A Clinical Lesson – Part III

One year of my nursing journey has somehow already passed, and unsurprisingly, the last three weeks have been the most significant thus far. My first clinical placement experience was an important milestone – I needed to test my strengths and weaknesses and bring all of the knowledge taken in throughout the year into the real world. Just how real is where the experience became a critical one.

There were many moments over the three weeks that will remain in my mind as I reflect on my interactions, but three moments in particular had what I feel will be a lasting impact. As in all accounts of a medical and personal nature, no real names are used in these stories that follow.

PART III

On the Thursday of the second week, we were doing a late shift. There was typically less to do on these later shifts as the only meal was dinner and most of the residents settled after this, either watching TV in one of the lounges or staying in their rooms. After helping with dinner, I saw a young boy and his father sitting beside one of the residents. The young boy was playing with three balloons and having a wonderful time, so I decided to go join in. He was close to two-years-old but he already knew the different colours of the balloons and each time I’d hide one behind my back, he’d know which colour it was. I was so impressed and his father seemed pretty happy about it too.

This was when I met his grandmother, who I later learned was of sound mind and full mental capacity, but had a failing body courtesy of Parkinson’s Disease. I didn’t know this at the time, and I certainly didn’t know that this woman would leave a very lasting impact on me.

The next morning, I was there to help with breakfast and lunch. As I approached the dining area before lunch, I saw three people sitting beside the grandmother and overheard them: “What do you mean a male nurse? Huh?” Her daughter (as I later discovered) was trying to make out what her mother was saying, as the Parkinson’s had now taken hold of her throat muscles, making her speech very difficult to hear for us, and making it very tiresome for her to even muster up a few words. So I walked up to them and introduced myself, to which the daughter smiled and told me how much the grandmother appreciated me playing with her grandson the night before, and apparently she’d never mentioned any of the staff before, but she was very happy with what I had done. I didn’t even realise the grandmother was aware of what I was doing that night! This is when it occurred to me just how cruel Parkinson’s is. To be of sound mind, but not able to express it must be incredibly frustrating (to say the least). I won’t attempt to suggest one disease is favourable over another, but at least with dementia, you don’t know that you’ve forgotten things – Parkinson’s strips you of your most basic abilities and you know it’s happening.

Once I got talking with the family, I discovered that this grandmother had the same name as one of my grandmothers (not a common name), so I started to feel a connection. I made an effort to always be there to feed her from this point, and most times, we wouldn’t say much, as I didn’t want to make her have to struggle to talk, but we’d glance at each other and smile (as much as she could anyway), and I’d just occasionally talk about random things.

After a few days, I told her that she had the same name as my Nonna, but my Nonna had passed away many years ago. Through her strained tone, she asked:

“How old?”

“66”, I replied.

“Too young”, she whispered while shaking her head. Yes, far too young. But then, as she stared straight at me, the moment I’ll never forget:

“I want to pass in my bed”.

I couldn’t make out what she was saying, there was a lot of noise in the dining area this day. I asked her to repeat it as I leaned forward to have my ear right in front of her mouth, and each time, I struggled to put the words together as much as she struggled to get them out. I felt so guilty that I was making her repeat these words, but I just couldn’t piece together what she was saying at that time. It only occurred to me later what she had said – her daughter had told me that her Mum had mentioned numerous times that she wants to die. The daughter wasn’t surprised, but she also knew there was nothing she could do. Victoria has just passed voluntary euthanasia laws, but they don’t take effect until June 2019. We discussed this, and she wished this was an option for her Mum, but the sad reality was, that the only thing her Mum could do was not eat much and let nature take its course. She was apparently refusing food most days and had recently lost a lot of weight. Her daughter knows what she’s trying to do, but what are you supposed to say to someone who tells you they want to die? She really has no quality of life and is bound to her bed and chair all day. All of her food has to be cut into very small pieces and all liquids need thickener added to them to stop her from choking. She clearly doesn’t like the taste of the thickener either, as she would always wince as I offered her a drink (with a straw, as this was the only way she could get a drink down). Who are we to say that her wish shouldn’t be granted?

Over the last few days of placement, I’d always seek her out and speak the very few Italian words I knew to her. I wanted her to feel seen, and to feel like she actually still had something to live for, even though I knew she was ready to go. And on the final day, just after I had finished feeding her lunch, with the little strength she had, she took hold of my hand, looked me in the eyes and simply said: “I’m very happy. You make me very happy”. I was speechless, yet so incredibly humbled at the same time. I wasn’t doing any of this for any other reason than to make her happy, and when she said those words, I knew this is my true calling in life. No other work I have ever done has given me this feeling and it’s quite difficult to put into words, but after she said this, I just smiled (trying not to break down into tears) and I said how happy I was that she was happy, and that it was an absolute pleasure to spend time with her. I thanked her for allowing me to care for her and then gently released my hand from hers and walked away. I can still picture this entire scene in my mind so clearly and I know this is going to stay with me for as long as my mind is willing and able.

While this placement presented many confronting situations, it also offered many highlights and uplifting moments. I have detailed some of the more challenging aspects but it just motivates me to continue learning and to look forward to my next clinical placement, which is less than two months away in a rural hospital. As there is in life, there will undoubtedly be more challenges to reflect on.

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