Gratitude - Ask A Nurse

After spending as much time in hospitals as I have this year, I’ve had a lot of conversations with nurses.  Nurses are great to talk with for a lot of reasons, not the least of which is that they’re in the trenches taking in more detail than any one body could ever possibly assimilate. They’re the complete package and if it doesn’t become glaringly obvious, I have the greatest respect for nurses of all stripes.

If you want to know what is really happening, talk to a nurse. A doctor will typically hedge around what’s going on rather than commit until a decision has been made. When joking about what is TMI (too much information), doctors will say, “You can’t tell us too much information,” while the nurses will open their eyes just a tad wider and mouth out, “Uh, yes…yes, you can.” Yeah, they still really do want to know everything from the color of your sputum to the consistency of your poop and they have a wonderful way of asking you about it!

I won’t idolize nurses here, but I will be very up front again in saying I hold most nurses I’ve worked with in the highest esteem. I can’t tell you exactly what makes a great nurse, but it just seems that the profession seems to attract the most amazing collection of attributes wrapped up in a heart of compassion that never stops amazing me with the limits it stretches. That’s not to say that there are people who shouldn’t be in the field and I’ve worked with them as well. In rare cases, there seems to be some sort of self-policing already in place and the conscientious nurses tend to shield the more sensitive patients from, shall we say the rare underachiever.

And that’s not to say the good ones don’t make mistakes. We all make mistakes. I had an instance where a nurse overlooked one small detail and even though it wasn’t serious enough to even register on a test, it required that I stay an extra day in the hospital. This person felt so bad about it that it brought tears and this person whom I honestly felt had it together couldn’t face me until the following day when there was an out-and-out apology. How many people do you know take on the importance of their job that fully and emotionally? Sure, you trust certain professions with your life and without doubt, medicine is one of them, but it would be just as easy to become jaded over time to emotionally protect oneself from the trauma of that responsibility.

After multiple inpatient stays involving many, many days with the kind of minute details with overlapping medical teams that have involved the complexity of leukemia not to mention the myriad of unexpected hitches along the way, there have been other mistakes, but they have honestly been minor and because I and those around me in caregiving roles pay close attention to everything that is happening, I’ve been able to get resolution on everything before moving forward – without exception. No nurse has given me a sigh about my questions. If anything, I’ve been cheerfully informed down to the most routine pill every time I’ve been handed one and encouraged to ask all manner of question right down to my relationship with that nurse - and that did come up in one instance early on, but again, not serious and not personal.

Unless you’ve been hospitalized for any length of time, you’ll not have experienced the acute loss of modesty and dignity that come part-and-parcel with anything debilitating.  Nurses have a way of stripping the embarrassment away and helping you just heal as best your body can. Some medications do funky things to you. They take away your ability to take care of basic bodily functions, make you say st-OO-pid things, and turn you into someone else for a time. I’ve experienced this quite a few times, but in extreme terms when I was in the MICU; the nurses there just smiled and helped me through it, especially when there were the foreign looking appliances you only see in medical supply store ads for the elderly.

And then there have been the most compassionate, sweetest things that elicit tears even today. Nurses actually saw me for who I was through my weakness. They listened to my kvetching or fear in the middle of the night when I couldn’t sleep or during those long chemo/IV sessions. A couple that stand out as examples were during my initial hospitalization in February and March earlier this year. I was struggling through this cancer diagnosis mentally and hadn’t really processed it. I mean, what do you say when you don’t even know the questions to ask? When a doctor gives you a 90-day death sentence, there’s not much more beyond the here-and-now. My guilty indulgence has been chocolate my whole life, so once every so often, I stop by my favorite coffee haunt and grab a mint mocha coffee which makes the rest of the day unassailable. I awoke in my mechanical hospital bed one morning to see a venti Starbuck’s mint mocha on my tray with “Don’t Give Up” written on the cup. I found out later a nurse had brought that in for me. Timing couldn’t have been any better. When I finally had my first emotional meltdown of this illness, it was a nurse in-training (the VA system calls them ‘health techs’) who brought me a warmed blanket, tucked me in bed with practiced gentle hands, and then let me regain my dignity back.

