Foot on the accelerator of Life.
Apr. 20th, 2012 09:50 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
midnightsjaneAnd it's the weekend already. Time just flies by these days. I know, they say that time seems to speed up as we get older, and it seems to be true. I remember the long ago days of my youth, when the days seemed to last forever, perhaps because I was impatient, wanting to get on with being an adult, making my dreams come true. Now that I'm a ways away from my youthful dreams, and I know that I've lived more of my life than I have left to live (I seriously doubt that I'll live to 128 to make this my halfway point, LOL), time seems to have hit the accelerator. Maybe I'm just having a mini age crisis or something; the other day I looked at myself in the mirror and all of a sudden it hit me that in five years and a few months, I will be seventy.....it kind of took me by surprise, and made me think about the fact that I don't have an unlimited life span ahead. Freaked me out just a little bit. I certainly don't feelold, I have lots of energy and interest in life, I don't think I look my age, but now I understand what my Mother meant when she said to me once "I look in the mirror and wonder who that old lady is, and how the hell did that happen!?" I get it now, Mom.
No matter how old we get, we're all still children in our parents' eyes. This was made clear to me the other day at work, when I met the parents of the person I was looking after. He was 61, critically ill, and most likely to die in the next 24 hours. His wife brought his elderly parents in, and it quite broke my heart to watch them. They must have been in their late 80's, and he was their only child..the tears rolled down their cheeks, and his mother told me what a wonderful son he'd been to them. He was still their little boy. I had to swallow a few tears myself.
In ICU we have a lot of interactions with families; sometimes it seems we nurse the families as much as the patient. Usually it's a matter of comfort and reassurance and support, answering questions etc; sometimes it isn't quite as easy as that. Family dynamics can be...interesting, and moments of crisis can bring out all sorts of issues. Occasionally we get caught in the middle, and it can be rather uncomfortable. (It's not for nothing that one of the very dark bits of humour we indulge in is the description of our ideal ICU patient: intubated, ventilated, paralyzed and heavily sedated, with a tube in every oriface...and no family.) We don't mean that, of course, but some days it would be more restful.
I had another patient yesterday, and the family was one of those very involved and intense ones, the kind that come with a little bubble over their heads that says "nurses, beware". The kind that wants to know every single detail of their family member's care, and whose need to be involved sometimes crosses that line between caring and concerned to controlling and interfering. I have no problem with most families, and respect their need for information and involvement, but sometimes it's hard not to get annoyed when it feels like the family doesn't trust the staff. The hardest ones are the ones like yesterday, when there is a family member who is in the medical profession. One of the daughters is a doctor, and I was warned in report that she tended to overstep her bounds a bit trying to direct his care. I had quite a conversation with her about it, after she came in, pulled the curtains and pulled out her stethescope and started examining her father. While I respect her need to have more details, to know about things like blood work, there is a certain line that she needed to stay behind, in my view. I told her she needed to step back and be his daughter, not his doctor; that when she tried to control his care, it was making me feel that she didn't trust me, or the ICU doctors. One of my co-workers got quite bent out of shape by one of the other daughters who tried to get him to stop doing something that although necessary was also uncomfortable for her dad; it's a hard position to be in, and we nurses are human beings with feelings that get hurt, even when we know we shouldn't take it personally. I don't know, what do you think? If you had a family member in ICU, and you were a nurse or doctor, would you be able to stand back, to be the daughter, or son, or parent, and not want to take part in the medical care? I know that when my mother was very ill, I was aware that my family is probably one of those intimidating ones for the staff: in my immediate family my sister, my two sisters-in-law, my niece and I are all nurses; my brother is an a doctor with a specialty in ICU; we all were very careful about overstepping that line, because we didn't want to be that family. Not to say we didn't ask questions and insist on getting the answers, but we tried to leave Mom's care in the hands of the staff; she got excellent care, and recovered, happily. It's just one of those conundrums that working in ICU brings.
Anyhow. It was a gorgeous day, the sun shone, the birds sang, the trees are bursting into leaf, the rhubarb in my little garden is growing, the horses are all frisky and feisty, and the traffic home was only mildly annoying.
I made a huge pot of vegetarian chili last night, and it was one of the best batches I've made yet, I think. I had a big bowl for supper with a piece of rye bread toast. I baked scones tonight, with dried sweet cherries, and now I'm going to have one with a cup of tea.
