The Emergence of Sacred Space and Time in Hospice Care

I knew he was close. His breathing had changed, but I also knew it could be hours. It was 4:30 on a Friday afternoon and I was ready to be done with my week. The apartment was full of friends and family, full of an energy that was neither nervous nor productive. It felt like the buzz of being. The man’s wife and daughter were in the bedroom with him.

In the February issue Reflections essay, “The Car Ride Home,” author Paige Fletcher movingly evokes an episode from her experience as a hospice nurse. This one-page essay, which will be free until the end of February, is written with unusual clarity and restraint and is well worth the five or 10 minutes it takes to read it.

Fletcher writes convincingly of a sense of sacred space and time that can emerge as a life ends in a supportive home hospice setting. And she describes her […]

2021-02-16T15:30:52-05:00February 12th, 2021|Nursing|0 Comments

Bringing Redemptive Voices from Greek Tragedy to COVID’s Frontline Clinicians

Bearing witness.

I enter my patient’s room and hear the sucking click as the door slides shut behind me. Vacuumed silence, negative pressure—but all the pressure in the world seems to settle onto my shoulders, my head, and down through my back, filling my feet like wet cement.

I need to move. His oxygen saturation is dropping again. He’s grimacing. Is he in pain? I wonder as I step closer to the bed. My pulse quickens as I take in the scene before me: glassy eyes inset upon a sunken, sallow complexion; bleeding mouth; the imperceptible rise and fall of chest to the biddings of the ventilator; swollen limbs. A lock of hair falls into my eyes, but my PAPR hood prevents me from pushing it aside. His heart rate and respiratory rate are higher now. Maybe he needs more sedation. If only he could speak. I take in a measured breath of filtered air as I suction his breathing tube. Breathe.

The doctor appears and is talking to me, but her voice is barely audible above the steady stream of air rushing past my ears. We’re practically shouting. The plan, a combination of trial and error, science, and visceral, pit-of-the-stomach intuition, is shaky at best.

As she moves away toward the door, I want to call out to her, to beg her to stay, to look upon the suffering and feel its weight, but I am silent and she disappears into a sea of blue scrubs. I am alone in this sealed room […]

2020-08-27T09:45:26-04:00August 27th, 2020|Nursing|1 Comment

The Balancing Act: A Dying Patient and a Spouse Who Can’t Let Go

Illustration by McClain Moore Illustration by McClain Moore

The Reflections essay in the March issue of AJN is called “The Balancing Act.” The author describes a situation she faced as an ICU nurse in which her efforts to keep a dying patient comfortable were complicated by a spouse’s reluctance to accept the inevitable. It’s often hard to advocate for a patient while honoring the emotional struggle of a close family member. Here’s the start of the essay.

I have just arrived to work in the ICU and am assigned a patient in respiratory distress. Her name is Darlene and her husband Tom is pacing the room. Within 10 minutes, he drinks three cups of coffee, ignoring the cot provided by the previous nurse so he could sleep next to Darlene. His wife has more than one cancer and both are growing. She left the hospital a week ago for hospice care, but has been readmitted after a decision by her husband to reattempt curative treatment.

[…]

How a Nurse Quietly Helped One Intern Out of a Tricky Situation

Illustration by Annelisa Ochoa. All rights reserved Illustration by Annelisa Ochoa. All rights reserved

In this month’s Reflections essay, “My Turn,” a recently retired physician tells a story of how a nurse adroitly helped him through a very disorienting moment when he was still an intern. Here’s a bit of the setup:

Medicine was my first rotation as an intern. . . . [T]he medicine rotation had a particularly intimidating reputation and a red-hot I was not. I was terrified.

On morning rounds every day our entourage of physicians, nurses, and students would go room to room discussing each patient. I can still see the open door to Mrs. Finkelstein’s room near the morning sunlight at the end of the hallway. Mrs. Finkelstein was old and was dying. And every morning when we walked in, her husband was sitting there next to the bed, holding her hand. He told us regularly how many years they had been together. We each dreaded being the one on call when she died.

There are many situations in medicine and nursing that require a certain amount of experience—most readers will agree that this is definitely one of them. At a certain point in the story, the author finds himself being asked a question that absolutely needs to be answered, and answered immediately. It’s not […]

Final Connection: An ICU Nurse Revises Her Feelings About Cell Phones

Illustration by Denny Bond. All rights reserved. Illustration by Denny Bond. All rights reserved.

Many of us have a love-hate relationship to smartphones, and each person (and generation) draws the line in the sand between invasiveness and usefulness in a different place. Cynthia Stock, the critical care nurse who wrote the Reflections essay in the November issue of AJN, “Final Connection,” starts her brief and moving story with honesty about such matters:

On Monday, if you had asked me how I feel about cell phones, I would have come up with this: I hate to listen to the drone of conversation coming from the person next to me on the treadmill at the gym. I don’t care about trouble with the HOA. I don’t care about a son who can’t decide on a career as a director or an actor. I work out to smooth the kinks in my soul from a job that requires me to navigate a relationship with life and death.

Today, ask me how I feel about cell phones. . . .

A good essay or story often centers around a reversal of some sort. What the protagonist believed may not be so true after all, or may be more complicated than first thought. As you can probably guess, in the […]

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