Nice About Death Flavor

There's this really cool girl in orientation with me. She's been a PICU nurse for a long time and traveling as one. Traveling nurses sign short-term contracts with hospitals who are short for nurses. They are thrown into the mix on hospital floors with very little orientation. They need to be adaptable and competent in their work. It is well-known in the profession that it is a very high-paying position. Hospitals go to travelers as a last option. It costs hospital units a large portion of their budgets. Most units would prefer to spend that money making new hires, but at times, there are none immediately available. When there are patients, hospitals must have nurses, so traveling agencies are services committed to filling those positions.

It's a general theme right now around the country that traveling nurses are landing regular staff RN positions at hospitals, because of the economy. They want stable positions, because the window of opportunity for getting staff RN positions has been closing. This girl has a rich background of experience in the PICU, and she's going to be working in my hospital as a PACU nurse. Pediatric Post-Anesthesia Care Unit. She takes care of kids in the transition between the completion of surgery and their transport to hospital beds. She keeps kids from dying as they wake up from surgery. She also reminds me of Meg Ryan, but looks more like Claire Danes. So I stare at her a lot. I hope she doesn't notice.

Anyway, she told me that people will come to me, because I am nice about death. Then our leader chimed in. "She has an oncology point-of-view." She says oncology and the PICU clash in their thinking. I guess PICU nurses are generally not welcoming to death. They generally do everything they can to stop it, even after it stops making sense. It's their job. It's the parents' wish. It's the doctor's order. For whatever reason, it's how they function psychologically. To switch the goal of care from "get better" to "die well" would be, according to our nurse educator, "too much" for the PICU nurse. I don't think that's true, though. But I have no experience to back it up. I think there are points where even PICU nurses want to tell the parents to give up. Anyway, my facilitator suggested that there should be a palliative care unit where patients can go after pulling the plug - a unit the specializes in helping patients die well, a unit separate from ICU nurses.

It's going to be different. In my last nursing experience, we were helping people die all of the time. It's a healthy thing to die well, to be allowed to talk about it, to be allowed to grieve it - even before it comes. That's how I see it. Death is a good part of life. But I would see it that way, because I come from oncology.

It all goes into the mix. Everybody brings their specific flavor to the team. There's a girl who wanted to be a vet and worked with tigers and dolphins and whales for a while. Another girl went to Bethel at Minnesota and prays before she eats. Meg Ryan brings her flavor. Us new grads bring our flavors. It's going to be a tasty treat.

This is what I do.

So, yellow man died of alveolar hemorrhage at another hospital. I just found out at work today. Wife and kids. Young kids. Acute myelogenous leukemia. This is what leukemia does. It steals your life. That man was my first real patient. I shaved his head when chemo hit. I guess he's dead now.

I can't tell you how strange it all is. I can try, though. He was young (late thirties/early forties), really good looking, in good shape. Competent and strong-willed like a man should be.

The numbers become people. I talked about numbers earlier. But the trouble is, when I think about each of these room numbers, I remember a person in that room who died. 2 is yellow man. 6 is the woman who died when we turned her. That happens sometimes. When you turn a patient, sometimes it quickens death. 7 is yellower man whose room smelled like mint. We put mint menthol in the room, because his necrotic tissue was really strong smelling. 14 is beautiful man, the one that looked sicker than anyone I'd seen yet. His dog came to visit here. And he said that he had a lifetime high after showering with a nurse. Then there was Candy. She died recently, too, and her face is ever etched in my mind. She made me think about the Father's love for us. Because she was so helpless. She was a mess. And we cleaned her up over and over and over. And you just had to love her. You had compassion on her so easily. It wasn't hard to take good care of her.

A man had "exploratory surgery" today. That means they can't figure out what's going on, so they open you up to try to find out. He had a bowel obstruction; couldn't poop. It wouldn't resolve. When they opened him up, they found cancer. He was full of cancer. So they closed him back up again. Six months to live.

There's some sort of comfort about people grieving and everyone knowing why. I can't describe it. People are crying, and it's normal. Nobody's telling you that you shouldn't cry. They're just letting you grieve. They're just being there when you're grieving. They're hanging out and getting you what you need, no matter what it is. Even if it's your dog. That's what nurses here do. That's what I do. I take care of the things they forget to take care of. I watch out for their bodies. I watch out for their families. I touch their hands or their feet. I clean them up. I help them fall asleep. I help them breathe.

work

I made a friend yesterday. I have another friend that says that I'm good at making friends. She says that I just sit by somebody and say, "Hey, I'm kt," and then we're friends for life. I think she's right; that's usually how it goes.

