Superman's Girlfriend

Can you imagine having the same name as Superman's girlfriend?
Or Batman's rl incarnation?
Or a new movie comes out and astonishingly the lead char has your name?It must be awful.
Today is a story about Zorro.

Zorro loved his name until he hit school. The kids all teased him mercilessly.
He pretended not to notice and staunchly kept the name through adulthood.
He had a psychotic break in his 20s and very quickly became institutionalised.
After a series of failed treatments, finally they hit on something that could manage his episodes.

Zorro was released back into the community where he took up lecturing to University Students on mental health. He had a degree or two in his pocket and was a very insightful brilliant man.
He knew he was not employable but that did not stop him from writing a book.
Zorro shone.

I ran into another Nurse and she was mentioning to me that Zorro was on service under the umbrella of Community... I was suprised.
"He gets rides to his program."
I thought that was interesting and never thought anymore about it except that she had commented that she thought it was wrong that someone like him perfectly capable of walking could get a ride on the Health Regions dime.

Without judgement. That is our credo. My own judgement was neutral.
He is on service he gets service. --period.

I was surprised that a few weeks I got panic calls asking me if I could go and pick Zorro up and drive him home. It was 1/2 assignment and I didn't even have to get out of the car. Zorro was pleasant and kind and I would sit in his driveway and chat with him about this and that.
He was a pleasure to have around and so very thankful.
For the smallest things.
Like a conversation.

I noticed that Zorro was wearing this strange shirt in the middle of summer.
I asked about it... and he said he was more comfortable in it.
I could see this odd protruding shape underneath so I asked him if he was all right.
"Actually, I have to go and have an exploratory on it. I am going tomorrow."
He was going to the big city 4 hours from here.
He had someone taking him but he really did not want to go at all.

We chattered on and he told me of his belief in various things.
As it happened I had an amethyst crystal in the car (somewhere under all the papers and coffee cups.)
It was just a small little thing. I gave it to him and told him to keep it for luck.
He believed in the healing power of crystals.
I believe in the healing power of belief.

I had another client so I bade him goodluck and farewell and he walked to his door.
I wait for him to go in, to make sure he has his key and so on.
He opened the door, and then turned around and walked back to the car.
I rolled down my window.

"I just want to tell you what a difference you have made in my life.
I really dread these rides home I know alot of people are afraid of me. I know they think I am dangerous. I can feel it.

"I was praying it would be you tonight, and God answered my prayer.
I want you to know that you are..."

He went on for a few more sentences very flattering things indeed. I could not imagine what brought this on. I smiled and patted his hand and told him he was very loveable and many many people cared about him and nevermind what anyone thinks... and good luck etc.

Zorro really did walk in the house then.
Two weeks later I was in the staffroom and I saw on the list of deceased clients Zorro's name.
He had been Palliative and never told anyone. The growth I saw evident was a secondary cancer, and the visit to the Hospital was for brain surgery from which he did not recover.
He KNEW he would never see me again and that beautiful sollioquay was his present to me.

God bless your sweet heart Zorro.
Tonight I remember you and remember you well.
You were a very good man.

"They can conquer who believe they can."

Michael the believer in Angels

Michael came on service late in his disease process.
He had been discharged from the Palliative Care Ward to die in his home.
The Hospital bed had arrived but there really was nowhere to set it up.
He was in pain by choice as he also wanted to retain his consciousness as long as possible.
Caring for someone in pain is something not for the faint of heart.
Once we were warriors. (!)

Battlefield: Michael's bedroom.
Manuveur: Setting up the bed and moving him into it WITHOUT his being able to assist at all.
Plan: Nurse Wonderful and I decide to use the sheet and his two sons.
We move the bed he is IN to under the window, as far against the wall as it will go.
We get the Hospital bed set up and move it alongside the regular bed.
I take my shoes off and crouch in the hospital bed holding the top right corner of the sheet.
Nurse W. has corner left top.
Sons are on both lower corners.
1-2-3- and we lift quickly.
Son 2 (the one on my side) gets a little vague on the concept and for a second or two I am holding deadweight alone. I bark and he gets with the program.
We quickly get Michael into the Hospital bed and as Nurse W. and I attend to him the sons
dismantle the regular bed and have it out in record time.


After that glorious beginning the really tough part started.
Michael was devoutedly Catholic and had his rosary near at all times.
He had some beautiful iconic artwork on the walls. I admired it once or twice.

Michael was clearly failing. The sons were having a very hard time with him being at home so I tried not to involved them at all. I was the main person in there so it was easier for them.
Michael touched me so deeply by a single action.
He was in his last conscious day.
I very gently had bathed him leaving his feet to last.
I washed his feet and lotioned them.
Cleaning up I went to leave and said my farewell.
His hand went up and caught mine.
I looked down at him and he was staring right into my eyes.
He kissed my hand. Then his arm fell back down to the bed.

I was so moved.
Someone told me that perhaps it was the action of feet washing which was symbolic of service in the early church. Perhaps to him it had religious connotations.
I do not know. It does not really matter, the why of it.
It was a genuinely amazing moment in my life.

Thank you Michael.
You believed in Angels and now you are sleeping amongst them.
I remember you with a tug of my heart.

"... today well lived makes every yesterday a dream of happiness and every tomorrow a vision of hope."
-- from the Sanskrit


Knowing the Whole Truth

Previous to my incarnation in Caregiving, I was an administrator and manager.
Addicted to information and knowledge, I took every workshop, attended every seminar and listened to every lecture I felt pertinent to managing people well. Noone ever suggested to me that less than perfection was allowable and sadly, it never occurred to me until far too late.

One of the most interesting workshops I remember was on the challenge of excellent employees.
It was a fascinating study on how the more highly achieving your employees are the more they can really screw things up for you. Impossible standards and so on. I now realise that the reason it felt so necessary to hear was that *I* was the person they were talking about.

Some professions attract prefectionistic people. This is not a bad thing not really.
It is like hiring people who are obsessive compulsive.
If you are a work-a-holic you may admire this "dedication".