They might be simple things otherwise considered ‘gestures’ by anyone else, but to me at that time, they were huge. They were what I needed at the time and these two were perceptive enough to pick up where no medical protocol would have prescribed anything. Perhaps it’s that compassion combined with intuition – that space between the symptom and the intangible – that makes a great nurse from someone pulling a shift. I still can’t say, but I know I’ve experienced some great nursing and I can say without a doubt that I have had some world-class care that without these incredible nurses, would be a very sterile experience.

I’ve made a point of dropping off gifties to the nurses stations I’ve been attended by, but there’s really no way to extend how genuinely grateful I am to nurses for the kind of care I have received – and continue to receive throughout my treatment. I’m pretty vocal about telling people to thank cops, firefighters, and veterans, but I’d be remiss if I didn’t add nurses to that growing list.

To all the nurses, health techs, and others that attend me and my host of infirm campadrés, my heart-felt thanks to you all. You deserve far more than you get and should be paid far more than you’re compensated.  You’re definitely worth your weight in gold.

Be well, stay strong, and much love to you all…and if you do find yourself un-well, I hope you see just how awesome nurses are.

Today’s music from George Michael – Heal the Pain

Let me tell you a secret, put it in your heart and keep it
Something that I want you to know
Do something for me, listen to my simple story
And maybe we'll have something to show

You tell me you're cold on the inside
How can the outside world be a place that your heart can embrace
Be good to yourself
'Cause nobody else has the power to make you happy

How can I help you? Please let me try to
I can heal the pain that you're feeling inside
Whenever you want me, you know that I will be
Waiting for the day that you say you'll be mine

He must have really hurt you
To make you say the things that you do
He must have really hurt you
To make those pretty eyes look so blue

He must have known that he could
That you'd never leave him
Now you can't see my love is good
And that I'm not him

How can I help you? Please let me try to
I can heal the pain, won't you let me inside?
Whenever you want me, you know that I will be
Waiting for the day that you say you'll be mine

Won't you let me in, let this love begin?
Won't you show me your heart now?
I'll be good to you, I can make this thing true
Show me that heart right now

Who needs a lover that can't be a friend
Something tells me I'm the one you've been looking for, oh
If you ever should see him again
Won't you tell him you've found someone who gives you more?

Someone who will protect you, love and respect you
All those things that he never could bring to you
Like I do or rather I would
Won't you show me your heart like you should?

How can I help you? Please let me try to
I can heal the pain that you're feeling inside
Whenever you want me, you know that I will be
Waiting for the day that you say you'll be mine

Won't you let me in, let this love begin?
Won't you show me your heart now?
I'll be good to you, I can make this thing true
And get to your heart somehow

Frequent Flier

In my previous professional life, I used to do quite a bit of traveling. I have a special portfolio of sorts where I keep all my frequent flier and hotel reward program cards. If you’re one of those road warriors, you know the drill when you check-in for a flight or a night’s stay at your chosen hotel chain. They see the gold or platinum colored card and they smile and thank you for your loyalty and give you the fresh baked cookies or other perk that goes along with the program. It’s kinda nice actually, especially if you have to be away from home for days on end.

"Just a spoon full of Starbucks helps the chemo go down....in
 the most unlikely way!" Starbuck's courtesy of my sister, Lynette
(big hugs). We won't be giving up our day jobs to be songwriters
 any time soon, but we do have the tried and true family warped
 sense of humor! My nurse of the day, Carol wearing the latest in
chemo blue fashionwear.

Now, if my calculations are correct, I have 31 days here at the Hotel California, one of the club ‘med’ chains where you can check-out when the doc says it’s OK, but you never really leave.  I keep coming back three times a week when I’m not inpatient and I’m bedding down on night number two for another one of those extended stays. My travel plans have me checking out Sunday morning if all goes well. I don’t know if that will put me over the line for the platinum level rewards yet. If I were to guess, I would say it does since I have the nice room, so they must have sent the special fru-fru card in the mail. No cookies on check-in though, but the room service is pretty nice. Once I finish up in Seattle, I’ll no doubt have the coveted black card! Not too many of us get that one…and honestly, who would want one?

