Little General….

Ok, it’s been more than a week since my last post.  I apologize for that, but it’s been CRAZY around here lately.  

To start, one of my sisters had major surgery. To say this was worrisome is an understatement. When this sort of situation arises, it sparks something that I thought was long lost: the nurse in me.  

I have to admit, it’s exceedingly satisfying to inform the medical professionals caring for a loved one that you know exactly what should be happening.  It keeps people on their toes, most of the time. 

For about 24 hours, we kept a vigil.  The pre-operative dance: checking in, sitting around, waiting some more, all while wearing the ever-fabulous hospital gown.   Then, after several hours, your number is called and off you go!  I’ve been in that spot as a patient close to fifty times, (maybe more?). Not just for major surgeries, but for “minor procedures.”  Tell that to my back, shoulder, arms and legs.  Nothing ever feels minor when you’re on the receiving end of multiple needles.  I joked once to my husband that I wanted to get a tattoo of a bullseye on my lower back, so they’d never miss.  Obviously, I haven’t.  But the thought of it, years later, makes me laugh.  A human pincushion, that’s what I became.  What we all become, at some point.  

Once a patient is in surgery, a new waltz begins: waiting and checking, waiting and checking – and worrying.  This combination repeats until you get the news you’re praying for, that all is well.  Sometimes, the news is complicated.  This time, things were more complicated than we anticipated.  But manageable.  So we managed.  

Though we planned an outpatient experience, an overnight admission was necessary.  Our beloved’s safety & well-being would have to be in the capable hands of the night shift.  This time, we were lucky.  Everything was taken care of, above and beyond what we could have hoped for. This time.  Morning came.  Then the discharge shuffle began.  

I was told by a friendly nurse that we could expect very specific instructions in our patient’s discharge folder.  Later that night, when said instructions were required, a search revealed only hospital forms.  Thankfully, FaceTime exists.  That and the quick teamwork of my amazing sister & mom.  They managed.  

Why relay this story?  Because there are countless patients having appointments, treatments and surgeries every day with no advocates to fight for them.  It infuriates me to no end, imagining what might have happened if I wasn’t a nurse, my other sister wasn’t a nurse and we didn’t know any better.  This happens every day. 

And this is how I earned my new nickname, “Little General.” Clearly the “little” part is a reference to my diminutive size.  The “general” is likely due to my tendency to take over in medical situations – other than my own, of course – and make appropriate care a certainty.  It’s easy when it’s other people.  I can advocate for others with my eyes closed.  These are the scenarios that make me forget my own medical crap for a few minutes. They help me take on the fight for others.   

Anyone in my family who’s had a surgery or hospitalization locally, especially in the last ten years, has a story involving me.  I need to express the fact that I’m not a troublemaker by any means, I just make people pay attention and do their jobs a bit better. The way I did my job when I was still working. Families counted on me to be nurse and advocate, and I was.  

Recently, I was talking to my daughter about my high school community service experience.  I worked at a hospital.  Conveniently, I was able to visit my great-aunt, a patient, during lunch.  She was in the hospital for a number of reasons.  She wasn’t getting better and eventually she had a DNR order.  On one of the days I was working, I stopped in to see her. Opening the door to her room, I will never forget the site before me.  My great-aunt was sitting up in bed, gasping for breath and trying to call for help.  I raced over to her, and grabbed the call button.  She was staring at me, drowning, and holding my hand, I can’t remember ever being that frightened.  The nurse arrived and asked me to step aside.  She called for additional help.  Suddenly, there was a team of people in the room, a crash cart brought in.  I snapped to reality and began yelling, “She’s a DNR!  She’s a DNR!” Do not resuscitate.  Do not resuscitate.  They pushed me out of the room and closed the door.  I was seventeen and alone.  There were no cell phones back then.  At that point, I was hysterical.  Reaching my mom was my first plan.  She worked a block away and could get there fast.  I begged to use the phone at the nurses station.  My mom and grandmother were on their way.  Not knowing where I should be or what the heck I was meant to do, I tried getting back into the room, unsuccessfully.  That’s when Sister Theresa came into my life.  She found me, sitting on the floor outside of my great-aunt’s room, crying.  It was an act of kindness I can only hope I’ve duplicated, in some fashion,  throughout my life.  This angel of mercy, a nun and a patient liaison, sat down next to me on the floor and said, “Now it can’t be as bad as all that,” and hugged me tightly.  I have no idea how long it was before the door finally opened and my aunt’s bed was wheeled away to the ICU, she’d been intubated.  My mom and grandmother arrived and discovered that the DNR wasn’t found in the chart.  So the team “saved” my great-aunt.  Sister Theresa gently handed me over to my mom and quietly disappeared in the confusion.  Years later, I met her again and thanked her. Though she didn’t remember that day, it didn’t matter.   In that awful moment, she advocated for me

A similar scenario unfolded when my grandfather had a stroke.  This occurred while he was a patient in a four-bed telemetry unit, post-heart surgery.  I was in nursing school at the time and full of straight-from-the-textbook facts.  Grandpa was over six feet tall and hated hospitals with a passion.  A “self-healer,” he actively fought (think fist-fights) anyone trying to examine him or administer treatments.  Then one day, the fighting stopped.  My mom and I arrived for a visit and things were…weird.  He was oddly quiet.  He didn’t see us when we stood on his left, didn’t feel the pinches or pokes on his left arm or leg.  I asked the nurse when things had changed so dramatically.  She seemed utterly confused by the question. At the nurses station, I asked to have a neurologist come see him.  “I think he had a stroke.”  If I said it once, I said it a hundred times that afternoon.  No one was listening.  Finally, I made enough noise that the nurse manager came out to speak with me.  After listening to my theory, she asked how I knew so much.  I proudly announced that I was in nursing school. Cue the heroic swell of music!  With a not so subtle change of expression, she “smiled” and thanked me for my concern but asked me to leave the care to them.  Clearly, my grandfather had “adjusted to the unit and was calming down.”  I may have shouted at her then, thus prompting them to ask me to leave.  Once outside, I called my registered nurse sister.  She came to the unit and agreed that his changes required action. He’d had a stroke.  The staff took her seriously, thank God.  Then things began to move along.  Suddenly everyone was on board with getting my grandfather to rehabilitative post-stroke care.  Clearly Grandpa had other ideas:he passed away in the early morning hours on the day of the planned rehab transfer.  

I was so angry.  Both times, no staff member listened to me.  Both times, it took involving older or more experienced people to be taken seriously.  Those moments in my life enabled me to practice nursing with empathy and advocacy.   They’re a part of me now and always will be. 

So if the “Little General” needs to make an appearance every now and then, so be it.  I resent the thought of countless patients and caregivers being sent home, ill-prepared for what lies ahead.  Everyone deserves to have an advocate, a “little general” on their side.  

Perhaps that’s a hat I’ll wear in the future.  Who better to help a patient fight for what they need than another patient? Someone who gets it, 100%.  

Until next time…….

Peace, painlessness and advocates all-around.

Beck

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