Tuesday, July 31, 2012

In the Sanctuary

     Sunday mornings were always challenging when my son was a toddler. The crying would begin as we walked back to the church nursery, and though his class was filled with toys and friends and people who would provide loving care for him, his separation from me would cause stress, fear and sadness. But I left him. 
     As I worshiped in the adjoining sanctuary I felt I was in the presence of the Lord. I was at peace and I was where I was supposed to be. I knew that my son was missing me, but our time apart would be short. I looked forward to the day he would be old enough to come with me into the sanctuary and we would stand before the Lord together. 
     I was reminded of these emotions years later when I lost my dad. I was the crying child while he had stepped into God's sanctuary in heaven. At times when I think " I will never see him again" I am reminded that he is where he should be and when the time is right I will join him there.  I have shared this analogy on occasion and hope it brings comfort.

Friday, June 1, 2012

Taking off your nurse's cap

    I felt an advantage being a nurse, acting as my mothers advocate as her advanced dementia required her being a LTC facility resident.  I was her daughter and loved her, and part of that love was monitoring her care, reviewing her medication orders, labs and watching for skin breakdown, fall risks, etc.  I was involved with her care plan and acted as her primary contact and power of attorney. I explained her medical issues to my siblings. I knew her medical history better than anyone.
     I had a history of caring for my mom since my fathers death 10 years before.  My father's last words to me being "take care of your mother". And so I did. I moved her near me and then in with my family  until her dementia made it unsafe for her to ever be alone. I worked full time on a telemetry unit, night shift and my husband a hospital pharmacist. I visited her frequently in LTC and took her to all doctor's appointments.
      I understood when it was time for hospice care and explained it to my brother and sister.   My way of demonstrating love to my mother did not change when she was actively dying. I spoke to her, held her and brushed her hair, but I also assisted in turning her, fixing her pillows, listened to her heart and lung sounds and asked for heel protectors etc. I helped bathe her because I had been doing so for years.
   The hospice social worker admonished me for being a nurse instead of a daughter, and told me I should let others be the nurse now. He told me it was time to "take off my nurse's cap" and just be a daughter. This went against the grain for me.  I don't think I was being the control freak nurse/daughter. ( We have all dealt with those before) I tried to explain that providing care to my mother was how I loved her.  I felt self conscious asking about her vital signs or medication doses after that.  After she passed I relented and let the nursing techs bathe her. Often I have thought back and wished I had bathed her that last time.
   Isn't it possible to be a good daughter and still think like a nurse?  Was my behavior any different than any other caregivers?  How do you separate the roles?

Wednesday, May 2, 2012

We are not Angels

     "I feel drained, like I have nothing more to give." This can be felt by nurses in many areas, but especially those caring for  patients suffering with pain , the terminally ill, or those with traumas. Compassion Fatigue can overcome a caregiver with little warning, unlike burnout which builds slowly.  There has been a lot of research done on this topic recently. I have offered links to websites offering support and training as well as a link to Professional Quality of Life's assessment tool so nurses can check their emotional vital signs every now and then.
      Don't keep it bottled up!  Debriefing, sharing with other staff members, and feeling supported by your co-workers and managers makes a huge impact on recovering.  Staff members should have an opportunity to express their feelings in a nonjudgmental atmosphere.  Many don't confide to co-workers because they don't want to appear weak, unable to perform, or incompetent.  C.F. often attacks the best nurses, those who set high standards in their practice and show compassion and empathy to their patients.
        Nurses must practice self-care and find coping strategies to keep balance. Sometimes the simple act of sitting quietly with controlled breathing will do wonders.  Don't ignore your health, and seek professional help when necessary. Remember, we are not angels, nor supernatural. We are humans with physical, spiritual and emotional limitations. Being compassionate is a quality needed for our role as caregivers, but it also makes us vulnerable.

Saturday, April 28, 2012

     Welcome to "Here, Angels Gather". a blog site created for those working with terminally ill patients, through hospice /palliative care, oncology, or as a caregiver to someone on the journey from this world to the next.
     Though I am not a hospice nurse at this time, I feel a "calling" and hope to join a hospice team in the next few months. My mother made her journey December of 2010 surrounded by family and supported by a wonderful hospice staff. We witnessed her smiling and reaching out to ....angels?. It was surreal.  When telling others my goal to go into hospice I am frequently asked, "how would you deal with all the sadness, wouldn't you cry, and how do you keep from being depressed ?"  I have my own answers but thought this would be a good area for research.
  I am an RN completing my BSN through the University of Texas, Arlington's online RN-BSN program. Part of my capstone requirements was to create a teaching tool using peer-reviewed, evidence-based research. I came across the term Compassion Fatigue and found quite a bit written on this subject.  After a long night of research I lay in bed thinking about how hospice nurses cope. In that twilight between jumbled thoughts and dreams I envisioned this website.  The next night I again tossed and turned and then just got up and created my blog.  My first names choices were unavailable and then " Here, Angels Gather" rolled off my tongue and into the blog title space.
   I still need to do some technological refining. I want to create pages where others can post comments or stories, and I want them organized by topic.  I will actually need to work on that after I have had more sleep!
   Thank you for being here at the birth of my new blog, just what the world needs, right?  I hope this fills a niche, and if it brings joy and reassurance to another then it was worth losing sleep over.
    Finally, I want to say thank you to those who choose to give compassionate care to the dying.  I hope you know how much you are appreciated.  Some call you midwives of the soul, and you truly make the experience of going from one life to the next a natural transition.                                      Gina Herman RN

Upon the Seashore

                                                                                                                     Vicente Romero Redondo

“Upon the Seashore”

I am standing upon the seashore. A ship at my side spreads her white sails to the morning breeze and starts for the blue ocean. She is an object of beauty and strength. I stand and watch her until at length she hangs like a speck of white cloud just where the sea and sky come to mingle with each other.  Then someone at my side says: "There, she is gone!"       
    "Gone where?"
Gone from my sight. That is all. She is just as large in mast and hull and spar as she was when she left my side and she is just as able to bear her load of living freight to her destined port.
Her diminished size is in me, not in her. And just at the moment when someone at my side says: "There, she is gone!" there are other eyes watching her coming, and other voices ready to take up the glad shout: "Here she comes!"   And this is dying.      
                                                                                                                                      by  Henry Van Dyke