Sunday, July 29, 2012

A Question Of Life

This is a bit heavy for introspection on a Sunday morning; I meant to write this last night but.. well.. forgot.  After work I kicked back with a movie and headed straight to bed.  So.. today it shall be.

I had a patient last night who didn't eat their dinner.  Nursing requested a substitution that I had to get approval for before delivering.  They were on a special diet - DMMOD, K50, PRO50, NA100 (no added sugar, low salt, low protein and potassium).  I called nursing to ask what they had/hadn't eaten on their tray to take in account for the carbs (I have to match carb level on the original tray).  Nursing said they were just diagnosed fully palliative (whatever you have is going to kill you, you're at end-of-life care), so they can eat what they want (at lunch they had ice cream!) :)  So.. cool.. I brought the requested item/substitution.

My question is this.... if you were diagnosed palliative, would you still respect your body and eat properly, or would you go full out?  Don't answer what you morally think you would answer, but answer the way you think you would *actually* act.  Hmm.. got you thinking, don't I?  I don't know the diagnosed time limit for that patient, so we'll leave that open (could be 6 months, could be 2 years).  What are you asking yourself?  What are your parameters?  Would you eat whatever you wanted?  Would you still eat within reason?  Would you eat within reason and cheat sometimes?  Are you highly medicated and without pain?  I asked a couple of co-workers and I got interesting responses; one said if what they ate didn't provide physical discomfort they would cheat, but otherwise eat somewhat properly.  Another said they would eat mostly properly and not go all out - if they did, what if that time limit extended to say.. 5 years?  You wouldn't deserve those 5 years.  Interesting.  What do you think?

I also witnessed a patient fall this week.  I hate that.  It's heartbreaking.  I get very upset very quickly when I see a fall.  I don't know what it is; is it the body giving into involuntary actions resulting in hurt (usually, to some extent)?  Is it not being able to help?  I don't know.  But it pains me.

I also had another incident with a patient; I was delivering HS Nourishments (bedtime snacks for diabetics) and walked into my pt's room (elderly) and she was crying.  I could have easily just walked out.  Maybe I should have.  But.. I asked what was wrong (this isn't typical behaviour of said pt) and it turns out she just found out her husband has liver cancer.  She was in shock.  Visibly upset.  Distraught.  A lot of in-shock/just-received-bad-news rambling.  So... I decided to drop everything I was doing and just... listen.  Nothing existed outside of that room.  She needed to talk to someone and I was the first person in that room after she heard the news.  She went on about how her husband was such a good man and now she's going to have to live in a home because she can't live alone at home (she's on dialysis) and she lost her son to cancer at 34, to which she got more upset (ugh.. that one hit me.  That's 2 years younger than me!).  I prayed quickly while she was talking as to what I should do.  So after I got her attention and got her to pause a minute, I gently told her not to put the horse before the cart and she doesn't know yet what his prognosis is, how advanced, etc.  "That's true," she said and took a breath.  Still upset, but not as.... freaking out like she was before.  I stayed with her a couple more minutes, had a few words, and left.  It was a little difficult to hold back my own tears, but I was able to.  But man.. it stuck with me the rest of the night.  Still does, really.  She's Dutch and reminds me a lot of my gram.  There is always someone in the hospital somewhere that will remind you of someone.. and that's good, it's humbling.  It reminds you why you're there.  You're helping to take care of someone's significant other (mother, father, aunt, sister, brother, cousin, friend or grandparent).

Well, on that note... I've gotta go to Mass!  Sorry to leave you with something heavy.  Will try to write lighter next time :)  Have a good Sunday!  Spend it with someone you care about, who cares about you.. or even do some self-care.  You deserve it.


hydra said...

I think the way you soothed that patient and brought her around to a less doomy way of thinking about her husband and the future was truly wonderful. You have a rare gift of patience and empathy. I find it really inspiring.

Perovskia said...

*smile* You're sweet, Hydra. Thank you :) I did what I could! I hope it was enough.

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