The past 2 weeks have been hard on my family and myself. My Grandmother had a large stroke which has ultimately has ended up with us sitting here in hospice holding her hand awaiting her passing. Sometimes I feel like events like these are harder on the family than it ever is on the actual patient. That feeling of never really knowing what to expect is a terrible feeling and equally as horrific is knowing what to expect. Trying to find the words to explain what is going on is the absolute worst feeling in the world. I want them to know but im shielding them because if they knew everything that I knew the pain would be too great.
When she was 79 I recieved a call that she was being admitted to my unit. New diagnosis of leukemia, elevated troponin, and CHF, oh by the way her BNP was over 6000. I remember saying to myself ok nurse. Her enzymes are elevated due to the BNP and her difficulty in breathing due to the congestive heart failure. But that leukemia I can do nothing about. I felt awful and I let my emotions get me all messed up. I failed at remaining behind that line that separates family from nursing. As her hospital stay continued it was found that she needed a heart bypass surgery. I shook my head understanding fully that to believe that this woman could survive a bypass surgery was pure craziness. She was with it in her mind so when faced with this question she said ill go for it. I was pissed. I was mad at the world for her being able to make that choice. I knew that there was no way that she could have fully known what was in store for her. I just knew she wouldnt make it off that vent and that this would be it. Not only did she prove me wrong… She just proved me wrong and I vowed then that for whatever reason if faced with any medical problem from here on out I will remain a nurse. Grandaughters do not make good decisions.
Grandaughters think with thier fears and thier hearts and I vowed right then that I will become the granddaughter when her life ended. Had I been her nurse then I would of cheered her on. I would have seen that her will to live was great. I would have took her at face value and could have spotted that stubborn streak a mile away. I would have felt wonderful about it instead of scared.
She is 84 years old. She went 5 years fighting leukemia and keeping it at bay, living life in a nursing home, being my stubborn grandmother who lived as independently as her body would allow. When she couldn’t walk by herself she tried anyway. When they took her walker she showed them a thing or two about stubborn women. Of course she broke a femur to make her point but alas the point was made in her mind im sure of it. If I want to I’ll do it .
Looking back I guess I could say I could have visited more. There are lots of things I could have done. Its all not really all that important now I suppose. But in all this time I have treated her as my prized patient and not my grandmother. I treated her with nurse gloves, respected all her wishes, and cheered her on.
So the big stroke happened. I took care of her while she was up on my floor as if she were my prized patient. I bathed her, I turned her, I gave her all the special attention I would have gave any of my favorite people. I believed in her. I believed she would get better. I told her this many times because although she was unable to talk back to me she understood what I said and nodded yes.
For whatever reason her condition deteriorated to a point in which hospice needed to be involved. I spoke with doctors and conveyed all the information to the family. This helped me stay on the nurse side of the line. I felt if I stayed there I would make better decisions and in the long run this would help her the most.
Over the week in hospice I called this woman Wanda more times than I ever have in my whole life. It got her attention and thats all I really needed. I spent time with her in a moment when I knew she needed it the most.
One night in particular I’ll never forget for as long as I live I decided that her hair needed fixed and she shook her head yes agreeing with me to do so. So I rushed out and bought a curling iron and returned to do this. While fixing her hair I did what I would normally do with my patients that are way out of this world. I spoke to her. I told her about the kids and my life and all the things that were happening now. Usually when I do this my patient doesn’t really respond but that night she shook her head yes and no so many times with the conversation that I thought her neck was going to fall off. It made me laugh and smile and in turn it made her snore and I knew she was comfortable for the night. Over the next couple of days she was alert and amazing. I was able to talk to her and see her watch me walk across the room. It wasnt so hard to stay behind that line.
Today it was hard. I looked at her and I knew. I just knew. I hardened up and I took a long look in the mirror and said you’re a nurse. Off and on for hours I sat by her side. I turned her, I rubbed her back, I spoke to her in her ear. I gave her all the words of encouragement I knew. I prayed with the family and I remained the nurse.
Time was coming, it was 9:30pm and I needed to go home so my husband could go to work. I kept saying in my head that I didnt want to let go of her hand. I kept having an irrational discussion in my head and I knew I was losing the nurse. The rattle in her lungs was deafening and I was trying to convince myself that I could come in early in the morning and she might be ok. Being the granddaughter was inevitable but I just needed to hold on just a little more. So at 9:59pm I said it out loud grandma I gotta go home my husband needs to go to work. I just hate leaving you. As I said the last word I felt her jerk and began to breathe agonally. I knew this was it and at that point I became the granddaughter.