The downfall of the health care industry--people like her

Today, I went to the hospital after 6 very intensely long days of not seeing my mom. Being up in Cleveland...yes I know, it's only an hour away from her, but when she has leukemia and preparing for a bone marrow transplant, not even living in the same house feels like miles and miles away. While I was there, I saw a woman, a nurse actually, that struck such a feeling of anger into me that I was actually taken by surprise. You know how you see someone, and you start to have feelings, whatever they may be, but you can't remember who this person is? And what's worse is when you meet eyes, and that little switch flicks on in your brain, but you just can't figure out where you saw their face? And then all of the sudden, it all hits you. Who they are, where you saw them, and why you are feeling the way you feel. What's funny is, this entire process takes a matter of miliseconds for your brain to put this all together, along with all the memories it conjures, and then, out of nowhere, all is clear and you are transformed into a different place and time.

My aunt Polly was moved to the Palliative Care unit at Aultman Hospital. She was dying from liver failure, encephalopathy for all you medical-fielders. She was severely jaundiced and retaining fluid so much that she was rendered nearly almost unrecognizable. You must remember, aside from my mom, aunt Polly was one of my dearest and best friends on this earth. I had even once described her as my "soul mate" to one of my friends. Truly, we were on this wavelength that only the two of us had access to. Very connected, like I had been her friend and grown up with her all through childhood, even though she was thirty-some years older than me. And she was dying a terribly painful death, that I sat by her side for, and watched. The only word I really can think to describe this is "excrutiating."

After she had been moved to the Palliative Care unit, one of my family members stayed with her every night so she wouldn't be alone. She was in and out of consciousness by this point, but when she woke up she always wanted to know who was with her. She was so full of fluid that we were told that we had to be very gentle touching her because she was highly sensitive and the slightest brush of her face could be painful. So we were very careful to touch her and hold her hand and to comfort her, always being 100% aware of the possible pain we could be causing her.

The night I spent with her was her last night she was conscious. I cannot express fully in words this process, but she fell into a coma this night, which is Stage 4 encephalopathy and the last one before death. Before this happened, she talked to people that weren't there, even reached out to people. I was very near to her when this happened, and I had first thought she was reaching out to me but her eyes never fully met or connected with mine, and I knew that this reach was not meant for me. I stayed with her for 32 straight hours, making sure she knew she wasn't alone. In fact, only hours before entering her coma, she ate an entire chocolate chip cookie that I fed to her.

Skip forward almost two days later. She is now in a coma, and she is doing the "fish-out-of-water breathing," which signifies that death is very near. She is not responsive to anything anyone says or does with the exception of when she is in pain. According to hospice policy, a physical assessment only needs to be done every 24 hours, which to me, even in 24 hours, is ridiculous. They're dying, we know that. Why do you need to know their pulse and blood pressure. It that really necessary? So the nurse walks in, and mind you, I've been with aunt Polly now all night, without sleep, and I'm very protective. She has to do a physical assessment, even though the nurse before her, already within the "24 hours," has already completed one. She puts the blood pressure cuff on her, and aunt Polly moans in pain and actually gets as loud as she's gotten in the last couple days. And this feeling...this feeling of anger and protectiveness. It was overwhelming. Now--I don't have children, but I have an outrageous love for my family that most people, sadly, only ever dream of having, and I am extremely protective over them in a way that I'm sure most mothers are protective over their precious children. Especially for my mom. And especially for my aunt Polly. How could this nurse, this person that has vowed to take care of people, especially dying people, do something that could make someone wrythe in pain? And when she's dying? And when it's not even necessary? I wanted to actually hurt this woman. And you know what she says to me?

She's leaning over my aunt Polly, who has finally settled back down, and she says, "I couldn't get a good reading. I think I have to do it again." It took all the strength I had in my body not to physically hurt her. Really hurt her. And scream at her. And tell her she's bad at her job. So bad, in fact, that she'd rather cause my aunt Polly more unnecessary pain than understand the fact that this so-called physical assessment was no more needed that day than her mere presence in the room. She simply had no business doing what she was doing. Her job was to make my aunt Polly feel comfortable, not to cause her more hurt. And to do it in front of her tired, distraught family?

