falling stars

day two, the patient census was the same, luckily there were no new admits or labs or xrays but the patients i did have were a handful. i plunged right in to the med pass and prayed nothing else would happen until i could get a good portion of it done. it seems it would make more sense to me, if there is a 7am med pass, to start report at 530 so we could be on the floor with the keys by 0600. but not much makes sense about facility organization.

those who are arguing over health care reform..press the reset button and please first start with the organization of facilities. the whole thing needs to be flushed and re-done. it's a mess. i don't even know where to start.

the bully nurse was there, once again schooling the night nurse on everything she didn't do, instead of thanking her for what she did do. i've developed a quick relationship with the night nurse and told her that she was doing a great job, that no single nurse can handle all those tasks alone. i must have had a very set expression on my face yesterday as the bully nurse left me alone. she must have realized that i am a damn good nurse and even after a long absence i busted ass and took names. she told me that she would handle the front desk and doc orders and i would run the floor..which i agreed to quickly. then i found her outside playing guitar. AND she left before shift report. i'm stunned. the agency nurse..that's me..was the one who stayed longest.

yesterday one of our patients was starting to ..fall.. we refer to hospice patients as falling stars. as you know i've done hospice work before and felt very fulfilled by it.

this lady , we'll call her Eve, was starting to have the shallow rapid breathing, body rigidity, slight fever, and was not responding to verbal anymore. i saw the hospice nurse assigned to Eve make a quick visit but she was outta there before i had a chance to ask anything. the family started arriving, all of them, so i ended up spending a lot of time with them and assuming the hospice nurse role. they needed answers to questions about the death process. they wanted comfort knowing Eve was not in pain. of course they asked me when she would pass and we can't answer that. one of the grand daughters asked me if Eve could hear her if she knelt by the bed and talked to her..i said yes, she can, so she spent some time talking to Grandma. There was a strong family dynamic, it was obvious one of the sons was the leader of the family and his distance and face rigidity made the other family members tense.

This facility does not necessarily do daily charting on a patient. I pulled the chart to see nothing had been written since the 27th. Her bp had been high and she had been agitated following a fall (no injury). I reviewed her history so I could better answer their questions and get a better picture of what was happening. The nurse who had visited that day had not left any charting or note but maybe it's faxed over later? I don't know. All I could see was nurse assistant reports with vital signs and the general 'no change' status.

I could feel with this nursing intuition I've been blessed with that this family just needed a nurse to be there with them to answer questions.

At one point I was standing next to Eve, the one son who was the family leader, unbreakable, showing no emotion, was standing on the other side of the bed. I touched Eve's hand with my own, then reached out and took his hand. He jerked away. I looked up at him and took his hand firmly but gently, then used my hand to place his hand on Eve. His shoulders dropped and he started crying. I could see relief ..there was a gasp in the room. I was later told that no one in the family had ever seen this man cry. He looked up at me and gave me a single nod.

There was a quietness in the room and there was also a glow as if tiny candles were set around the room. I'm not sure how to describe it..death has an anticipation somewhat similar to the arrival or birth of a baby, of course the energy is different but there is an anticipation in the room. Eveyone was very peaceful.

My prayers to Eve and her family.