Da Goddess

Nursing Observations

Even though I currently work in pediatrics I have worked Labor and Delivery, and general adult Medical-Surgical as well.

You know, there's an interesting phenomenon with caregivers that I see time and time again. They lose themselves in their efforts to care for their loved ones.

I bring this up now because a friend of mine called yesterday to tell me that her brother had just passed away. Linda's mom had flown down to Florida to spend time with her son and help ease his final days. They all knew that he wasn't long for this world. His stomach cancer had spread throughout his body and his organs were shutting down rapidly. Prior to his illness, David and his mother had been estranged for four years.

So, Linda and David's mother arrives at the hospital to tend to David in his time of need. He wanted no one else around. Not his devoted sister. Not his father. Not his girlfriend. He just wanted "Mom." David spend most of his final days unconscious. The drugs were bumped up many times to help relieve his extreme pain. Mom spent much of her time talking to him, singing songs from his childhood, and reading him the news. She called Linda and held the phone to David's ear so that Linda could tell her brother how much she loved him and how she understood that he needed to be free of the pain.

Mom didn't leave David's side for four days. She'd get up to go to the bathroom only when a nurse or doctor was in the room. Last Saturday morning, a nurse came in the room to give David his medications. Mom went to the bathroom. From the bathroom she heard David yell, "MOM!" By the time she was back in the room, he was gone. The nurse comforted her as Mom cried and held her son.

The nurse told her that many patients seem to know when their loved ones have stepped away from the bed and choose that moment to finally let go of life. While it offers no comfort to the living, the fact is, sometimes we hold on too tightly and the needs of the living become a great burden on the dying. The dying seem to hang on for the sake of the living. Only when they have that moment of peace or rest can they make that decision to slip from our grasp.

So here I sit. Wondering how to convey my message after retelling that story. No matter that it didn't happen to my family - this time. It has in the past and will happen again for us in the future.

As a nurse, I see families tending to their ill loved ones. Sometimes it's the mother. Sometimes it's the father. Sometimes it's a brother or sister. Almost always, the caregiver puts him or herself last. Tending to the needs of the ill, coordinating all the details of visitor schedules, medications, other treatments...all to make sure that the patient is cared for by family. We nurses let them do this. If others have experienced something different....shame on the nurses who interfere! As long as we can give medications on time, perform our assessments in a timely manner, and as long as we can be doing something useful, we should be allowing family and patients to play a large role in the experience. For us, it's a job. For them, this is family.

As I was saying, though, caregivers rarely take the time to tend to themselves. They're often exhausted, in need of a shower and fresh clothes, hungry, and generally in need of fresh air. This is the point where focus is lost. There is a tension which surrounds everyone in the room. It's not therapeutic for anyone.

I encourage other family members or friends to give the main caregiver a break. He or she will fight you on this initially, but when they've had a chance to freshen up and rest, they understand that they can focus anew on the patient. Once they have relaxed, there is often an immediate change in the patient. Gone is the tension that was so thick in the air. The patient's heart rate slows, the blood pressure lowers, the respiratory rate and rhythm stabilize to a more natural rate. Even their temperature returns to something closer to baseline.

Whether the patient is on the road to recovery or slipping closer to passing, these changes are for the best.

The very loving and nurturing family and friends that surround a patient need to understand that being a caregiver means taking care of EVERYONE - that means the patient and themselves. You, as the caregiver, are capable of doing so much more to bring about actual CARE when everyone's needs have been met.

It's not easy to do. But it needs to be done.

Sometimes it's as simple as taking a shower and changing clothes. Maybe it's going to the bathroom and splashing water on one's face. Or, perhaps it's stepping outside the hospital, breathing in fresh air and taking a moment to rejuvenate one's spirits. Whatever it is that brings about a sense of refreshment, it's important to the overall health of the patient.

I've often taken time out of my day, usually during lunch, to step in and sit with a patient so that the family might have a chance to partake in a little of that renewal - however they might find it. It's a small, simple, and subtle thing for me.....and an enormous, pivotal thing for the patient.

If you ever find yourself in a situation where you're sitting at the bedside of a friend or family member, please don't lose yourself in the caregiving that you're performing. Take a little time for yourself and allow the patient the opportunity to relax as well. No matter what, you've been there - giving your all and they'll know.

I understand your hesitance to step away. What if something happens? What if your loved one passes away in that moment? That's something we all worry about. But, what if that break you took is enough to allow them to relax and return to a calmer, more comfortable state? Isn't that something to consider?

Be therapeutic to the patient and to yourself. It makes a difference.

Posted by DaGoddess at June 5, 2003 09:50 PM