Anyway this is my today post about me. It is more to make the reader (not me) aware of the why of my thought processes.
I realise that in itself is a perfectionistic notion. hah
Enough about me... on to the post about someone REALLY interesting.

I am an ordinary woman in an ordinary job but I hear the most amazing stories and meet the most fascinating people. My goal is to impart some of what I see. Even dimly as reflected glare from a diamond can still be dazzling. Or be-dazzling.

"One thing at a time, and all things in succession.
That which grow slowly endures."
--Josiah Holland

Who am I anyway?

Just a girl.
An old timey girl.
A girl destined to be another feisty old lady.
Do you know it takes for buggery ever to figure out these things (ie: who AM I? and who would I like to be?) when you are me.

The girl thing as you grow up:
Girl 1:"What do you want to be?" (playing with toy pony)
Girl 2:"I am going to be a TEACHER!"
Girl 1: "Know what I am going to be? A nurse!" (cuts hair off Barbie)

I never knew what I wanted to be other than happy.
Falling into a series of interesting and very challenging careers was effortless.
I had trouble STAYING interested.
I just had no idea at all what I would really say was my passion in life.

A strange thing happened when one of my parents became ill. The sicker my parent got the more I saw the difference between me and my siblings. Where they wanted to run away and let someone ANYONE do the hard stuff, I wanted to do the hard stuff myself. I just was not very fast nor good at it. In the end, I thought perhaps there was something wrong with me and that this was a strange and loathsome dysfunction. After all you cannot very well say to people:

"Hey guess what? The coolest thing happened! Someone in my family died! Damn I liked that!"

Grief counselling was my first step. Then I got involved with Hospice. Then I took on a few private clients although my training in Healthcare was minimal. I knew that had to change so I went back to school to take Nursing. I was the eldest in my class and I had to try twice as hard as everyone else as God blessed me with an imaginative brain not a no-nonsense one. I graduated as the Outstanding Student in my year which made me very pleased. It was a battle for that let me tell you. One of the people who really did not like me very much was my teacher! She thought that I was full of myself rather too much. She always thought I was a show-off. My reponse was: "And..?" A life in the Arts what else could I be? A career manager of course I was in charge. People don't change personalities when they take up new careers. I did however understand that I was at the bottom of the totem pole. Believe me, people love to point that out. I guess it comforts them to know a big old blowhard like me can be humbled.

I did my practicums in various hospitals and then in Community Nursing, the field most people dread and call the "lowest level of Nursing." yeah well I LOVE it. Bring it on! I love it because you have more one on one time with a person and do the extra things that would not be possible in a Hospital setting. I love it because I am accountable to myself chiefly and that means I do not have to check and re-check and call in for permission. I am a responsible caregiver.

The sheer amount of emotion that comes my way in an ordinary day necessitates unloading somewhere. I choose this blog. I used to write in my little diaries but you know what?
It is alot easier for me to type than to write longhand. Also I can fool around with colour and doodle with ascii I like that!

Does this help?
I suppose I am rather one of those people who were inevitably meant to take on life full-board.
I can do it for others too.
And when I come home at night I am happy. I feel good about things. I like to think that actions can impact the world however smally. I cannot change what is happening in Iraq or Africa. I cannot take away the aches and pains of life for anyone. But I CAN distract them from themselves even if just for a tiny while. Sometimes thats all you need.

The First Time ever I met Death at Work

Praise the Lord for his Goodness and Mercy unending; the lovely young woman died yesterday. Mercy indeed.

I am thinking of her struggle and looking around my own life and wondering why her and not me. Why indeed. This reminds me of the beginning days when Community Nursing was brand spanking new to me.

Orientation had just finished and I was feeling marvelous.
I was so grateful to have been hired exactly where I wished to be. I was also focused primarily on Palliative Care. I asked questions about protocol when a death occurs at the time of our visits. My Team all looked askance.

"That almost never happens."
"What if it should happen? What procedure do you follow?"
"Well, the regular... make sure the Doctor is called and so on."

I pressed for more information and again was assured that it really wasn't necessary to worry about this.

"I do not think it has happened more than twice that the client has died during the visit."
I laughed and then they all really looked at me.
"I KNOW it will happen to me. This is my calling."

I think they might have been worrying about ever hiring me at that moment.
We went on to other topics and then out into the field I went.

In my second week, I had a call to go to a woman with breast cancer mets to the bone.
No further info available... just palliative client needing assistance.

I rang the doorbell and a woman in her 50s in a housecoat answered the door.
"Are you Bess?" I asked.
She gaped at me and hmphed.
"No I am not Bess. THAT is Bess."
She motioned behind her to where a Hospital bed was set up in the living room.
Even from that distance it was apparant that the person in the bed was critically ill. Gaunt and pale she lay there while another woman was hovering at her bedside. A third younger one appeared from another room and then her husband entered.

"Ah this is my wifes sister and her daughter and her best friend. I will just leave you ladies to it."

Two of the women disappeared and the third was glued to me. This is not the ideal situation for care when family members are hanging about making "helpful" suggestions. Even worse, they were all Nurses. God help me. Do this dont do that be careful. Why on earth was I there?
It may sound like I am being petty. I want the best for my clients. The best I can give in those circumstances is not to have someone articulating every move. The woman is still alive still listening even if she is unable to respond. The other problem was that this woman was an O.R. nurse trained to save lives and assist Physicians in complicated surgeries. She did not know how to cope in a no-win situation. There was to be no healing. Not that she wasn't going to try.

I asked the woman: "Would you prefer to do this yourself? Or would you rather I just assist you?"
She murmured a few little clucking sounds and then said brightly:
"I think she is full of gas. I think we should give her an enema."
---- boggle ----

"Are you SURE you want to do that?" I said.
I wanted to shake her. This was not a good idea.
"Yes, yes I think that is what we should do. She is full of gas."
The little lady in the bed was very thin and her tummy was not particularly distended.
She was determined.

I cradled the clients head in my arms as I held her on her left and right as the enema was administered she died. She had had enough of that. I looked over at the other woman. Tears were streaming down her face. What a thing to have to remember.