Taking my foot of the gas for tonight. :P
No matter how old we get, we're all still children in our parents' eyes. This was made clear to me the other day at work, when I met the parents of the person I was looking after. He was 61, critically ill, and most likely to die in the next 24 hours. His wife brought his elderly parents in, and it quite broke my heart to watch them. They must have been in their late 80's, and he was their only child..the tears rolled down their cheeks, and his mother told me what a wonderful son he'd been to them. He was still their little boy. I had to swallow a few tears myself.
In ICU we have a lot of interactions with families; sometimes it seems we nurse the families as much as the patient. Usually it's a matter of comfort and reassurance and support, answering questions etc; sometimes it isn't quite as easy as that. Family dynamics can be...interesting, and moments of crisis can bring out all sorts of issues. Occasionally we get caught in the middle, and it can be rather uncomfortable. (It's not for nothing that one of the very dark bits of humour we indulge in is the description of our ideal ICU patient: intubated, ventilated, paralyzed and heavily sedated, with a tube in every oriface...and no family.) We don't mean that, of course, but some days it would be more restful.
I had another patient yesterday, and the family was one of those very involved and intense ones, the kind that come with a little bubble over their heads that says "nurses, beware". The kind that wants to know every single detail of their family member's care, and whose need to be involved sometimes crosses that line between caring and concerned to controlling and interfering. I have no problem with most families, and respect their need for information and involvement, but sometimes it's hard not to get annoyed when it feels like the family doesn't trust the staff. The hardest ones are the ones like yesterday, when there is a family member who is in the medical profession. One of the daughters is a doctor, and I was warned in report that she tended to overstep her bounds a bit trying to direct his care. I had quite a conversation with her about it, after she came in, pulled the curtains and pulled out her stethescope and started examining her father. While I respect her need to have more details, to know about things like blood work, there is a certain line that she needed to stay behind, in my view. I told her she needed to step back and be his daughter, not his doctor; that when she tried to control his care, it was making me feel that she didn't trust me, or the ICU doctors. One of my co-workers got quite bent out of shape by one of the other daughters who tried to get him to stop doing something that although necessary was also uncomfortable for her dad; it's a hard position to be in, and we nurses are human beings with feelings that get hurt, even when we know we shouldn't take it personally. I don't know, what do you think? If you had a family member in ICU, and you were a nurse or doctor, would you be able to stand back, to be the daughter, or son, or parent, and not want to take part in the medical care? I know that when my mother was very ill, I was aware that my family is probably one of those intimidating ones for the staff: in my immediate family my sister, my two sisters-in-law, my niece and I are all nurses; my brother is an a doctor with a specialty in ICU; we all were very careful about overstepping that line, because we didn't want to be that family. Not to say we didn't ask questions and insist on getting the answers, but we tried to leave Mom's care in the hands of the staff; she got excellent care, and recovered, happily. It's just one of those conundrums that working in ICU brings.
Anyhow. It was a gorgeous day, the sun shone, the birds sang, the trees are bursting into leaf, the rhubarb in my little garden is growing, the horses are all frisky and feisty, and the traffic home was only mildly annoying.
I made a huge pot of vegetarian chili last night, and it was one of the best batches I've made yet, I think. I had a big bowl for supper with a piece of rye bread toast. I baked scones tonight, with dried sweet cherries, and now I'm going to have one with a cup of tea.
Taking my foot of the gas for tonight. :P
no subject
Date: 2012-04-21 03:29 pm (UTC)End-of-life issues are also horribly complicated. Here in the USA doctors will automatically do FAR more than make a patient comfortable, they will do all kinds of insane things like putting a feeding tube into an 85 year old who is suffering from advanced dementia. There too I feel family and personal wishes trump the nurses and doctor. Sigh.
No easy answers.
It was almost 90 degrees F in Ukiah this week. Beautiful with the trees just leafing out...
no subject
Date: 2012-04-22 04:14 am (UTC)It's a conundrum, for sure. I certainly think families have every right to question the medical staff if they have doubts about treatment, and to get second opinions if their questions aren't answered satisfactorily. The issue I have is when the family member takes on the role of physician; then medical ethics come into play. I don't know the right answer.
In Canada (or at least in the hospital I work in) we try to make end of life issues a conversation involving all the parties: the person who is ill, family, and care givers. We have family meetings and discuss the issues, and try to respect the wishes of the family and patient as much as possible. That's why we encourage everyone to think about what they would want if a catastrophic illness should occur, so the direction of care is easier to determine.