I just spent the past week working "in the field" as a home health nurse to fill in for 2 sick nurses and 1 nurse on vacation at my brand new job. It was exhausting.....an explanation for my home-care buddies, I was doing an average of 8 points per day on HCHB.....and because I am a rusty-field nurse, the documentation was KILLING me! But, I got faster and more adept at using my smart-phone to document my visits as the week wore on.....but I am not NEARLY as young as I used to be when I was out doing 8-10 points daily when I first started out in home care. I did realize a bunch of things this week....and I was reminded time and again WHY I am a nurse to begin with. Here are a few of my lessons:
Nursing is HARD work. At one visit, I did a wound vac visit on a stage 4 decubitus ulcer that I could fit both fists into.....practically standing on my head for the 40 minutes it took me to undress, clean, measure, repack, and re-seal the wound. The patient's only bed was a couch that sat about 6 inches off the floor and he wasn't able to transfer to any other (higher) surface for me to do the wound care. After about 20 minutes of bending/stooping down in the precarious position, my legs started to shake.....and after about 30 minutes, sweat was dripping off my nose and by the time I finished and the wound vac machine let us know we were successfully sealed tight, I was ready to cry. I had to limp back out to my car. My legs and back were sore the rest of the week. Nursing is hard work.
Nursing is sometimes thankless work. I saw a patient this week who literally screamed at me; red faced, spit-flying, cursing, yelling.....she was most unhappy. Her unhappiness was not my fault.....and there was absolutely nothing I could do at that time to fix what made her unhappy. All I could do was allow her to vent her frustrations, while trying to maintain a calm, objective demeanor and offer support. I left her home feeling like a verbal-punching bag that had been given a royal punching. I actually cried once I got back inside my car. Not really because she hurt my feelings, not because she had yelled at me and spit at me in her rage.....but mostly because it was just emotionally draining and I also needed to vent. So I got in the car, rolled up the windows, turned up the radio, and did a little 2 minute therapeutic bawling session. Then I was able to dry my tears, blow my nose, and move on with my day.
Sometimes, nursing is just gross work. I visited one home that smelled like giant litter-box (and they didn't even have a cat!!) and I visited one home where a poor, pitiful, old, blind bulldog kept scooting and dragging his butt on the nasty shag carpet the entire time I was there. I visited one home where the carpet was so matted and disgustingly dirty that you couldn't tell it was carpet and not a dirt floor. More than one house had so many roaches that the surfaces of the furniture seemed to be alive with scurrying movement. Some wounds smell like rotting, festering hamburger meat left out in the sun. Some homes are just like the ones on that TV Show about hoarders - garbage, newspapers, magazines, car parts, empty 2 liter coke bottles, all piled up from the floor to the ceiling with only narrow 1 foot pathways into and out of rooms. Some old men patients are "handsy" and "grabby" and eagerly hold their arm up for their blood pressure to be taken, always managing to somehow graze your boobs with the back of their hands, no matter how artfully you dodge.
But sometimes.......often times.....usually......nursing is BEST work. I was thinking about how I am a guest in these patient's homes. I am invited into their homes during a crisis.....usually right after a major diagnosis or hospitalization or injury.....and my job is to help the patient and family make sense of their new reality and to teach them the skills to cope with their illnes - be it insulin injections, a new and difficult diet, changing an ostomy bag, or how to take their myriad of new medications. I get to meet them where they live.....in their most vulnerable and intimate spaces...and I get to minister to them. I get to explain, teach, soothe, treat, explain, touch, care, and heal.
I was thinking about how many different homes I had visited in just the span of a week. All of the families and patients.....with all of the different cultures, religions, ethnic groups, life-experiences, and back-grounds they represent. And I thought about how I learned so many different things from each patient.
From the multi-million dollar mansion in a gated estate..... to low-rent senior high-rise apartments.... to modest suburban homes... to an RV in a campground..... to a mobile home park...... to what some would call "the ghetto"...to the assisted living facilities. This week, I have been invited into all of these places to care for someone. Doesn't that just blow my mind? How many people in other professions EVER get this priceless chance to see and experience how so many other people live?
Some patients have loving, doting spouses. Some patients have extended families with children, grand children and great-grandchildren all there to lend a hand. Some patients live with friends. Some patients live alone and long for companionship. Some patients live with significant others or life partners and some patients live with their adult children. Some patients live with their cats or their dog. One of my patients lives with a pot-bellied pig. One of my patients lives alone...and he is a nudist. One of my patients was a priest and he lives with other retired priests in a home run by the Catholic church. One of my patients is a Buddhist. One is an old hippie. One is a Jehovah's Witness. One just got out of jail. One is a retired navy-man. One is a disabled vet who lost a leg - he is only in his 20's. Several are Grandmas. Several are great-grandpas.
Some patients are very private and quiet and want their visit to be over and done as quickly as possible. Some patients are outgoing and boisterous and love to talk and tell stories and jokes and want you to spend as much time as possible with them, just for the company. Some patients are warm and welcoming and some are merely tolerant. Most patients are respectful.
This week, I was offered coffee, tea, water, soda.....and one special lady even wrapped up a piece of homemade rum cake for me to take with me for later (she didn't want me to eat rum cake and then drive). I was given a piece of fresh coconut at one home - the lady and her family barely spoke English, but the ladies of her extended family were in the kitchen cooking for her and they wanted me to experience a taste of their culture. One gentleman made me a tiny cup of Cuban Coffee....his specialty from his native country...and that was the most exquisite coffee I've ever tasted....and as powerful as jet-fuel!! My left eye twitched the rest of the afternoon, but I had some zip and pep!
Each one of these patients and their families gave me a gift - a glimpse into their every day lives. I've learned that we all have different customs, different values, different religions, different beliefs, different styles of clothing, different languages, different foods, different ideas.......but the glorious thing is that we can still all connect on such a human level!! Disease, illness, sickness, injury - it happens to all of us. We may not believe the same thing, we may not look the same, we may not sound the same - but we are all so similar as well in that....we all hurt....we all love....we all sleep...we all eat....we all suffer from the human condition. We are all on this planet together.
I set out to minister to my patients - but as it turns out, they usually minister to me instead. I am so much richer for having opened my eyes, mind, and heart to these patients. The human experience really is a kaleidoscope - ever changing, ever beautiful, ever hopeful, ever poignant...colors shifting and changing shapes over and over again into mesmerizing patterns.
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