But anyways, my friend Joe is in the same program I am in at M. He works on the floor above me. He works in the ICU. So when my patients get too bad for us to take care of (which is really really bad), we send them to his floor. He sees death more. And yesterday, he talked about it a little bit. He had a code on his floor, and he had to do chest compressions on this lady, and the family was wailing in the background, cause she was in her early fifties. And she died.

And he was going to leave it at that. But I can't handle that. Because there's more to it. There's coping with death. There's going to work again. "How are you?"

He went on to say that the next day, he just stayed in his apartment the whole day long and didn't really move. He just watched a little tv, ate a little, just sat there thinking. He said work was a relief when it finally came. Something to do. C.S. Lewis says that work is one of the best things in life. I agree with that. I get depressed if I'm not moving. And work is one of the best ways to move, because you accomplish something.

I worked at a state park for a summer, and I loved it. I worked hard every day. I felt really strong by the end of the summer, and I had the meanest farmer's tan. And my work pants were really dirty. I worked in the mud and in the dry dirt on sweaty, hot days, so you would take a shower, and the tub would be black. You had to make sure you cleaned it out so mom wouldn't have to clean it up. And there were always black boogers, and you had to be careful when you cleaned out your ears so you didn't push the dirty further in.

Usually after work, that summer, I would go for a run. Almost everyday, and it didn't matter how hot it was. I'd get my shoes on, get my tunes, and run to EastWest and Three Cord Wonder, my favorite pure volume bands. I'd listen to music about loves gone all wrong or being in heaven or seeing His face or something else that stirred a fire in me and run and run. I got pretty good by the end of the summer, cause I ran with Katelyn, and she said it was a good run for her, too.

And I was with my best friends at work every day. And we laughed until we couldn't move and would complain about how we'd lost all muscle control cause we were laughing so hard. We were stupid girls sometimes, but it didn't matter.

I think that's part of the reason I want to go to the jungle. I want to work hard. I want to move well and be strong like I was that summer. Even stronger.

There was this one time that I blazed a trail at that state park. My boss just gave me a tri-blade and said, "I want it to go from here to there." And I did it. And he came back later and said, "That's the best trail I've ever seen." My dad even got to see it. And he said it was a good trail, too.

I felt pretty good. I'm a good trail-blazer. I felt like that when I crushed beaver dams, too. I got sent on that mission by myself a lot. It was way out in the boondocks. Just me and the beaver dam and my awesome tools. I liked going out there alone better than with one of the guys. Cause they would say things like, "There's no way we're gonna get any more of that dam." or "We did everything we could." I never felt that way. That's usually how it goes when I have to quit something. If I just had one more hour. Just think of how much more awesome it would be. I always felt like that when I counseled at camp. I just wanted one more day with so and so. She would gain so much more in that one day.

I was on weekend maintenance, and I was the only one. So I would get there by myself and get to do whatever I wanted, mostly, which usually consisted of mowing or fixing things. Sometimes they were the things that I had broken earlier in the week and didn't tell anybody about. Sometimes my boss would even forget to make a list for me. But it didn't matter, because I usually finished the list in a couple hours anyway.

This one time, I was mowing on the weekday, and I ran into a sign, and it fell over. The 4x4 was rotten right at the base, so when I hit it (kind of hard), it broke. So I hid the top of the sign in the trees, and fixed it on the weekend. The sign was about a foot and a half shorter when I got done with it, which I still laugh about. But nobody ever noticed. At least they never said anything.

death

Three people died on my floor this weekend. I took care of all of them.

One was even yellower than yellow man. He was mustard colored. His liver stopped working completely. And his fingertips were black and hard - necrotic tissue. And they smelled awful. He was unresponsive, but was breathing through a trach on his own. His family took him off curative cares. It's called comfort cares. And he lived for five or six days after that. They had begun to wonder if they had made the right choice. He died on his wife's birthday just after my shift was over and before my next one started.

The other man was one I talked about before - the sickest man I ever met. You know, if you're in the medical field, you hear people say, "I could just tell when I saw him; it was cancer." or "I knew he wasn't going to make it. He had that look about him."

I get it now.

He made it home before he died. That was what they all wanted.