Her husband came in and I took him aside and asked him if he would like his wife washed and dressed. I asked him if he would like her to wear a nightie or a dress. He was thinking about it when the sister-in-law came in shoved me aside looked in the bed and said: "She doesnt care what she is wearing. She is dead."

Yes this is true. But the husband is not. And the husband is agonising about every decision he took and assessing if he could have done better.

"Sir would you like your wife washed and dressed? I can take care of that for you."
"Yes, yes I think yes."

I remember how my Aunt had told me that when her husband died in the hospital noone had cleaned him up and his body lay in the bed unattended to until the morticians arrived.
She went in to say her goodbyes and it was a nasty sight. Those sorts of things etch in your brain. I did not want anyone on my list no matter how well or how little I knew them to have a memory like that.

The one who had done the deed I asked to help me and she was a fantastic assist of course.
I felt it was important to give her a good memory to fall back on. She had just arrived the night before. And now this....

When I left I took the woman aside and told her she was a great friend and thanked her. Then I told the husband he had done a wonderful thing for his wife giving her time at home and he should be very kind to himself as that was a huge thing he had done. He puffed up a little at that. He thanked me and then....

The little bossy sister-in-law told me I was more or less in the way and goodbye now.
She was on that phone in seconds saying: "Well thank God she is finally dead."

Nevermind. It is all training isn't it. She taught me something invaluable. And I learned it.
So for that I thank her and God Bless you Bess.
Today is for you.
Your husband loved you dearly and your friends wanted nothing but the best for you.
Rest well.

"The art of being wise is the art of knowing what to overlook."
-- William James


Gregorian chants

Gregorian chants.

There was a man by name of Greg living in the home he had built for retirement. His wife cooked and did all the gardening keeping them stocked with canned everything. He built fine furniture and tooled with a knife carving exquisite figurines of incredible detail. He was a true craftsman. He still spoke in an eastern European accent but seldomly. He let his creations speak for him.

Greg was devoutly Catholic. He came on the list when his wife could no longer meet his care needs. He had been a rather tall man and she was a small person.
He was also intensely private. It was a living death for him to have people attending to his private needs. Unfortunatly he had a different person every visit. Twice a day.

Greg refused morphine on the ground that Christ Jesus had suffered on the cross and as his servant he should at least try not to be weak. He would pray the rosary quietly and continuously. Then he would chant in Latin. After a few days the praying ceased but the chanting continued.

"What is he saying?" I asked his wife.
She shrugged.
"Is it a prayer?"
"In a manner of speaking."

Turns out he was chanting over and over again
"Deliver me from my enemies who are persecuting me."

Now how sad is that?
Again: sometimes nothing works.

We call it "PLEASANTLY confused" (!)

This is a story about a wonderful lady who retired to a beautiful community.
She had been married twice and was recently widowed.
She had a jazzy little red sports car which made all the other women in the neighbourhood rather envious and her blonde hair was turning the most attractive shade of silver. She looked rather like a model always dressed smartly and conducted herself with great finesse.
She was a stylin' long before it was in style to be so.

The home was a rancher similar to most homes in the subdivision.
The drapes were a crushed velvet and the crystal in her China cabinet sparkled against its' rich walnut finish. She had lavishly entertained in her time and was well-equipped to do so.
She still had at least three closets of the most gorgeous clothes which increasingly she found no reason to wear. She was a proud gun owner and had to be told by the police not to walk outside rifle in hand. Just a little quirk left over from her childhood in the wilderness wilds. Those were the good days. We had progressed to the not so good days. She had sweatpants on most days.
She still had the beauty and the inner resolve intact.

I met her when I was on the evening shift. She was a hoot!
She had lost alot of her short term memory but she took alot of pleasure in retelling a choice few events from her life. She could remember the darnedest things like the name of the ship that had brought her here from her native Sweden at the age of 4 years.
No matter what she was remembering, her stories would inevitably contain a part where some silly man or woman would say to her:

"Greta, honey, I would tell you but you would not understand."

To which she would reply: "I'll have you know I not only ____ but I also ____."

And they would come back with: "What? YOU? A mere woman?"

Somebody in the long ago past had belittled her for her gender and by golly they were going to pay. We were discussing vacations and I remember telling her about a flight I had taken.
She interjected with a story about how she once had to fly a plane. ( uh huh )
And of course the co-pilot said:

"WHAT?? You? A mere woman? You would not know how to fly!"

"I'll have you know my father taught me how to fly and I was flying before you were born."

Then she landed the place safely to much acclaim.
I pressed for details on that one but we waved me off with an imperious hand.
I pretended to be amazed and impressed.
I don't THINK her father knew how to fly a plane. He was a fisherman, logger, builder and all round pioneer fella but you never know. It could have happened.

We call people like her pleasantly confused.

Her father HAD taught her to shoot a gun as cougars were not uncommon in her younger days. Her father also let her lend a hand building and designing things. She had been a Realtor by profession.

Mrs. P.C. has been declining lately and she knows it. Mostly it is the memory. Where she used to be happy to see people now she is suspicious of most and often threatens the girls with her fists or her walker. If you volunteer to assist her in the personal care department you might as well just leave and leave fast. I used to be fairly successful with her. Used to be.

"Hello! Good morning!"

"Is that your name? Hello?"

"How are your pets this morning?"

"None of your business get the hell out."
---- busy me doing this and that----
*sound of walker coming down hall*

"G**d**n it what the HELL are you making so much noise about?"

"Med time Mrs. Greta."

"Med time? I don't need you to tell me that. You think I am an idiot? You are the idiot. Get the hell out."

and so on, and so forth.

Tomorrow I have the pleasure of trying again. I wonder if it will be the fearless female I meet or the woman afraid of someone noticing she has forgotten exactly what she is doing.

God Bless You Greta. You fiesty old bird you.

"We are here to add what we can to, not to get what we can from, life."
-- Sir William Osler


We are all trained the same (aren't we?)

My dear end-of life care client made it to Sunday.
During my two days off there should have been one visit per day from the Palliative Care Team and one from the Home Care Nurse. I say *should have* been because there is nothing in the notes to indicate anyone was there. I know they were as the family had a few messages for me from the Morning Nurse. I have a message for her too! (ROAR!)