There have been a lot of things I’ve wanted and when I got it, found it wasn’t all that it was cracked up to be. I can remember a quotation on Mrs. Van Rosendaal's (my 9^th grade health teacher ... impressed I remember her name?!) chalkboard that pretty much put that sentiment in a nutshell: Far better to receive not what one wanted than to receive what one wanted not.” That’s true on a number of levels. Very clearly, I didn’t want to be a ‘frequent flier,’ so to speak, at the hospital, but there have been a number of silver linings I’ll write about as I am able to list them out. The term, ‘pay it forward’ has been poignant for me as I’m seeing so many of the things I’ve done both in my recent as well as my distant past coming back to surprise me in so many wonderful ways that I continue to be astonished. People’s true colors have shone through – thankfully, most for good, but some have risen far above what I could have conceived. For lack of a better term, I feel truly blessed, especially considering the extreme circumstances.

Now that I’m physically attached to an IV pole that has the yellow chemo bag ensign only a few hours a day, I have been wandering about the hallways and tunnels connecting buildings in the Veteran’s Administration Healthcare complex. I’ve seen a lot of people who are in pretty bad shape and not all of our wounds are visible. Some of our guys are returning from war where the scars are in their minds, some are amputees, some are like me and battling a chronic or other long-term illness, some are traveling great distances to be here and just trying to get that ache taken care of. You can see it on the faces and that of their loved ones. And then there are those you don’t see.

Of the many evenings I spend here, weekends are generally when the patients who need a little extra attention or are en route to another facility show up in the acute care ward where I am. My first weekend as an inpatient was in a semi-private room and my roommate was an older gentleman who had broken his hip and was suffering dementia. Every single exhaled breath was a moan. I didn’t sleep well that night. I came back Monday for aggressive chemotherapy and that first weekend brought another veteran suffering dementia who didn’t have the presence of mind to use the nurse call, but rather shouted for help. Ear plugs were required for sleep that night. Again, last night, my next-door neighbor wasn’t suffering from dementia, but he could out-curse any sailor I ever met. I had heard him shouting for a nurse earlier in the day, but about 11:30 pm, he was at it again and even though my door was closed, he was shouting loud enough for me to make out every word, every epithet, and every threat. My naval officer training was pushing its way up and after about 30 minutes of his tirade, I was ready to walk next door and find out who thought he was the hospital’s most important patient, but about midnight, it finally quieted down.

Today, it has been mercifully quiet.  I can only assume that he has been given the extra milligram of the pain medication he had been demanding…or a lovely placebo. That, of course, makes me wonder truly what it was that he wanted: was he, like so many veterans here, alone and in severe need of someone to give some attention or was there some legitimate pain that needed relief? Or perhaps a bit of both?

Because so many people on staff know me by name now, it’s not uncommon for them to stop by and chat me up. One of the administrators who takes the brunt of people like the man who threw the temper tantrum yesterday has much more patience that I do with that kind of behavior (obviously the person for the job!) talked to me a bit today and put the event into perspective without going into any details. It drove the point home that this particular Club Med is for healing, even if sleep isn’t a high priority! It drove home just how compassionate and longsuffering the staff is. That’s something I knew already, but the people that are hard to understand, hard to communicate with, or hard to placate prove that there’s an unwritten part of the job description for the nurses and med techs that transcends mere compassion and extends to a kind of love for one’s fellow man that is nothing short of awe-inspiring. I’ve seen it, I’ve experienced it, and I’m grateful for it.

This isn’t something I asked for as a frequent flier, but it took being one to really grasp it both in the big picture and in its many nuances. It’s more than knowing someone’s name; it took sharing the vision of hope in a child; it took mingled tears of losing a patient, of surviving one’s own cancer, of the promise of retiring in good health; it took sharing a smile, of our mutual humanity. I can’t say that these difficult patients will understand the kind of commitment that the people who work in health care have for their patients and their career, but you can be assured it’s completely devoid of politics and completely full of the qualities that allow for healing and for a thriving and healthy community.

Today’s music is a blast from the past, but the lyrics seem to be both a tribute to my medical professionals here as well as a reminder to myself.  Argent’s Hold Your Head Up, originally released as a single in 1972.

And if it's bad
Don't let it get you down
You can take it
And if it hurts
Don't let them see you cry
You can take it

And if they stare
Just let them burn their eyes
On you moving
And if they shout
Don't let them change a thing
What you're doing