Whatever It Takes

 

photo-1484100356142-db6ab6244067 (1)It’s funny how our minds work, and the way we never know what random memory might pop up during conversations about something else. My nephew and I were talking about looking forward to seeing each other on Easter (we don’t get to be together often enough) and about music. In a family with some really talented singers, we always joke that we are the ones who can’t carry a tune despite never giving up trying… repeatedly…  loudly. I suspect he really can sing but holds back to spare my feelings! Talking with him reminded me of what happened with one of my patients years ago.

Adam was a 35 year old man who had received a transplant several days before I took care of him. He had been in relatively good shape prior to surgery so the team and I were eager to get him up walking. Unfortunately, he was not eager at all. He would walk once a day, sit in the chair for maybe 30 minutes, and then he was done. Finished. No more.

His sisters and I tried everything we could think of to make him increase his activity; they would plead, beg, threaten… I tried compassion, empathy, bargaining, and taught him about the risks of post-op complications until my mouth had gone dry every single time I went in his room. He’d laugh, blow us off, say “maybe later”, or sometimes just refuse to speak altogether.

By the end of my third shift with him, his sisters had gone home to take a much-needed break. I totally understood as my own patience was wearing pretty thin too. At 6:00 pm, armed with last-ditch determination and a co-worker by my side, I entered his room, saying “Okay Adam. The time has come. Up you get, we’re going for a walk. You had your pain pills a half hour ago, so let’s do this!” His response, as predicted, was a yawn, a stretch, and a “Mmmm, maybe later.”

“No! No later.”

He started laughing which led me to doing the unthinkable.

I said, “Adam, if you don’t get up right now, I’m gonna start singing. I’m serious. You don’t want that.” My coworker, always a great team player, jumped in enthusiastically and told him, “Yeah! We’re gonna sing Ebony and Ivory!”

I think it was pretty fair that we gave him to the count of three to make his move. When that didn’t happen, we burst out singing as loudly as possible with “Ehhhh-bon-eeeee and Eye-vor-eeeee, live tooooo-getherrrrrr in puhhhhrrrr-fect har-monnn-eeeee!” Before we even got to the word ‘Ivory’, Adam had his hands out scrambling to sit on the edge of the bed and pleading, “No more! For the love of everything good, please stop singing! I’m getting up!” When the three of us got to the hallway, everyone was gathered around wondering why we laughing so hard!

Adam has done great with his transplant and comes to visit me at the hospital a few times a year. It’s great seeing him healthy and enjoying life! For some reason he always declines my offer to sing for him.

 

 

To Our Patients and Their Families- From a Transplant Nurse

We are often humbled by the grace and courage you display. We remember your words many years later as you affect us so deeply and we are honored that you allow us into your lives at the most intimate times. Because of you, we love harder, smile wider, and appreciate the little/big things in life that we used to take for granted. Thank you for that gift. You are our greatest teachers.
We don’t want you to be in pain and we feel frustrated when we can’t make it better.
When we have been off for a few days, then return to work and find out you were discharged home, it makes us smile and we wish we had been there to say goodbye.
We get excited when we see your labs before we enter your room knowing that ‘new’ kidney is working well and are eager to share that news with you. We also dread entering your room when your labs indicate no signs of improvement knowing we will see your disappointment.
Sometimes we think about you when we get home, wondering if you are doing better, and cannot help calling to check on you. Sometimes, too, we try not to think of you as we are reminded of our own mortality and that frightens us.
We are moved when we hear you speak with sincere gratitude about your donor and the donor’s family. We want to hear about how transplant will change your life and what you are looking forward to the most- walking your daughter down the aisle on her wedding day, going shopping with your friends without having to carry an oxygen tank, looking into your newborn grandchild’s eyes and feeling him grasp your finger with his tiny hand for the first time.
We love having you come back later to visit and giving us the opportunity to see you feeling well and enjoying life. You give us hope and that hope inspires our care of future patients.

A Tale of Two Patients

model cars

Sometimes we pray for signs from God giving us guidance, asking Him to let us know we are on the right path as we struggle with our own inadequate decisions. My answer was given when a bible literally slammed into my chest.

Patient One, Sam:

Sam lived on our transplant unit for about six months some fifteen years ago awaiting a new heart to replace his own. He had dilated cardiomyopathy (in essence, a giant and floppy heart) and was dependent on two continuous IV infusions to keep that heart beating, in addition to a slew of oral medications. A magnanimous man in his 40’s, Sam was the kind of person others cannot forget. Always wearing a smile and having a great sense of humor, he was a born-again Christian who had remarried; he had one little boy from that second marriage in addition to several grown children from his younger and wilder days. I was his nurse most days I worked.

Passing the time at a hospital is challenging, particularly when a patient is there for a much extended stay. Sam built model cars during his days there. His family would bring him a couple of new ones every weekend, and he worked on them throughout the week. He’d sneak to the nearest stairwell, pulling his IV pole with him, to apply paint to his latest car; when administration happened to visit our unit, the other nurses and I would cover for him and deny that we had any knowledge whatsoever of just where that lingering scent of spray-paint was coming from.