I am a little annoyed as we are all trained the same way. Aren't we?
We are all blessed with common sense and we have opportunities throughout our lives to home our skills and learn from our peers. End of life care is something JUST as important as the care we give to infants. Would we say about a new baby:
well so what if he stays in the same position for a day... he just was born, that was alot of stress on him?
We better buggery not.

Or how about this:
  • "It's alot of work being born so be quiet in here."
  • "dont bother the newly born person."

I think its a load of hooey when people try to sequester away people as they are dying. A private person will still wish to be private but that does not mean leaving them alone except to come in and weep. No human being should have to die alone. We have only ourselves when we are born too but we surely would not leave an infant alone.

So: after 2 days off I was surprised this lovely woman was still living but some people do not wish to die and hang on as long as they can. I often think of it as someone who is dangling from a ledge they can not possibly climb onto. They are going to fall and they know it. They can let go early or they can cling until their fingers fail their grip. Our client is clinging. A few fingers failing but one or two left. She is a fighter.

I could smell the usual things but she seemed to be very uncomfortable. I asked the family if she was on track with her meds as Morphine should be taking care of that nicely. She was feverish and struggling with something & it was clear that she had not been moved for a very long time, possibly all day(s) .

She was so weak I could not in all conscience roll her alone so I asked the daughters for a brave person. I told them their mother would probably cry out in pain and it would be hard to hear but we absolutely had to turn her. (One of the things the Nurse of the morning had said was to tell me to check the dressing on her coccyx and remove it if necessary. I guess she was just way too busy to check it herself.) To her credit the youngest girl came and helped me. It was not a nice task and her mother was not happy about it but I washed her back which was on fire with heat and gently massaged some lotion into her bloodied under the skin body. The entire length of her body the blood was pooled. Pre death condition.. She was so hot and so uncomfortable.

Only the initial turn is painful and only for a second, and if you position a person correctly they can be turned minimally with pillows just enough to allow pressure off boney prominences.
I felt villainous for moving her but in those moments I fall back on training. It has to be done and NOONE else had done it. Someone has to. Good God: how sad it is to think the next movement she would have would be the mortician! Shame on us! Shame on the people who did the easy thing and minimal care. That woman still is IN that body. She won't die conveniently before the next Nurse comes just because we think so. She has to lie in the same spot we put her because she is too weak to move on her own.

Try that sometime. Lie in one spot without moving. Not a whisker nor a hair, just lie there.
Try staying there for 10 minutes. Now 20. 30. Now imagine hours. Many hours.
It gets pretty uncomfortable.

When you finally do move you will feel it all right, and you may even call out in discomfort.
So yes, I know this woman will likely not be alive tomorrow at this time. I know some people think it would be kinder to leave her be. I disagree completely. Live til you die. Treat others like they are alive BECAUSE THEY ARE right until that brain stops firing random neurons.
Give a dying person the grace and dignity you would want for yourself. If you could not move nor speak you would surely want someone to treat you in the same way they did when you could. The room is holy ground when a person dies. It is a sacred season but it is also the normal conclusion of a life. We celebrate and fete the newly born. We also need to embrace the dying; gently, with great humanity,

Through all her pain, through that difficult ten minutes of tricky care where she was on her side, my client was held by her daughter. It was not a moment of terror it was a time of tender graceful care. Her daughter whispered nice things to her and stroked her cheek. What a great daughter. Then when we finished and had her looking fresher, the client smiled and sighed.
I KNOW she felt better. I KNOW she appreciated it. The smile was such a treat.

It is too much to expect people to do their jobs?
Some days I wonder what is in the mind of someone who would leave that woman in that room for the next guy to deal with.
They should remember the next guy up might be God.


"We do not wish for friends to feed and clothe our bodies... but to do the like office for our spirits."
-- Thoreau

Not everyone loves me

Always be a little kinder than necessary. That is my motto.
It has served me well throughout my life and continues to inspire me to be better.
Every now and then I wish it was the motto for others. Usually when I am thinking this, it means someone is unimpressed with me OR even worse they just want me to go away, preferably now.

In my regular life, if people do not like me-- ohwell! It's a big world and we can all fit. If you do not like me just go over there ------------------------------------------------------>
way way way over there!
In my work life if people do not like me, I make the best of it. A time or two I have almost bitten my tongue off being nicer and kinder. Here are a few of the ones who really wish they never met me.

The Debutante and the Famous Scribe.

These two were a pair in glorious love; she the beautiful daughter of a reknowned family and he the up and coming young man. They married and had beautiful babies and as his career unfolded and the people who attended their parties got more important on a GLOBAL scale, their relationship steadied into a long romantic lifelong love.

Retirement had been 20 years ago and since then a few diseases had taken hold of both of them. He seemed outwardly healthier, she seemed frailer. Not necessarily the true way of things.

He explained to me very carefully that theirs was a house of SERIOUS disease and to be as quiet as possible. He further explained they really did not need anything but continued the service as it was easier to continue than to restart. I thought privately it was a colossal waste of HealthCare dollars.

In the beginning he would tell me how helpful I was, how wonderfully everything went during my visits. A phonecall changed all of that.

I walked in one evening and he seemed a little annoyed. The telephone rang.
"You might as well get it, it is for you."
I got it. It was an urgent matter. One of my later clients was a serious risk. There was some violence issues and the Case Manager wanted to make sure that I was adaquately prepped for the assignment as it was a Friday night and noone but the On call Pager would be my back-up. She had alot of information and she was very concerned. When I hung up, I was trying to assimilate all these facts and stood in the hall.
"That must have been a very important phonecall."
"Yes Sir. It was."
" You must be a pretty important person."
"No Sir. It is just a serious situation I am going to later on. That was a safety check call."
"Well I have news for you. We are important too."

hmm.... was I showing some rude dismissive qualities? I did not think so.
He gave me a little lecture about the importance of himself and his wife.
I nodded and thought nothing more of it until the next week when he did it again.
The difference was that wherever I went in the house he would call out some rude comment about what I was doing being wrong or loud or whatever. He was making me a little pissy but I took pride in not showing it.