I didn't get attached to the other lady. It's a good thing, too, because hers was the first and only body I saw dead. I was in the room when she died. She was on comfort cares, too, but her family wasn't around when she died. They had gone out to eat. And didn't come back for a few hours after her death and didn't answer their phones. She had been seizing all day long, the nurses think. Her eyes were rolling back and forth, back and forth, slowly, slowly, all day long. She appeared to be in a lot of pain. And we went to clean her up, and it all happened so fast. Body processes I won't tell you about. I was amazed at the nurses I was working with. They were incredible. It happened at six pm, just before my shift's end at 7:30.

That morning, I had been teary-eyed. Everything I was doing was making me cry. So I took a minute. I thought that's all it would take, but when I got in the bathroom, I couldn't stop crying. I was beyond the point where I could wash my face and look normal. So this girl opened the bathroom door - she didn't know I was in there. And she was totally cool with the fact that I was crying so hard that I was hiccuping. And we talked about death. Cause she's a nursing aid on that floor. Has been for like...three years or something. And I was a little more composed until I went in the room of mustard man with my preceptor to clean him up. And we talked about death more. Death process. Death paperwork. Family coping. Personal coping. Still wanting to come to work, even though there are hard things. And how getting through this and coping with this job says a lot about a person. "If you can do this, you can do anything," she said.

I'm okay, really. Yeah, I think I'm okay.

PS: Sushi fell through.

"dontcha be doin that cheerch hop"

A little bit ago, I wrote this:

This weekend I went to a couple of church services. One was bad news. But the Saturday night service was beautiful. C. John Steer, a British man from the Spurgeon Seminary in Great Britain spoke at a Saturday night, college-oriented service. He spoke on the end of John 12. Verses 20-36.

"We would see Jesus." - gutsy Greeks requested...to which Jesus responded by speaking about His death and the agony thereof. His sermon touched my heart in a tender place. Jesus let them see Him, but He showed them a specific part of Himself. He showed them His agony and death.

Do you see, O little one? Do you see what the cross is? Do you see the bitter agony of separation? This is the cross. I have shown you the cross. Do you see? Do you see Me? You want to see me, but do you see Me? This agony, this terror, this difficulty of soul - do you see? This is My story of beauty. There is nothing so beautiful - this terrible story.

This man presented another thing - something about faith. He claimed that the people that lived then didn't hear God's voice for one reason: they were not expecting it. He said, 'If you don't believe something happens, you have to have an explanation for it when it does happen,' and 'God speaks and we miss it.' I have thought about this so many times. Whenever somebody articulates something I have been thinking about for a long time, I feel a deep sense of relief that somebody else is on the same page, that somebody else thinks those thoughts.

I keep thinking about this verse in Matthew. 13:58 "And he did not do many miracles there because of their lack of faith." This verse, and a few like it seem to be proof that the people's lack of faith have a direct role in the amount of miracles Jesus performs.

The second sermon seemed almost to be a perfect rebuttal of this british man's eloquent, faith-filled words. Sunday morning, I walked into a big church - lots of full pews. My particular pew was packed, and I wished for a little more elbow room. The music started and was upbeat and cheesy and had too much treble. There must be a place for this, but it's not my personal preference. I couldn't help but laugh out loud while thinking about the synchronicity of this music, Kathy Trocolli, and my friend Zach Backstrom from camp's clapping dance. We even sang a song we did for closing ceremony at camp. Classical.

Then the preacher came out and began his discourse on prayer. His point was that it's difficult to pray, because we think it doesn't really matter - God's going to do what He wants anyway. And when we pray, we don't get what we want. Then he went on to define and explain six reasons we should pray anyway. I don't think he really believed most of them - not deep down - and it came through in his preaching.

I found myself watching random screenplays in my mind: I punched this man's medium sized belly, and he puked out all his unbelief. I threw tomatoes at him, and upon impact, they exploded all over him. I went through a vast array of options for ammunition that would allow for "splat". Pumpkin guts were my personal favorite. I think I should become a millionaire by inventing a super soaker that spews out pumpkin gutbombs. I could call it Gut Pumper. Or Putt Gumper.

I wanted to give him a good talking to, and my finger would shake at him, and I would whip out my best black talk, "Boy, you gotta believe! You gotta have faith! And you gotta get out of spoiled America!"

He told a story of obvious miraculous healing. Actually, I think it was a situation in which a missionary in a foreign country brought another missionary (who just happened to be dead) back to life. His response was, "I don't know what to do with that. I certainly never expect to ever hear a story like that in my life again."

And perhaps that is the very reason he won't.