Thursday, June 23, 2016

Why I Became a Nurse and Not a Doctor

As many of you probably don't know, my mother passed away in late April after 3 weeks on hospice. I finally got Kaiser to make the referral! But that's a story for another day.

Mom lived with us during her last 3 years of life and it was often a struggle for all of us. But in those last few hours I was afforded the opportunity to share with her why I had become a nurse. She never understood why I wouldn't want to be a doctor instead. Her (much older) cousin had indeed been one of the first women doctors in the U.S. and my mother had considered medicine herself, but after a social life ended her first stint at college with very poor grades, she returned and focused on journalism. It was a decision I think she often regretted. I was always surprised that she didn't pursue nursing. It wouldn't have been looked on with disapproval from family.

I tried so many times over the years to explain my reasons to her and she acknowledged them, but always with a hint that someday I would change my mind. In those last hours when I sat at her bedside and the only person talking was me, I had the chance to show her why.

She had had a series of TIAs and strokes and was now unable to talk and required total care. Her body was shutting down. Her arthritis had riddled her body with awkward stiffness and pain. Her heart had caused her multiple syncopal episodes that left her fatigued and eventually her existence was bed to chair.

In the final days the haldol finally eased the terminal agitation and hallucinations. She was no longer frantically trying to climb out of bed. Nor was she ordering me to stand in the bathroom and see why the house was flooding and the house was going to break apart! I tried to play along, but that only made her more adamant and angry! I tried so hard not to laugh because she was soooo confused and angry. It was just silly.  I had talked so many families down from this as their loved ones transitioned. These would be the longest and perhaps most challenging hours of our lives; and yet the shortest!

It finally made sense that the oxygen concentrator bubbles sounded like water slowly flowing around her. The previous concentrator had been so noisy you couldn't hear the gentle sound of the water bubbling. Reluctantly, with her "You're always right," attitude she calmed down. But I knew she was bracing herself for the flood, the house to crack and the "I told you so" moment to arrive!!

That final stroke left her unable to move any extremity but her hands were no longer stiff. They were soft and relaxed. She required morphine and haldol to ease her transition. That last night she stared at me with her beautiful bright blue eyes and I knew she wanted to know what was happening to her and why?

I was moistening her lips and feeding her a very few ice chips just to ease the dryness in her mouth. (She chewed the toothettes and spit them!!!) I applied some Vaseline lip ointment that she hated, but I knew it worked on her.  I rubbed her legs because they hurt despite all the pain meds --just tired of being in bed.  I starred back into her eyes and told her it would be OK now. Her body was shutting down after 3 strokes and a possible MI, but we would do everything possible to keep her comfortable! I would see to that!!! That had been her end-of-life wish.

And then I held her hand and looked at her and said, "you know Mom THIS is why I became a nurse! Because nurses sit and hold your hand and tell you the truth. They tell you it's OK to go now. They wipe your eyes, and moisten your lips and pad your sunken cheeks from the oxygen tubing. They make sure you get your medication to keep you comfortable. Doctors don't have the time nor the artful skill set to just be with patients. That's why I did NOT want to be a doctor. I only wanted to be a NURSE!!!"

She stared harder like she was trying to say something. Her face softened and she smiled ever so slightly and closed her eyes. I think she finally knew what I meant and it was finally OK with her. And now she knew what was happening to her. A few hours later she was gone.



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