Should A Nurse Provide Palliative Care For A Relative

Should a nurse provide palliative care for a relative?

The answer is No. The answer is Yes.

It’s taken me quite a while to formulate my thoughts on this topic.

Four months ago my father in law died after a long 2 year battle with a blood disorder. During those 2 years there were many ups and downs but throughout it all he continued to live his life to the fullest.

For his final few days I was sort of, maybe, his palliative nurse. Like so many I have looked after, in the end, he gave me so much more than I was able to give him.

About a week earlier he’d been hospitalised with a high fever and eventually his kidney function declined to below 10%. It didn’t take long before an infection settled onto his chest which soon turned into pneumonia. The IV antibiotics being given to him were doing nothing to fight the infection. There was very little his doctor could do and they told him that he had “two weeks to live”. He did not want to die in hospital so I offered my services to nurse him at home. He wanted his final days to be where he loved to be. At home looking over the ocean.

This wasn’t a big stretch for me and I was more than happy to do what I could to help. I’ve nursed many people at home palliatively so I knew what to expect and what resources and facilities would be required. With the help of the hospital discharge facilitator we ordered an electric bed complete with a pressure relieving mattress and a commode. We also arranged for a community nursing service to be involved just so there was an independent professional also involved.

His GP was agreeable in providing support and home visits, medication scripts were arranged, an ambulance was booked and we were set to go. This was on the Thursday. As Friday was a public holiday nothing could be finalised until next Monday.

Over that time I did what I could at the hospital without overstepping my boundaries. I helped with eye and mouth cares, kept a watch on his heels, bottom, shoulders, elbows, ears, back of head and any other spots I could think of that might develop into a pressure area. I prompted when necessary for PRN medications to help ease secretions and maintain a pain free body. I answered questions posed to me by my family as honestly and gently as I could.

My self appointed role was to see that he received the best care possible and didn’t get “lost” in the under staffed hospital system.

Months before this and before he became ill his family had arranged for a get together of sorts over the long weekend which would culminate in a grand “ball”. Music had been selected, a mirror ball secured and dance cards arranged. People were coming from far and wide. It promised to be quite an event full of good cheer and laughter.

Circumstances being as they were the original plans had to be altered. My father in law was given day pass for a few hours on the Saturday afternoon. Those who could, dressed in their best and finest ball attire. Each had the opportunity to have time with him and in their own way say goodbye.

On the Sunday my father in law rallied. For a time he became very alert. Jovial and joking. I had seen this many times before and although I did not try to dampen down the optimistic enthusiasm of those present I knew that this was only a short bright interlude.

By the time the Monday morning came around my father in law was very unwell. We had arrived early in order to make final preparations to take him home where the bed had been set up so that he could look at the ocean. He was non commutative and his breathing was slow and irregular. It was clear to me that his time was almost up. To take him home would have been cruel. Sadly I had to tell all his family assembled that I didn’t know if he would survive the ambulance ride home. I didn’t go into great medical detail. They didn’t need to hear what was happening to his body.

The decision was made to stay.

Should a nurse provide palliative care for a relative 2

He died later that morning. Peacefully. His wife and daughter holding his hand. A few of his grandchildren had the privilege of being with him also. He never got to see his ocean that one last time but in the end maybe that didn’t matter. Maybe it did. Is location really that important? All efforts were made to accommodate his wishes but sadly, in the end, it didn’t happen. Like I said … He died peacefully.

The most painful thing I have ever had to do in my life was to be the one to let my family know that he was gone. I knew what to do and what had to be checked. No breath sounds. No pulse. No audible heartbeat. I had no words. All I could do was to shake my head. I couldn’t look at anyone. I had to leave the room. At that specific moment I hated being a nurse more than anything in my life. Emotionally I was spent.

For me those few days were both the hardest and most rewarding of my nursing career. It was hard because I knew the process. I knew the journey my father in law was taking. I knew the erratic breathing patterns, the colour changes, the secretions, the noises. I knew what was happening but I didn’t, couldn’t share it with my family. They didn’t need to know those details and I wouldn’t have told them anyway.