Bad went to worse and one night he said to me: "I cannot believe you still come. Can't you take a hint?"
"You are on my list. I am obliged to come unless you cancel."
"Consider it cancelled." *slam*
-- and then:
"If I sign a paper will you leave?"

I had already told the Office not to send me there. He was just not going to have me in their home and that was it. One of them had some surgery and needed aftercare. I got her on my list for a 15 min visit. I queried it and was told surely I could cope for 15 mins. Yes, surely I could,

It was pouring rain. I knocked on their door and it was a fully 5 minutes before he came and opened it. "You are late!"
He was yelling.
"My poor wife has been waiting while you do whatever it is taking your time."
I was choked. I had just driven about 35 minutes to get there. There was noone else working the area that night.
"Sir, it is raining pretty hard. Can I please come in."
"When I am told 7:30 pm I expect you to be on time."
It was 7:40

She was just as bad. "Are you sure you are trained to do this?"
"You missed my eye."
I felt my danger valve rocking so I turned to her and verbally assured her the drops were in, while she went on about how I had gotten more on her cheeks and blah blah pissy blah and he started in his rant again.

I turned with the meds and handed them to him and said: "Perhaps you will want to do this yourself then Sir." I picked up my things and left.
"Goodnight Sir. Goodnight Ma'am. Have a PLEASANT evening."
I make sure to tell the Case Manager not to send me there for one minute five minutes or bloody 35 seconds.

"You certainly did rub them the wrong way," she commented. "Whatever did you do?"
"I used the phone."

She thought I was kidding.
I saw the woman one more time after her husband was gone. She did not recognise me right away but when I was leaving she suddenly got a little gleam in her eyes.
I just left.

Moral of the story?
nah, no moral.
Some people are just way too important for the likes of me.
Not enough bowing and scraping in my skillset.
Cheek of the working class.


What's so great about dying?

Jim was another country guy. He lived on a little working farm where he had built his house 45 years ago. The area grew up around him and he refined his little homestead over the years. The house was on a bluff overlooking the surrounding flatlands and bay. Behind him was the Mountain still First Growth timber on it and he owned most of it. He had married his sweetheart 60 years ago and had a family of boys. They were all country folk with a strong sense of civic duty inherited from their dad who had been a charter member of the Volunteer Fire Department, Boy Scouts, and Search and Rescue. Everyone for miles around knew his name.

Time had decided it had been too kind to him and sped things up. His wife became pleasantly confused and was no longer able to cook or manage general household tasks. She was prone to asking for her father and mother. He held his own denying any ailments until a lump interferred with some essential function.
The diagnosis: Cancer.
The prognosis: 3 to 6 months.

It had been six months since his surgery and diagnosis. The family were having trouble coping with things and service was established 2 times daily. I had him on my list 5 out of 5 nights. The first night he told me he did not require any service but possibly I could talk to him.
His sons were polar opposites. One took me aside before I got to his Dad's room and asked me to try to do as much as I could. A moment later the other popped out of another room to tell me that his dad was a very private person and to do the minimum allowed.

The end of the first week came, and he was re-assessed as pps 30.
Basically bedridden, unable to care for his own needs is what this means.

I walked in the door one night after driving 50 kms from the previous client and went in to see him.

"Oh it's the CHEERFUL one," he said.
"Is that bad?" I answered.
"Hmm, not sure yet".

I was doing something or other in the other room and came back in to see him and he had a sour look on his face.

"I want to know why you are so happy", he asked brusquely.
"Hmmm," I said naughtily, "I am not sure yet".
I poked him lightly in the tummy and he laughed out loud for the first time.

After that night he talked my head off every visit and let me do things he had previously not allowed. He had been lying in bed too long in the same place for too many nights and he had some nasty sores. I taught one of the sons the fine art of pillowing and within a few days we had the sores under control. His pain was another matter.

Cancer pain is the worst pain a human being can be in. Alot of people do not realise that the hidden curse of treating cancers is that the prolonging of a life means the increasing of the pain.
If a person does not manage the pain by the prescribing of very potent drugs in dosages that would kill a horse they will experience more pain than ever God intended. These huge dosages scare many Nurses and Doctors. Some even write journal entries equating it with euthanasia.
How do I know this?

More research than you can imagine and unending education.
I really should have gone into Medicine as a first choice.
Puzzles fascinate me and I am an exceptionally fast reader retaining most information.
*I bet you are thinking right about now that I have a high opinion of myself.

If you can believe it, after getting on the Dean's list in College I almost failed Nursing over bedmaking. yes, you read right.... BED MAKING. That and condom catheters were my nemesis.

Luckily for me I mastered beds and catheters. Through Hospice I had the privilege of taking many workshops and meeting many world class Palliative Workers: Doctors, Nurses and just plain folks. I keep a lively correspondance with some very excellent health professionals.
I am an information junkie.

So now back to my country friend.
I learned in Hospice that when people live on when their body has failed them, there is something left undone. It was an interesting premise and one that resonated in me.
What did Jim have left to do? I had no idea nor was it any of my business but seeing him wasting away was horrific.

"Hey cheerful!"
"Hey Jim!"
The smell in the room was awful. I had to mention to the family the old tip of putting kitty litter under the hospital bed to absorb the odour of decay.
"Get my gun".
"uh... can you say that again?"
"My gun dammit get my gun."
"Sir I am not going to do that."
"Tell my son to get my gun and take me out and shoot me".
"Jim... you know he isnt going to do that".
"It would be alot kinder than this. I treated my dog better. JUST SHOOT ME!"

I sat down beside him and held his hand.
"Sir, there has to be some reason God is keeping you here'".
"God? Are you kidding? God? I hate God. Why would God do this to anyone".
I was sad and silent.
"Damn it cheerful, what's so great about dying?"

