.
Yesterday while giving her her meds, she gestured with her eyebrows raised, her signal that she wants to tell me something. I guessed several of her possible needs, all of which she shook her head "no" to. Finally I guessed, "Does it have something to do with me? Not you?" She nodded "yes." I realized she must have noticed I had been crying. (My beloved friend was in the process of dying at her home at the time, and I had bid her goodbye the day before.)
 I said to Susan then, "Are you wondering why I am sad?" "Yes," she nodded. Then I told her about my wonderful friend Holly, dying of kidney failure which had developed due to old age. Susan continued to mouth one or two word questions pertaining to my friend. I have never been able to understand these  mouthings before, not being a lip reader.
But I believe because we were connecting on a heart to heart basis,  it somehow became very natural for me to see what she was saying instead of hearing it.
Susan was able to communicate with me rather easily in this way and I believe it was because we were sharing on a spiritual level. She mouthed the words "I love you" and I said "I love you too, Susie."
Sometimes being a nurse is not so bad, as long I am real.

Holly 6/29/12

This past week a dear friend of mine died naturally of old age. She died the way we all should, at home, in the loving arms of the one who cherished her most. He did not shirk his duty and scuttle her off to an institution to be euthanized so he wouldn't have to deal with the misery and helplessness of watching a once vital, intelligent and extraordinary being slowly slipping away. He did the right thing, the brave and honorable thing. He participated in her death as he had participated in her life.
What a grand lesson we can learn from this. Instead of warehousing our old people in nursing homes, find a way to keep them where they belong, surrounded by familiar sights, smells, and objects. Do not unmercifully prolong their lives with technology and invasive procedures. Respect them enough to accompany them on their last adventure, the passage from life to the end of life.

I have a resident who turned 102 today. She has no children and her Power of Attorney is a  niece (who I have never once seen visit her). She went to the hospital a couple weeks ago with a BUN of 101, which is extremely high. To make a long story short, she returned with a PEG tube. We are all just sickened by this. A feeding tube going directly into her stomach to pump "nutrition" into her.
 The reason the niece did this? She said that the resident told her once "I love life." Yes, but who knows how long ago that was, and what does loving life include? Being force fed when you are over a century old?
I read the paperwork from the hospital readmission notes. There was an ethical committee meeting to consider the morality of placing a feeding tube in a person of this age and condition. She also has very bad skin breakdown,  Stage 4 and beyond pressure ulcers due to age.
The notes were appalling. The doctors concluded that she was "a relatively healthy 101-year-old who enjoyed eating" and that placing a feeding tube could "help with wound healing."
And today, on her birthday? She did receive a bouquet of roses, from the Nursing Home, which she couldn't even open her eyes to enjoy, let alone inhale their fragrance. And from her beloved niece? Nothing.

It's been a bad week at my job. One of my supervisors who has been there 13 plus years turned in her resignation on Monday. Thirty days notice, but she was let go at the end of Monday. She felt she would be fired so she wanted to quit before that happened. Luckily she had another job before she quit. It's a rough time for everybody, even those with longevity at one place.
You never know when a write up could be your last, the one that ends your job.
As if it isn't stressful enough being around unstable irate family members and more paperwork than you can ever hope to catch up with.
Ironically, most people get into nursing for a fairly decent reason, to "help people." Then  the rude awakening dawns upon us: the corruption of the powerful happens in even the "caring" professions.
Sad but true.

Before I became a nurse, I was a nursing assistant for many years. In fact, the reason I never wanted to become a nurse is because I saw how they were: always overburdened and bogged down in paperwork. The reason I loved being a nurse's aide (as we were called back then) was because I was a part of my patients' lives in a very intimate way. Not just physically, obviously, but spiritually. Entering into their daily lives I was transported to a higher plane of existing. I was, by way of empathy and compassion, a better person because of knowing these demented, senile people who were actually fully realized beings.

Am enjoying a 3 day holiday from the hellhole which is work.
Nursing home nurses have a pretty bad reputation from what I hear. That what we do isn't "real nursing." Well, in many ways this is very true. Especially since the Medicare cutbacks, the documentation has gone from horrible to worse. I feel more like a medical secretary than a caregiver.
Of course, the reason we go into nursing is USUALLY to "help people." The real reason I have stayed in nursing these 15 years is MONEY. Being at one facility for that long your salary and vacation days really add up. "The Golden Handcuffs" we call it.