As much as I loved Sam, I was very uncomfortable when he spoke of his faith and of Jesus; it was a time in my life I just wasn’t ready to hear about it. He would start talking and I’d try to change the subject. He would push, and I’d resist. He eventually won… I’m so glad.

When a heart finally became available for Sam after all those months of waiting, he decided against having a transplant. He was discharged shortly afterwards and died at home with his family by his side. Before leaving the hospital, Sam gave me a bible. I keep it at work, and have shared it several times throughout the years with patients and their families who have expressed the wish that they had a bible to read.

Patient Two, Lindsey:

Lindsey is a 24 year old beautiful girl that we have known since she received a liver transplant at the age of thirteen. Since that time, she has spent at least half of her life with us in the hospital. Most of her Christmases and birthdays have been at the hospital with our staff as her only visitors. We have seen her through multiple surgeries and recoveries, loads of new hairstyles, and a particularly difficult period of smart-aleck teenage attitude.

The last major surgery Lindsey underwent was about three years ago, and it nearly killed her. She spent weeks in ICU, hooked to machines, with no one at her bedside other than our staff. It is a miracle that she survived.

Lindsey’s mother visits once a month, on the first of the month, so that her daughter can sign over her disability and welfare checks to her. The only times that the visits last longer than 20 minutes is when the woman falls asleep on Lindsey’s couch in her hospital room. Lindsey’s siblings are the same way- they drop by to get their sister’s car keys.

The Moment:

I had a break from being charge nurse, and was caring for my own small group of patients when Lindsey’s nurse approached me and said, “Lindsey is crying her eyeballs out, and I don’t know how to help her.” When I went to her, Lindsey was crying hard enough to barely catch her breath. I held her as she sobbed that her family didn’t care about her- she’d finally had enough and had understandably reached the point of utter despair and loneliness.

We spoke of faith and how much God loves her. When she said that she wished she had remembered to bring her bible, I offered her mine-relief washed over her.

When I opened my locker, the bible immediately slipped quickly off the top shelf and hit me so hard in the chest that it made a loud thud! Two of my coworkers were eating lunch in the break room, and jumped at the sound, asking, “What was that?” They remembered Sam with great fondness from all those years ago, and we all shared a laugh as I briefly explained what was going on… Sam always knew I needed to be pushed a little (or a lot!)

Lindsey and I held the bible in our hands; when we opened it, we saw Psalm 40 and read aloud together.

A little side-note here… Just a few days before, my sister Mary had shared part of Psalm 40 with us as she offered an Easter prayer for our family. It was a beautiful prayer of love, hope, remembrance, and gratitude that felt like a new beginning of healing for our family.

Amazing how perfect God’s timing is…

Just a nurse

Yesterday was Transplant Nurses Day; as a charge nurse on our step-down unit, it is such a deep honor to work so closely with some of the best nurses around. Every single day, I am awed by the works of the nurses. We care for the types of patients who are considered to be ICU patients in other facilities.

  1. A nurse is the first person to lay hands on a patient whose heart has stopped to initiate CPR.  When God saves a life, it is the nurse who feels that heart begin to beat again beneath her hands.
  2. A nurse is the one to recognize the earliest signs that a patient is having a stroke, to get the needed diagnostic tests ordered for a patient, and to administer life saving medication.
  3. It is a nurse who touches her patient’s cool skin when she hears the words, “I just don’t feel right,” and realizes her patient is having a heart attack. That same nurse sees a slight change in blood pressure with another patient, gets orders for a sepsis work-up, starts antibiotics immediately, and saves the patient a trip to ICU… or worse.
  4. A nurse is the one who catches an error in medication dosing before it reaches the patient.
  5. A nurse is the one who teaches a new doctor which medication reverses the effects of benzodiazepines with a patient who is barely breathing, gives the medicines, and watches the patient wake up.
  6. A nurse holds a 41 year old man newly diagnosed with end-stage heart failure in her arms and lets him cry big tears on her shoulder as he worries about what will become of his wife and three children.
  7. A nurse shows her patient who just received a kidney transplant the urine pouring into his foley catheter, sees the tears of joy in his eyes, and chants with him and his family that pee is beautiful.
  8. A nurse puts her stethoscope in her patient’s ears and lets him listen for the first time to the sound of the heart that was transplanted into his body a few days before.
  9. A nurse holds a ten-year old little girl’s hand as she whispers a final goodbye to her dying mother.
  10. A nurse cheers loudly with unabashed shouts of “Whoo-hoo!” as she watches a patient who wasn’t expected to live walk out of the hospital.
  11. Nurses are the ones who teach transplant patients how to avoid infections (which can be lethal) once they go home, and teach them self care so that they can enjoy their new chance at life.
  12. When there is no hope left for a patient and the family says, “There’s nothing anyone can do,” it’s the nurse who tells them “There is something we can do. We can keep your dad comfortable.” 

These are just a few of the things our nurses do…