30.8.04

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