I looked at his eyes welling over with tears of frustration. I looked slowly around the room. There were letters and cards and even a newspaper article or two.
"Jim: Wouldn't you say that the measure of a man is how he is remembered by others?"
"yes I expect so."
" Well *I* think that most people equate their success with what they have done in life and who loves them. I see here you have touched the entire community, all these people trying to wish you well and your family is here day and night just loving you wanting it to be all right for you."
He was silent.
"I think you are a pretty damned successful fellow Sir. God put some of his love in you and you shared it with the whole place here. And now it's time for you to go on home."
"You mean the guy upstairs?"
"How do I get there?"
How indeed.

We are prohibited by the rules of our Employer to mention any religion or try to promote our faith but there are times as a Human Being you have to speak the truth to your brother man.
I held his hand and told him that nobody really wants to die but if you have to die it is pretty cool to have the whole town on your side thinking about you and praying for you. I told him his sons were wonderful men just like their dad. I told him I believed Heaven was waiting for him if he would just clear it with God and his family.

It was my last visit with him, and he kissed me before I went. Both the sons came out when I left, both bleary eyed. There was a baby moniter in his room and the whole time I was in there the sons had been sitting in the kitchen listening.
"Thank you for talking about death with Dad. He never let us mention it."

I had two days off. The second day I woke up with a happy smile and a laugh and to my surprise I was saying: "Goodbye mr. Jimmy." It was a very surreal moment. Later that day,
I called the Office.
Jim had died around the time I woke up.

God Bless you Mr. Jimmy
See you on the other side.

"The love we give away is the only love we keep."
-- Elbert Hubbard


The Man at the End of the Road (2)"

The Man at the End of the Road.(2)

The neighbour was devastated by the idea that someone would choose to live in pain, ready to die, alone. She came over to help every night after work, feeling it was her duty to make sure nothing happened. The more she helped the less she was sure that he should really be allowed to stay at home.
"He has NOBODY you know. There is some family that used to come around but they dont speak anymore. I have to check up on him."
"He has the right to die in the way he so chooses."
"How can you say that? Look at him!"

"Sir... Sir... do you want me to call an ambulance?"
"Sir your neighbour is here. She says you were very ill again yesterday."
"Nevermind bout that. I want to stay in my house here."
"Sir I cannot do much for you here. Just make you comfortable and clean. I cannot treat your pain."
"I dont care I want to be here. My house."
"Sir your house isnt going anywhere."
"You got that right MY house. That no good nephew of mine thinks he is going to get it and thar aint no way that's happening. Over my dead body."
-- I winced.--
"Sir, can I call your Doctor for you?"
"No Doctors. No Hospitals."

What to do what to do?
The neighbour continued to try to force me to do something.
This to her, meant taking him against his will to the Hospital.
In the end her desparation caused me to say; "if YOU feel you must call the Ambulance then sobeit."
She called.
I went in to where he was laying and broke the news to him, as gently as possible.
He went out like a whupped pup.

Guess who is living in the house now?
It is sad when no matter what you do the end is unsatisfying.
Sometimes nothing works.

"Some people are always grumbling that roses have thorns;
I am thankful that thorns have roses."
-- Alphonse Karr

The Man at the End of the Road.

It was definitly the country. The address was shabbily painted on the mailbox that was tipped sideways, the barn on the back 40 was half missing and everywhere wildflowers bloomed in gay profusion.
The house itself was set back about 50 yards from the road. It looked to have been a few years since anyone had cleaned the windows or painted the trims. A few shingles were missing and the downspouts were at radical angles pointing to the sideyards.

"See if you can persuade Mr. __ to have a bath." Thats what they sent me for.
"A BATH???" I thought he was going to faint on me. His face coloured red and his eyes were round and shocked.
"Why the hell would I have a bath? I had one a coupla months ago. I aint going to waste my water on THAT!"
More fool me. I should have known.

He was born early in the 1900s to a Pioneer family. His pa was a farmer and a logger and he was the same. Town to him meant the little store 5 miles down the road. He had a couple of kids somewhere, sometime, least he thought he had but darned if he could remember where they were. I suspect they were dead as was his wife. Pictures of a happy family were in frames along the hall walls, covered in dust and grease from the oil heat. It looked to be somewhere in the 1940s or 50s but I couldnt be sure.

"I expect you want to do something for me."
"Yes sir."
"I suppose you could cook for me."
"Yes sir!"
"NO BATHS tho. "
"Yes Sir!"

I had no idea and no direction from the careplans or the nursing notes but it seemed he had come on service after a neighbour had found him feverish and dehydrated.
"I aint going back to that place no way!"
"No sir."
"You aint goin make me are you?'
"uhm, what place is this Sir?"
"You know: they make you undress. Terrible people. Shameless."
"Do you mean the Hospital Sir?"
"Yes thats the place. Hate it."
Of course he hated it. The Hospital is in the City.

We went on like this for a week or so. It was getting to be obvious that the smells were not from a lack of bathing as much as from sickness.
The neighbour met me at the door a few days in a row. She was distressed and scared.
"I found him again. On the floor. Can't you do anything?"

No I could not do anything other than assess the situation and decide whether his right to live at risk was greater than my right to call emergency services. I decided that until he wished to go to the Hospital, I would not call the ambulance.

(more later)....

The things people say

Truth comes with death.
Somehow people cut to the bone with their words when only a few might be left.
In a very interesting workshop sponsored by Hospice, the idea of communicating with the dying when they speak in metaphor and how to interpret the meaning was brought to mind. My mind.

Not everyone in the Palliative Care Roster speaks in metaphor, some of them do not speak at all. But when it is a long palliation from a cancer you tend to see it towards the end.
G.L.: "Why are they killing me like this? Tell me it is not necessary."
A.M.: "The dealers were here again. I told them you were coming. I told them to watch out. They have guns you know. And drugs. You better call the Office for backup."
R.W.: "It is in the other room now. Help me God help me... it killed him and now it is here for me."
B.R.: "Take a message to my wife."
M.S.: "You don't fool me. You are a witch. Get away from me. "
K.D.: "My angel, you are an angel. God sent you. How did you know to come? How did you get in here? Is it all right?"
E.B.: "My angel sweetie let me sleep. You better get a blanket it is going to be a long sleep."
B.B.: "It was the war that did it. I knew this would come back. I wish you could see it."
N.R.: "I know that doesnt really make sense. We were all dead then. R__ was the first to get past it. I wonder if he knows how to do it?"
My favourites are the people who want to pack. Or they want to buy a car or charter a bus or taxi. The trip is going to be soon. Make sure you are ready!

