Wednesday, December 10, 2014

The hardest part

Today is one of the hardest of days in this walk with mom. Just the reality of it all settling in, hopes dashed and crumbled once again, and trying be present as a loving child and caregiver while holding myself together. Its a lot of pressure to bear up under. And it's these days that being a nurse are the most challenging. I have a job where I make people better, and if I can't I find someone who can. ER nurses are tough and we don't take no for an answer, we save lives in a matter of hours. We may lose a patient from time to time but we save so many that we always have confidence and hope that we can do it again.  But this situation is different. This time it's my mother and this time I can't save her. What is a nurse to do?
The hardest part about today is after realizing that things are worse now than they have ever been is trying to find a little piece of hope to stand on. Without hope I start sliding down this terrifying hill that you can't see the bottom of, and the hill isn't bad but it is oh so scary and so foreign. The faster you go the better you can see the fast approaching base of the hill, and terror with it. Finding a little hope blinds me to the fear and helps me find joy in the midst of the fall. Somehow I'm stuck. I know my mothers ultimate hope and my hope for her is getting to pass on from this world into eternity, and into the loving arms of Jesus. But the daughter and the nurse in me cannot find solace there yet. There is so much suffering and illness in the meantime and the path is a long hard one.
There is just so much to consider, so much that my medical brain and spiritual heart run through.  The nurse in me never really stops and I'm constantly assessing mom with my eyes, trying to see ways to help her, weigh out the difference between dangerous new symptoms versus acceptable progression of the disease. I'm so tired of chemotherapy. I'm tired of seeing the fatigue, the neuropathy, the fog, and the compromise brought on by it even though it is preventing advancement of tumors. I hear her wheezing and short of breath and I just don't know if it's tumors in her lungs or if it's because of her low blood counts depleting her body of the necessary oxygen her body needs. 
My nurse brain is constantly trying to fix this very special patient, this most critically ill patient. How on earth do you teach an ER nurse to see altered mental status or wheezing or sheer fatigue or anemia or critically altered lab values and do nothing?  I fix things and I fix people, that's what I do when I go to work.  Even more challenging is trying to turn the assessing off at home and a few hours later turn it back on at work.  I must suddenly value the minute suffering of a headache or a sprained ankle with the same compassion as that of my dying mother. All the while my moms illness process and the questions of her care plan still run through my head. 
You nurses all know we learned to make care plans and learned to hate them. I promised myself I wouldn't make a care plan for mom; but here I am with goals for healthy skin and prevent skin break down and falls and promoting oxygenation and ADL's in the back of my mind while looking in a 2 year olds ear.  I want to let the doctors be her doctors but 10 years have taught me doctors don't know everything and the compassionate nurse often has the wider scope. The reality is setting in that my dear mother will become my most challenging patient. The reality is setting in that I'm not supernurse and I can't fix everyone. Only My Jesus can fix her. And only He is my hope. He must be.

"And hope does not put us to shame, because Gods love has been poured into our hearts through the Holy Spirit" rom 5:5

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