Patients that Changed My Life: Carol

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here.

In one of my first ever nursing jobs, I worked in a facility specifically for Alzheimer’s and Dementia. I didn’t really know what to expect, but I found that I loved working with them. They kept me guessing, and usually laughing. We had this one lady, who I will call Carol. She was active, even though she was declining rapidly. She used a merry-walker, which kept her safe when she would suddenly get tired and need to sit down.

She had almost no short term memory. You could have a conversation with her and seconds later, she wouldn’t remember it.

That doesn’t mean that she didn’t remember anything.

She had an issue with me almost immediately. No matter what I did, she got angry, and she would scream at me. It wasn’t that unusual, since she had a temper, but she did seem to single me out more often than not. I had no idea why until a few months into the job when she said something that surprised me.

“Get off my husband!”

I wasn’t sure how to respond, but I let her know that I wasn’t on her husband. Over time, she kept making comments that made me believe that her husband must have cheated on her with an Asian woman. Comments like:

“Get out of my house!”

“Get out of my husband!”

“They’re my kids, not yours!”

“Tell me it didn’t mean anything and you didn’t enjoy it.”

Most people don’t really think about it, but it’s the emotionally traumatic events that seem to stay with Alzheimer’s patients. They may not remember that they just ate, but they remember how people made them feel. Those memories stick with them longer than anything else, even if they don’t even know my name.

Just because they’re confused, it doesn’t mean they aren’t there, and that they don’t notice what’s going on around them. 

Patients that Changed My Life: Donna

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here.

This patient was back before I became a nurse, when I was a CNA working in an assisted living. Assisted livings aren’t nursing homes, they’re mostly for people who need a little bit of assistance but can mostly survive on their own. As patients grow weaker, or sicker, they move to nursing homes.

I didn’t really understand the nuances or differences. In an Assisted Living, you’re supposed to encourage them to be independent for as long as possible. One of my patients, Donna, had early onset Parkinson’s, and she had a difficult time eating. For those of you who work in the medical field, and especially in long care, you know that we have all sorts of tools to help people like Donna. There’s the weighted silverware, which makes it so that the tremors are more offset, there’s the lip plates, which are almost like bowls, so that you don’t have to scoop the food, you can push it against the lip, and there’s nosey cups, which makes it so you don’t have to tip the cup back so far. There’s obviously much more than that, but those are the basics that I’ve seen used.

Now Donna had been working with different therapies, and she had weighted silverware and a lip plates, but even with that, she would spill food all over the place because of her tremors. She sat at a table with three other women, and I noticed that after a while, she stopped eating. She was so embarrassed by the fact that she made a mess that she refused to eat.

I served them their food every day, and we all noticed as she became more frail and weak. Finally, one of her tablemates asked me if I would be willing to feed her. Of course, I said yes, and I sat down with her, and she was able to eat almost half of her meal, which was more than she’d eaten in weeks. 

Later that week, I heard one of the other CNAs talking about it, and how Donna was now dependent on someone to feed her, and that if I hadn’t done it the first time, she would have done it on her own.

It kind of broke my heart to hear that. In a therapy standpoint, and looking back at it, yes, she probably would have kept trying at least a little more, but the fact was that she would wait until the dining room was cleared to even try. And by that point, the CNAs were eager to clean up so they could get on with their next chores. She always felt rushed, and she was so embarrassed that she put aside her own health, her own needs so that she wouldn’t annoy the people around her.

I started bringing snacks to her, little things that she could eat without using silverware. Now I know that they’re called finger foods, and I worked in a facility that actually had that as an option for those who had a hard time using silverware. Unfortunately, I haven’t seen it in any other facility that I’ve worked in. It’s an inconvenience for the kitchen to prepare a meal purely of finger foods, even if it makes it so that the patient is able to eat better.

It’s still hard for me to see patients who struggle to eat, or healthcare providers who are so busy looking at the bottom line or the health side of things to realize when dignity is being compromised.

