NURSING ... THE CARING PROFESSION

[gingot]

IT IS NOT ALWAYS THE FINANCIAL GAIN THAT COUNTS...


Expressions of What Nursing or Caring Is?


THE RACE

He’d come to see his doctor because of his complaints of headache for 2 days now. A piece of cake, really, unless you have a history of hemophilia. What started as “routine” spiralled into complications …. Needles, tubes, a ventilator. Trying to sustain a body that would no longer sustain itself.

That was February 1996, at the Pediatric Intensive Care Unit (PICU) of then Children’s Medical Center Phils. (now Dr. Fe del Mundo Medical Center). His name was Lanz, only 5 years old, the eldest of two siblings. He was only 2 years old when diagnosed of Hemophilia. A cranial CT-scan revealed a clotted blood. Upon history, his mother admitted that Lanz complained to him a nagging headache demonstrated by pounding his little hands to his forehead. Few hours after he accidentally banged his head on the floor while playing “horsey-horsey” with his brother.

He came to us for end-of-life care. Pale, breathing hard, a feeding tube hanging uselessly from his nose. Only five years of life condensed into a slim chart of medical relevance: an admitting sheet, history, medication sheets, nurses notes. Bare facts: prognosis poor. Running out of options. Running out of time.

His family came to him…. Daddy and Mommy alternately knelt at the bedside, their faces wet with knowing. Touching. Talking. They wrapped their arms and voices around him in a passionate effort to keep him connected to the world. “We will go home, son”, Daddy said. “I want you to be home to die with us”.

Health-care professionals often toss around phrases like “comfort care”, “supportive interventions” and “the patient’s right to self-determination”. We say then as if we know what they mean. But what did they mean to this child and his family?

“We will go home, son”. “I want you to go home to die with us”, repeatedly uttered with disbelief by this grieving father.

His family came to us for help in achieving that wish. They knew it would not be easy, as did we. They knew there were no home-care arrangements in place. They knew his blood pressure was 50 palpatory. They know home was an hour away (minus the after-5 pm traffic); not a vast distance by most standards, but a tremendous journey under these circumstances. They knew, too, that there was a strong possibility he could die in the ambulance. “It doesn’t matter”, his family said. “He will know he is on his way”. In that knowing, perhaps, lies the ultimate “comfort care”.
And so, we, his medical team of doctors, nurses, orderlies and more, blended our planning efforts. That was after Daddy signed the waiver for D.A.M.A (Discharged Against Medical Advise). We were all participants in this last leg of the race. There were discharge orders to be obtained: portable oxygen, IVF’s, ambu-bagging, NGT feeding. There was urgency, pressure, and determination. Voices were raised and minor misunderstandings occurred, but despite of this, a major victory was achieved.

Two hours and forty minutes after we began our efforts, the ambulance arrived. Making an exception to policy, the hospital allowed two family members to ride along, in case death came too soon.

Our patient made it home by eight o’clock that evening. Four hours later, he died a peaceful death in his own house, in his own bed, with his family present and his favourite Barney show playing on TV.

[rheb]

why does it have to end like that?
i miss lolo te ging!

[gingot]

hello rheb,

it has to be like that.... in oncology/cancer(terminally ill) nursing, we care for death and the dying. if we have immediate newborn care we also have end-of-life care. we assess and render nursing care for the patient's imenent death for him to have a dignified meeting/joining with the Lord.

Lolo is with Him right now. I'm sure he is happy to see Nanay, Uncle Douglas,Tom and Maan there.

[rheb]

it's still hard for me to accept what happend.
everytime i'm in a conversation regarding lolo,
my eyes gets teary.



this is why i don't like to be so attached with
someone. it's hard for me to recover.

[kampanaryo_spy]

one of the incontrovertible facts of life is: some good things (or people) never last. and while they say that letting go is easy and it's holding on that's hard, still, life must go on.