Deborah Kirwin
November 2015
Deborah
Kirwin
,
RN, BSN
Surgical Intensive Care
Covenant Health
Lubbock
,
TX
United States
Deborah was asked to describe her special relationship with her patient. Here's her report:
J entered my life on Easter weekend. I received report on her and began my brief, but life changing relationship with her. Though I only had direct care of her for 3 days, I continued to oversee her care indirectly while she stayed in SICU. E, her mother, and no life-long friend, was in an unfamiliar land. I made a conscious decision to become her self-appointed guide through the maze of halls and units that prolonged care demands. I contacted case management at Specialty Hospital and set up a meeting for her to tour the facility. From Specialty Hospital, J moved up the chain of recovery to Inpatient Rehab and from there she left Covenant to go to Lakeside Rehab. I spent a lot of time with J and E in that time.
You see, J had made a miraculous recovery from the insult dealt her by a pontine bleed. Not locked in - she had the use of her mind, her voice and her left side. She showed herself to be a brave, determined and loving woman who never showed self-pity for what she had lost. Instead, she showed a spirit of love and gratitude for what she had and for what she could yet achieve. J recovered and regained function by leaps and bounds. She was doing things no one thought she could ever do.
I was privileged in all this time to get to know both J and her mother, E. We spent quite a bit of time together and I became very close to them.
J was at Lakeside Rehab awaiting surgery to restore the power of speech. Soon after her tracheostomy she weaned quickly from the vent and began speaking. She recounted the thoughts that went through her mind as she lay in her hospital bed listening to me care for her and conversations between her family and physicians regarding her brain function and chances for "meaningful recovery".
Unfortunately, she suddenly lost the ability to speak and awaited surgery at UMC to repair her trachea. While at Lakeside Rehab something really bad happened. E summoned me to the Emergency Department after J's arrest.
This time, the insult to J's brain was too great to overcome. Anoxia had caused permanent damage. She was admitted to MICU where they took wonderful care of her and cared for E also. During J's previous recovery, Mother and Daughter had had a "what if" conversation. "Give me three weeks, Ma," she said. E did just that, and spoke with the doctors and nurses caring for her at every opportunity. This time, there was to be no miracle. Instead, E spoke with the Palliative Care team and made the painful decision to withdraw care.
Once that decision had been reached, I spoke with E and asked if she felt comfortable with my being J's nurse one last time. She said yes. She knew that I would advocate for J's comfort. I went to my Nurse Manager and told her. She was very supportive and gave assurance that she would work with me. I then went to S and spoke with her. S was amazing and very supportive and gave her consent after satisfying herself that I was indeed serious and emotionally prepared to be J's nurse since my relationship had become such a deep and personal one.
I have participated many times as the nurse of a dying patient. This one was different though -very special and very sad. Her Mom, her aunt; her son, D. D's Uncle J and his wife and mother-in-law were there, as well as a Christian pastor and a Jewish Rabbi. Also present was L, J's speech therapist who, like me, became very good friends with E and J.
Dr. B was there for Palliative Medicine. He had spoken to E the Friday before and answered all her questions as only he can with that special gift he has for communicating in such circumstances. It didn't take long. J's trach was removed at 1110. She was pronounced dead at 1130. I then had the honor of bathing her one last time to prepare her for her return to New York for a traditional Jewish burial.
I have been profoundly affected by the experience of caring for, and getting to know this extraordinary young woman and becoming friends with her mother. I will never look at things in quite the same way. It was an honor to care for her and an honor to be her nurse as she crossed the threshold between an end and a new beginning.
J entered my life on Easter weekend. I received report on her and began my brief, but life changing relationship with her. Though I only had direct care of her for 3 days, I continued to oversee her care indirectly while she stayed in SICU. E, her mother, and no life-long friend, was in an unfamiliar land. I made a conscious decision to become her self-appointed guide through the maze of halls and units that prolonged care demands. I contacted case management at Specialty Hospital and set up a meeting for her to tour the facility. From Specialty Hospital, J moved up the chain of recovery to Inpatient Rehab and from there she left Covenant to go to Lakeside Rehab. I spent a lot of time with J and E in that time.
You see, J had made a miraculous recovery from the insult dealt her by a pontine bleed. Not locked in - she had the use of her mind, her voice and her left side. She showed herself to be a brave, determined and loving woman who never showed self-pity for what she had lost. Instead, she showed a spirit of love and gratitude for what she had and for what she could yet achieve. J recovered and regained function by leaps and bounds. She was doing things no one thought she could ever do.
I was privileged in all this time to get to know both J and her mother, E. We spent quite a bit of time together and I became very close to them.
J was at Lakeside Rehab awaiting surgery to restore the power of speech. Soon after her tracheostomy she weaned quickly from the vent and began speaking. She recounted the thoughts that went through her mind as she lay in her hospital bed listening to me care for her and conversations between her family and physicians regarding her brain function and chances for "meaningful recovery".
Unfortunately, she suddenly lost the ability to speak and awaited surgery at UMC to repair her trachea. While at Lakeside Rehab something really bad happened. E summoned me to the Emergency Department after J's arrest.
This time, the insult to J's brain was too great to overcome. Anoxia had caused permanent damage. She was admitted to MICU where they took wonderful care of her and cared for E also. During J's previous recovery, Mother and Daughter had had a "what if" conversation. "Give me three weeks, Ma," she said. E did just that, and spoke with the doctors and nurses caring for her at every opportunity. This time, there was to be no miracle. Instead, E spoke with the Palliative Care team and made the painful decision to withdraw care.
Once that decision had been reached, I spoke with E and asked if she felt comfortable with my being J's nurse one last time. She said yes. She knew that I would advocate for J's comfort. I went to my Nurse Manager and told her. She was very supportive and gave assurance that she would work with me. I then went to S and spoke with her. S was amazing and very supportive and gave her consent after satisfying herself that I was indeed serious and emotionally prepared to be J's nurse since my relationship had become such a deep and personal one.
I have participated many times as the nurse of a dying patient. This one was different though -very special and very sad. Her Mom, her aunt; her son, D. D's Uncle J and his wife and mother-in-law were there, as well as a Christian pastor and a Jewish Rabbi. Also present was L, J's speech therapist who, like me, became very good friends with E and J.
Dr. B was there for Palliative Medicine. He had spoken to E the Friday before and answered all her questions as only he can with that special gift he has for communicating in such circumstances. It didn't take long. J's trach was removed at 1110. She was pronounced dead at 1130. I then had the honor of bathing her one last time to prepare her for her return to New York for a traditional Jewish burial.
I have been profoundly affected by the experience of caring for, and getting to know this extraordinary young woman and becoming friends with her mother. I will never look at things in quite the same way. It was an honor to care for her and an honor to be her nurse as she crossed the threshold between an end and a new beginning.