And then there was Flo: "The chocolate is behind the baby powder. I think you can take it now."
For some reason it made perfect sense at the time.

Auntie Marj

She was not my Auntie. She was everyone's.

Auntie Marj lived in an Assisted Living complex. She had a two bedroom suite at the end of a long hall from the dining room and entry hall. Every night my visit would end with two of the ladies along the corridor calling in to say goodnight. It wasn't that she needed them, more that they needed her.

Something in Auntie Marj reached out in love for the entire world. She had no children of her own and had lost her husband long decades ago. Never a quitter, she decided to get her teaching certificate. Then she travelled the world teaching and learning. I think she was in her fifties at the time. "Every place I go I meet the most wonderful people," she would say before launching into a story about someone in Japan or The Phillipines or France who affirmed her endless faith in the inherent goodness of mankind.

"There sure is a difference in you girls," she would say. Later I found out that was her very discreet way of signalling that not everyone did peri-care, a small but necessary task she was no longer able to do on her own. "Sit down and have a coffee with us." She knew very well I had a list of 13 people to see but she offered anyway.

The two ladies from down the way would come in and sit by her bedside. One was legally blind the other had had a series of devastating strokes and could speak but with varying degrees of clarity. I would get my things together and wave cheery-bye and the trio would sing back to me. It was such a beautiful sound.

That summer was the first of our very hot ones. It generally does not stay above the 70s F let alone the 80s for longer than 3 or 4 days. We think ourselves lucky to get 2 weeks without rain. Something in the climate is different these years and that summer came in like a lion roaring in sunny splendour. We wilted and replenished ourselves in the late nite coolness. Auntie Marj was having trouble with her ears. "I just feel like I am on the top of a building looking down." After two falls she more or less took to her bed except for an hour or two when she would get up in her wheelchair.

"I am turning 90 you know". No I had not known. For 2 weeks there were people coming and going and staying and leaving and flowers lined every surface. Auntie Marj had a party in the dining room and managed to make all her well-wishers believe she had nothing worse than a stiff knee joint necessitating the wheelchair. Trickster!

July ended with a fall. August started with another one. My heart hurt to see more bruises every day. "I just cant seem to stay right end up!" We sat and read her cards to her, I and the lady of soft voice. Singaporeans, Alaskans, people from all over the globe... every card started the same way: "Happy Birthday beloved Auntie Marj" or variants thereof.

That night as I left she took my hand and said: "well kid: Nice knowing you!"
"WHAT?" I was leery of those sort of remarks.

"Oh I did not want to spoil your visit. I am leaving tomorrow. I sold my place to my friend here and I am going to live in the Hospital. But it sure was swell knowing you."

Auntie Marj lived another year almost to the day in the Hospital where they say she availed herself of every opportunity to socialise and went on every outing, greeted every visitor and went off to eternity with a great big smile.

God Bless you Auntie Marj. Today is for you.


Comfort Zone

Sometimes I am so close to the edge of my comfort zone it makes me a better caregiver.
Today was one of those days.

I have a new client who is but a few short years older than I am. She lays abed, foley catheter in, dressings on heels, coccyx, op site meds... awww

I look at her and I see myself. Just the version where I marry a slightly older man and have 3 kids. I attain my dream home and my husband adores me. The only kicker is that I get cancer in an unusual place and it turns out to be terminal.

My heart is three sizes too big today. There is nothing I would not do to make that woman more comfortable. It has nothing to do with her lifestyle of privilege; I would feel the same if she was in assisted living or a hospice bed. We are the same under the skin. All of us.


Hello Hello lovely to see you I must be going now


Pauline was genteel and lovely and lived with her husband who was trying very hard not to notice her increasingly grey color and her inability to stand at all without assistance. She was very very ill.

"Hello Hello dear. Lovely to see you thank you for coming."
yes... hello Pauline. Hello hello.

"Thank you for coming. Goodnight my dear."

Inbetween those two things was a bedtime visit.

I had seen this cancer before in others and was a little in awe of how well Pauline was managing. Truth be told I could not believe she was still so vibrantly alive.
Again my Hospice training made me believe there was something she wanted yet to do and lo and behold if one night there wasn't a visitor from afar, a long expected visit.
Pauline would stay up until my arrival at which time she would wave her hand at her friend.
"I must be going now. Goodnight my dears."
And off we would go.

Friday night her husband told me the visitor was leaving in the morning.
As I was turning out the light, Pauline deviated from her usual farewell and said,
"Hello Hello I must be going now. Lovely to see you, wonderful time, Hello I must go."

Saturday night I had a panic call from the Office asking me if I could drop by Pauline's as another Nurse there had a bit of a problem. I got there and of course she was no longer alive. The problem was the other person did not really like after-death care. Pauline lay in the bed or at least the shell she had worn was there. Grey and pale. The lips still held a little smile.

"Hello I must be going."

Goodnight and God bless, Pauline.
You were a class act.

Mrs. D Divine

Mrs. D came on my client list in the evening shift. Thursday night bath night, no showers THANK YOU very much. It might sound easy but factor in a prothesic leg and legal blindness and a good old age and the result is tricky.

She lived in the proverbial little old house down the lane with an oil stove that heated the living room and kitchen. The bathroom was cobbled on at the back down one BIG step where I imagine the back door to the outside plumbing had been once upon a time. The bathroom was too small for one; you could not turn around without opening the door. She would get into the tub by clutching the sink and maneuvering herself *magically* over and in. In was not a problem. Out was.

The time was growing short on the days when this would be feasible. I offered all sorts of alternatives. There is a bathbus after all that picks clients up and takes them to the beautiful tubs of the care homes in our area. Not for everyone, certainly not for her. I told her that until the day where she could no longer get out of the tub I was willing to help. If for some reason she could not make it out I would be obliged to call 9-1-1 as we are a no lift workplace. Until that day we would carry on.