It was also the most rewarding experience in that it was intensely personal. The old man I was helping to look after was not just a patient. This was my father in law and he and his family were trusting me for advice and guidance. It is the greatest gift that anyone has ever bestowed upon me.

Would I do it again? Absolutely. Without a second thought and in a nano second. For as emotionally draining and painful as it was, I’ve been blessed \ cursed with the knowledge and skill set to be able to make a difference (as small as it was) as a nurse.

What do you think?

Should a nurse provide palliative care for a relative?

Squealed Like A Little Girl

Have you heard the phrase – squealed like a little girl?

squealed like a little girl

Often it’s attributed in a negative way. For example “God, did you hear him? He just squealed like a little girl”. A put down of sorts when somebody gets so excited over something or other that they automatically make a spontaneous sound without thought of the consequences or what others may think.

Usually the person making the negative comment, tut tutting or shaking their head has no real understanding of why the squeal has occurred.

Perhaps it’s a chance meeting with a famous movie star or sporting hero? A selfie with a celebrity while out on the tiles. Maybe it’s hearing the answer to the question “Will you marry me?” or maybe it’s opening up that envelope and inside is an invitation to a long anticipated event.

Whatever it is, I say that the time has arrived to bring back the squeal of excitement. Make noise, clap your hands and smile your broadest smile. To be accused that you squealed like a little girl should be worn as a badge of honour and not as something to be embarrassed or ashamed about.

Too often as adults we get caught up in the hustle and bustle of everyday life. Paying bills demands that a certain amount of hours must be spent in the pursuit of employment. If you are lucky enough to love your work then hats off and pants off to you.

For many work can be a soul destroying activity that is done purely for survival. Commitments to family leaves no choice and alternatives may not be realistically available. Joy can sometimes be difficult to find.

So if the opportunity presents itself to squeal like a little girl I say go for it. Express yourself, let others see it and be damned with what they think. Be that giddy little girl without a care in the world. Love the moment for what it is.

As the saying goes “Dance like no one can see you; Sing like no one can hear you”

You deserve it.

You owe it to yourself.

 

My Top 5 Bakery Treats

When the weather turns a bit cold and miserable comfort food should never be far from the mind. With rain and wind howling it’s only natural that thoughts of highly processed and excessively sugary bakery treats present to the frontal cortex for serious consideration. So with that in mind here are my all time five favourite bakery treats.

 

5. Tiger Bread

bakery treats 1The smell of a freshly baked loaf can make even the most stout of men tremble at the knees. Add to this aroma a doughy white interior topped off with a crisp crust and here is one bakery treat just demanding that butter be lathered over it and shovelled post haste into your gob.

 

 

4. Jam Doughnut

bakery treats 2With cinnamon sugar dripping on the outside this circular bakery delight is just begging to be chomped into so that the bright red raspberry jam inside can be enjoyed by the taste buds. Eating enough of these little puppies can satisfy the sugar cravings of the sourest of humans

 

 

3. Sticky Bun

bakery treats 3No social engagement, morning tea or spontaneous dropping in unannounced on friends is complete without a sticky bun. Be it filled with caramel or custard, jam or apple, the sticky bun has for years been the ultimate bakery treat accessory when a good impression is required to be made.

 

 

2. Finger Bun

bakery treats 4A close relative to the sticky bun its smaller cousin first found it’s way into my mouth by way of the school tuck shop. Split in half and generously buttered it was then filled with a sausage roll and covered in sauce. With advancing years I have matured and the sausage roll is rarely inserted these days. My biggest dilemma is typically should I choose the one with pink icing or the one with sprinkles

 

1. Meat Pie

bakery treats 5Now I’m not talking about any nancy pancy pie here. You won’t find any exotic charred buffalo with fennel seeds on my list. You won’t even find a chicken pie. My meat pie is just that. Tradition and unchanging. Ground up bits of by-product and offal that otherwise may have been carelessly thrown away. All topped with Heinz Big Red Tomato Sauce. Yum.

How about you? Do my bakery treats differ from yours?

Send me a comment a let me know.