Nursing Influence

99 years old… that’s how old this patient was. He lived in an assisted living facility with his wife; they lived in an independent apartment, but had assistance with things like cleaning, shopping, cooking, etc. He was admitted to the hospital with an exacerbation of a preexisting medical condition, but it sure took a toll on his body. He and his family were faced with the decision to take steps to aggressively treat the disease (which would make him feel worse in the short-term) or resign to hospice care.

He and his family had spent two days discussing the options and still were unclear of the path they wanted to take. The patient fell asleep for an afternoon nap and when I went into the room to wake him for dinner he said “no thank you. I don’t want to do this anymore. I’d like to stay in bed and be left alone.” After sitting down next to his bed and asking him what prompted this sudden decision and listening to his thoughts about this being “the end”, I let him sleep awhile longer and I called his son and asked him to come in. His son brought a radio, for him to listen to the Arizona State University Sun Devils in the baseball Super Regionals as the patient played baseball for ASU before the school was ever called ASU. They talked and the family agreed to his wishes and he would go to a hospice facility the next day.

The next morning, the family came in to visit. The first thing out of the patient’s mouth was “Did the SunDevils win? I didn’t get good radio reception.” His son confirmed that they won and that they would be playing in the College World Series the next week, the patient grinned, and then his eyes opened wide, he stopped responding, and the nurse called a Code Blue. Fortunately, the code was cancelled before the patient was revived (due to the fact that he was going to hospice that day, and this was confirmed with the family who were at the bedside).

I had a chance to speak with the son shortly after the event and he commented on how fitting it was for his dad to pass away just seconds after hearing about the SunDevils victory. He would surely be missed in the family, but his wishes were clear and he wanted to go in peace… and he did.

Between nurses and patients, teaching is often a two way street. There are many instances that patients teach us about life and about ourselves – redirecting our morals & values. In this particular instance, I took care of a patient who had surgery to remove a part of his lung that was overtaken by cancer. The surgery was successful, the margins were clean (meaning that all of the cancerous tissue was able to be removed). Although, it was a tough surgery… the surgeon had even told the patient (in jest) that there were many times that he was cursing him during the operation (because he had such a hard time getting through the patient’s thick chest cavity and tough lung tissue). I first took care of this patient on the 2nd day after his surgery; he was doing well, getting in and out of bed relatively well, starting to walk in the hallways, but having a lot of pain issues related to the drainage tubes in his side.

He was one of those people that I really enjoyed taking care of. I would bring the computer on wheels into the room to do my charting just because I really enjoyed talking to him. He told me everything about his life- from his time in the service, to how he met his first wife… and then his second wife, and how much he had learned about himself between these two women. He had several children and I felt like I knew every single one of them by the time I transferred him to a telemetry room (which was a good sign because it meant he was leaving the ICU) that afternoon.

I stopped by his room every day that I was at the hospital to say hi and would spend a few minutes talking to him and his family. Then, it was the weekend and I was off work (yay!). I came back into the hospital on Monday morning to find his room empty and I was thinking that it was great that he was able to go home, but as I did rounds in the ICU, I saw him… laying in bed, eyes closed, hooked to a ventilator. Oh no… it can’t be…

Turns out, the mix of his chest tubes being removed on Friday and the effectiveness of his blood thinners caused his chest to fill with blood and him to need emergency surgery at 2am.

I now think back to the long conversations we had and the biggest thing that stands out is him telling me not to wait to live my life. He and his wife had put off traveling, waiting for the kids to get older, waiting to have more money, waiting to retire, etc and he went and got lung cancer… and needed major surgery… twice, before they got to follow through with any of their plans. He talked about spending quality time with the ones you love; while you may see your significant other on a day to day basis, remind yourself to cherish the moments – all of them.

So, I’m doing just that. I’m going to Hawaii with the love of my life. I don’t have the proper “emergency fund” set up per Suzie Orman’s standards, but it’s time. At 26 years old, I’ve never seen the ocean and it’s about time to change that with the best company that I could possibly ask for.

So, I’d like to thank D (as I lovingly call him) for the words of wisdom. He was discharged from the hospital a week and a half after his second surgery and I saw him almost every day in between. Who wouldn’t love a patient who’s going through hell, but has a smile and a positive outlook through it all?