Patients That Changed My Life: Jimmy

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won't use real names, but I want to tell you their stories.

To read about previous patients, click here

In one of my first jobs as a nurse, I had a patient whose name was Jimmy. He was an active guy, and because of his dementia, he wasn’t able to sit still. He would pace the hallways for hours, and even during meals, he couldn’t sit down long enough to eat. The more stimuli he had, the more agitated he would get.

I think one of the reasons why I connected with Jimmy was because he reminded me of my dad. He was obviously a hard worker, and he usually thought that he was our supervisor. He would come up to the nurses’s station, go through the clipboard and then nod his head and tell us to keep up the good work. He loved it when we asked him for help or advice.

One of the things that I realized about Jimmy was that he did really well with personal, one on one interaction. He was definitely confused, and he didn’t make much sense when he talked, but he craved the human interaction, and not just being in a room full of people. He needed to make a connection.

I started saving his meals at dinner, and put it in the fridge in the kitchen. Then, after everyone was asleep, I would take him in the dining room, heat up his food, and the two of us would sit and talk. While he had the human interaction, he was able to sit. He was able to be distracted enough to relax, and he was able to eat something.

Even after he lost his memory and his home, he still was Jimmy. He never lost his identity, no matter what the disease did to him. Yes, there were moments when his personality would change, but as I got to know him over time, I realized that he was still the man he was his whole life. He was a supervisor, he was a father, and he was a friend.

Patients That Changed My Life: Susan

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here.

When working in skilled nursing, sometimes it’s so easy to go through the motions. We have a huge cart full of cards and each card has a medication. We pull the cards out, we check the boxes or click on the button to indicate that we’re giving the medication and then we carry the cup of meds into the patient’s room.

I had one patient, Susan, who was admitted in the later evening, and her admission was a little bit of a mess. She was having a difficult night, which is understandable. No one wants to be in a skilled nursing facility. Add to that, doctors just couldn’t figure out what was wrong with her. She was grumpy, and most of her medications weren’t even in the facility. I spent the evening running around, calling pharmacy, searching our pixus and generally pulling my hair out. Finally, I got the majority of the medications, brought them to her room and she had decided to take a shower. So I labeled the cup with her initials, put it in the top of my cart and continued to the next patient.

About twenty minutes later, Susan asked for her medications. I grabbed the cup and brought it into her, and she asked me what the medications were. I honestly couldn’t remember. I’d prepared them twenty minutes before, and I’d passed medications to at least three or four other patients since that time. She was appalled and told me that she wouldn’t take any of the pills until I could tell her what they were.

I’ll admit, it was a long night. Susan and I went back and forth several times before she finally took her meds. But she taught me one of the most important lessons I’ve ever learned as a nurse. It’s too easy to go through the motions, or to take an order and just follow it. As a nurse, we should be doing more. We should know exactly what we’re giving our patients, and why. They depend on us. This patient was able to ask questions, to tell me that she wasn’t comfortable with specific medications. There are others who don’t have that luxury.

Since then, I’ve always stopped when preparing medications. Whether I’ve done every night for the past six months, or whether it’s their first night in the building, I always make sure that I know what they’re taking. And I make sure that they know what they’re taking. It’s my responsibility to protect my patients, and the best way to do that is by keeping them informed.

Things My Patients Say: Part II

As a nurse, I get to interact with all kinds of people. Some interactions are fun. Others are quite unpleasant. And then there are those that make me smile. I’ve started writing down a few things my patients have said to me, and I’d like to share them with you. If you'd like to read the first post, the link is here.

-          You always look so wide awake. (Said to me by a patient who called for help multiple times during the night. For some reason, I’ve had a lot of patients who assume that when I work nights, I’m sleeping until they wake me up.)

-          Thank you for your help, little one. (It was the little one that cracked me up.)

-          You’re doing it wrong! (Now, I wrote this one down a long time ago, and I can’t remember who it was that said it to begin with, but I hear this a lot. Many patients and families think they know better than their nurse)

-          I must be repenting for my sins. (Said by a little old lady who had broken her hip. She was such a sweet lady, and told me that her fracture was to pay for her sins)

-          You actually look nice tonight.

