When Did I Become a Realist? July 12, 2011

When did I become a realist? This is a question I have thought on for a while, and I think I have finally come up with an answer. As you know, I am a nurse and I work in the long term care industry, which brings with it a unique perspective on life and what happens when things don't work so well anymore. When I first got into nursing, I truly believed I could save the world. I used to read the latest nursing magazines about new procedures, equipment, medicines and the like. I was going to make a difference and everyone was going to go home a healthy person. I was going to save everyone! I learned CPR and thought it meant that I could save a life and everything would be fine in the end. I thought everyone should be a full code, with everything possible being done to preserve and continue life. Then one day after working in long term care, I realized that there are things in life much worse than death and that the journey to death could be one of peace and serenity, comfort and dignity. I realized that life at all costs wasn't really a life at all. One day, I got a patient who had suffered an acute, life threatening brain injury. She had a living will, and her sisters chose to honor her requests. This patient did not want to be kept alive by artificial nutrition and hydration( a feeding tube). At first, I thought this was horrible, that this person was going to starve to death if something wasn't done. The patient was nearly comatose, with little response to anything. She lived for about a week, and never appeared to be in any pain or distress. She died quietly and peacefully, with her sisters by her side. It was then that I first realized that death was not the worst thing that could happen, that death is part of life and that we all have our time to die. I have also seen what happens when life is preserved at all costs, and trust me it usually isn't pretty and neat like all the TV shows would have you believe. There is little dignity in having to depend on someone for every thing you need done, because your body doesn't work anymore. There is little dignity in fighting infection after infection, each one worse than the last, until one day the antibiotics don't work at all anymore. There is little dignity in not recognizing yourself or your family or your spouse of 60 years. There is no dignity in going through a fresh grieving process over and over, because you forgot your spouse died until someone reminds you.  I strive every day to provide a life for my patients that allows them whatever dignity, self worth and self purpose they still may have. I try to make people laugh, or at least smile. I freely dispense hugs, because sometimes the human touch is more powerful than any medicine made by man. I share in the simple joys of good food, good weather and the antics of squirrels on birdfeeders. I have learned to agree with your reality instead of conforming you to mine. I have learned the value of time well spent, of living day to day, and realizing that one day, tomorrow will never come.