We were both in the same Sun sign. I would read her our weekly "horriblescopes" and we would chuckle madly. Sometimes we would just sit and chat about the ways in which we would change the world if we had that power. Never did she complain or mope or moan.

I was off for 2 months. When returning to my usual clientelle, I was shocked to find Mrs. D. almost teary-eyed at my entrance. "I am so glad it is you."

She was smaller and seemed to be fighting some sort of bug, but had been denied a bath or two having had to resort to spongebaths was not going to miss her big chance to get in the tub again. The water would be warm and she would be able to lounge and soak for 15 mins or so after the essentials were done.

God bless her but that was the night she couldnt get out. She couldnt even get up. It was not warm out. The little room was cooling down as the water drained out. The panic in her face as she told me: "I can't get up. I just cant."

I got a towel a jumbo extra large towel and got in behind her. We wrapped it around her waist twice and I squatted down behind her firmly holding the towel with both hands and told her to get up on the count of 3. We did it and I had her out and on that board in moments. She cried happy tears and I had to call in an extra 15 minutes which I would not normally do but it put me so far behind I would be 35 mins late meeting up with another worker at 11:30.

Naturally I got in a spot of trouble over that. I maintained it was not a lift merely an assist.
We actually had a video in our resource room showing that exact assist which is where the idea had sprang into my mind from. The Supervisor walked into the resource room and removed the video. (!!) It is not that I am unusual in my practice. I am just honest. Other workers do not admit to anything. They are afraid they will get in trouble. Me, I AM trouble. ;)
Been the boss too many years to start being a weeny now. hah.

Dear Mrs. D. it was indeed a nasty bug and she was gone not long after.
I remember that night as I left tucking in her bed she reached out and pulled me close and hugged me tight. She said again: " I am so glad it was you. Thank you."

Thank YOU Mrs. D.
Always a pleasure.



Back to Normal (silly but happy)

Today was a most excellent work day. Most excellent.
The 2 people I worked with were outstanding as are most. Whew!
After yesterdays horrorama I was curiously anticipating my assist.

Both the women I worked with today told me they also have had their share of attitude from various other workers. I am not sure why anyone would want to try one-upping their co-worker in the HealthCare profession but I suppose it is a human thing. Whatever it is I DO NOT LIKE IT!

I am loving my hours; a very short shift. Although I would love to make more money, the difference in lifestyle makes the lesser pay unimportant to me. I feel great every day and I wake up happy and have wrung out an extra 2 or 3 hours of every day. THAT is invaluable.

Looking at my list of dear departed. Again I am flooded with memories sweet.
Today is the day to remember Dorothy K.
This little lady had alot of health struggles, not the least of which was a battle with anxiety and depression. She knew her demons well and worked very hard at staying independant.
All was going very well and then a little fall landed her in the hospital. She was so tiny and thin it did not take much to get a break or sprain.

She recovered well and then, prior to release caught the dreaded superbug.
Valiant her struggle but quick her end.
Dorothy K. this one is for you.
I remember you in happiness and grace. Always a smile always a thank you for even the smallest of things. You were a pleasure to know.



dropping on by and by

When I first started my little career in Community Nursing I decided that I would keep a list of those I cared for who passed on from the now to the forever. The first few people I diligently recorded all my notions and felt this to be a necessary task to both honour them and to keep myself aware of their humanity. It is awful when a Nurse treats the disease better than they treat the person.

One of those lists dropped out of a book not so long ago and gracefully reminded me of my clients of the prior year. So many names. Oh so many memories. This prompted a visit to the Office. I took down the "Memory Book" and looked at all the people listed. Dozens of clients. After reading for a good half hour I jotted down some names. I will post about them in a little while.

There is something sacred in end of life care. Watching the door of eternity open just for a moment and the departure of a being. It is amazing. Anyone who does not believe in God nor life after death should be a Palliative Care Worker.

I thank God for the chance to actually have some meaning to my work.

differences of opinion


There is a real sorrow working with people who have skills that are low and attitude that is high.
It is bad enough to meet them irl but to work in OUR field...
I had alot of trouble trying not to react to a pain in the arse today. This woman was clearly one of those who was a housekeeper/cook who upgraded and must have gotten a *by*
She did not position our clients feet correctly for getting her up,
She wore the same pair of gloves the entire time AND she answered every question I put to the client herself in a tone of upmost exasperation.

The best part was the way she ordered me about asking me to do the obvious.
Oh I know, I do not take direction well.
In fact, I do not take it at all. hee hee



hot stuff

All right I admit it.
I am a bit of a hothead.

When I feel disrespected I get angry. I got angry last night at someone and wrote a very blunt letter to them (digitised version of course).
I felt very much vindicated by sending the letter. In true keeping with my personality, this morning I felt much differently about things. This is the reason I cannot work evening shifts or night shifts. I just am not the same person in the nighttime.

I opened my mailbox this morning to an apology ...
I am very not good at these sorts of things.


In other news:
The clientelle just gets odder. Today I had two people on my client list who all but declined service. The Government is paying $35 an hour for this. No wonder we are in dire healthcare straights.

I see alot of people dehydrating. They know it and I know it but will they drink water? No, of course not. They want coffee or tea or something else that will dehydrate them further. I met a junkie in her 70s today. Not sure she even realises she falls into that category. What on earth would be in the mind of a Doctor who prescribes oxycontin in a regular dose to an elderly woman who weighs less than 80 pounds? I am but the hands. The brain however, seems to have some connections gone awry.


Its too deucedly hot

Holy heatwave batman!

Sweet slumbers in the afternoon! It has been decades since I napped but here we are the middle of August and I come home to find my eyelids shutting and my consciousness drifting away away far away..... most disconcerting.

To my unending delight, I have got a new shift. This is bliss divine. Of course on payday I may not say such things.

Todays clientelle went smoothly with no troubles.
I can see the heat is hard on everyone. We are all tired and some of us are cranky. Not *me* of course. Nope. Not. Never!