Here's my suggestion for you Ms. Joke-of-a-Palliative-Care Nurse: Go work in construction. Because your bedside manner is probably more useful for operating a jackhammer than touching anyone on this earth. Thanks so much.

I apparently was so angry that she read it on my face, and I turned around and looked at my cousin Doug. "I can't friggin' believe this," I said, and I just shook my head. The nurse took her stethoscope away from my aunt Polly and placed it back around her neck. "Is everything alright?" she asked. I, as kindly and calmly as I could, explained that the nurse on night shift already completed a physical assessment earlier that morning before leaving and that it was not necessary to complete another one, especially since it caused her physical (and completely unnecessary) pain. She simply replied, rather rude, "Well, that's my job."

By this time, the argument, as I suppose you would label this, was moved out to the hallway, with me and her, and a couple of my other family members all standing in a circle. "No, your job isn't to hurt her. A physical assessment was already completed, she doesn't need another one. She's freaking dying, we all know that. What will an accurate blood pressure reading tell you now?" The nurse's face looked a little pinched, and she started to explain that sometimes, when people are "near the end of their lives" (I wanted to hurt her again for saying that), they will explode in an agitation that no one can really know what the cause is...and that there's no way to know if she was in pain or what caused such a reaction. And very slowly she looked around at all of us and then directly at me and asked, "Does anyone have any questions about that?" She was just dripped with condescention. She wreaked of it. I hated her. Loathed her very existence and the fact that she was standing anywhere near me or my family. Or taking care of aunt Polly. And her image was etched on my mind.

So intensely, in fact, that seeing her tonight brought back such strong memories that I was talking to my friend Sara, and when I caught a glimpse of this woman and she actually made eye contact with me, I stopped talking mid-sentence. And what scared me more is that she was on the oncology floor when I saw her. How could they even let that woman work there, let alone on the oncology floor?

But what really bothers me, what really makes me upset, is the fact that this woman probably thought, "Hmm, she looks familiar," like you do when you see someone that you sat behind in chemistry three years ago but you never really spoke to them except to say "sorry, can you take off your hat? I can't see..." You know what I'm talking about? She probably had no recollection of who I was or where she knew me from. And here I am, sitting here, bothered enough to actually write a story about it. Who's winning now? Certainly not me. And certainly not the families she is probably currently "caring for" (ha!). Unfortunately, there are people like this in the health care industry who are not worth a damn to the people they are caring for. But it is our duty as a loved one, as a family member with rights, to speak up to these so-called caregivers. Because my family and I had such a reaction to this woman, she did not continue to check my aunt Polly's blood pressure. And after that discussion, she never came back to be my aunt Polly's nurse. A new one came. One that was wonderful, and very compassionate. She, in fact, made me proud to be entering into the health care field myself.

As my friend Sara and I were walking to my mom's room, down the hallway, after I had seen that woman, I looked at her and said, "That woman better not go anywhere near my mom." But I realized, what's done is done, and she is still working there, and still near patients that need love and a gentle touch, every day. And that thought disgusts me. And I have made a promise to myself, starting that very second I relived that memory, that I will not only never act like this woman when I am caring for my patients, but I will remember to make up for the lack of tenderness that unfortunately plagues parts of the health care field. I will make sure that my patients and their family members never know this feeling, this overwhelming anger that comes with playing this memory over again in my mind. I will be so much more than her. More than she every could possibly be. Because I love my family. I think you must really, really love your family to understand that connection between the two--why I would want to be a great health care practitioner because I love my family. So hopefully you understand. But if you don't, know that there are people, truly, genuinely good people out there, that will care for you loved ones and family members with the utmost respect, the way they would care for their own.

There will never be anything less for me.