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