-          One night, when I was taking care of someone, I noticed something dangling from their ear. When I looked closer, I found out that it was a piece from their oxygen equipment. When I asked them what it was they said: “I don’t know. I found it, and I put it on my ear.” Fair enough.

-          I had a patient whose oxygen tubing wasn’t in their nostrils. It was between their eyes. When I went to adjust it, I told her, “It looks like your oxygen fell off.” She responded with: “Nope, it jumped up.”

-          And finally: “How do you say pee-pee in Japanese?” (There’s always one who comments on how Asian I look.)

Patients That Changed My Life: Dorothy

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories. To read about previous patients, click here.

Several years ago, I worked at an Assisted Living. Those facilities are usually for people who can take care of most of their needs, but need help with a few essentials, such as cooking or taking medications. Because they’re supposed to be fairly self-efficient, there’s a lot less staff then there are at a skilled nursing facility or hospital.

I had one patient, Dorothy, who was a very sweet lady that loved to walk around. She would take her walker, and her little dog, and they would just cruise around the nursing home all day. She would visit other residents, go outside and sit in the sun, or gather in the front room. When I first started working there, she pulled me aside with one very special request.

She wanted someone to cut her toenails. It’s something so small that it would only take a few minutes, yet no one seemed to have the time to help her. Most CNAs can’t cut toenails because of the risk for infection, especially in diabetic patients, but nurses can. I went into her room before I went home, and I cut her nails. It was such a simple act that I didn’t even think anything of it. But for her, it made her day. Actually, it made her week. She was so grateful, she came and found me every day to thank me.

We don’t need to do something big to make a difference in our patients’ lives. Something as simple as brushing their hair, shaving their face, or cutting their toenails can transform their day.

Patients That Changed My Life: Wheelchair and Oxygen

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here

Before I was a nurse, I worked as a caregiver in an assisted living, and as a food server in a retirement home. That’s what got me through high school and college. While I was a food server, we had a very sweet couple who sat at the same table every night. When I asked them what they wanted for dinner, they would order, and then the husband would lean close to me and say “And we want a fruit plate. To share.”

He was a war veteran, who had an amputated leg at the knee, and used a wheelchair to get around. She was able to walk, but she had a hard time breathing, so she always wore oxygen. Whenever they went anywhere, she pushed his wheelchair, and he held her purse while her oxygen tank hung on the back of his chair.

They were my relationship goals. They were so devoted to each other, even after all their years, and with all of their illnesses, they used their strengths to support one another. Together, they were stronger than they would have been apart.

Patients That Changed My Life: Jessie

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here.

I want to tell you about Jessie. She was ninety years old, and had Alzheimer’s. By the time we met, she’d lost basically all function and sat in her high back chair day in and out. Every once in a while, she would say something, but not very often. In this facility, almost every single one of our patients were feeders, which mean that we had to spread ourselves out to feed everyone on time. I would take a whole table of patients, usually 3-4, and each CNA would take the same number.

When I first started, the nurse before had sat at Jessie’s table. I found pretty quickly that she wouldn’t eat. I tried everything I could, but I couldn’t get this sweet lady to eat. It took several months before I realized that she would drink. She liked the small cups, but if I took my time, she would drink close to 600 ml of supplemental health shakes.

I sat with her for over a year and a half, feeding her every night. We grew a very special bond. There were some nights that would be difficult, when she would clamp her lips together and refuse to eat. Then there were nights that she would drink. I talked to her about random things, about my own life, about what was going on. Whenever she was having a good night, she would give me the brightest smile when I talked. Every time I saw it, my entire night went well.

That’s all she gave me. She never spoke, she never said anything profound. She just smiled, but I still remember that smile, even years after it happened.

Sometimes, a smile really can change a person’s life.

Things My Patients Say

You know how kids say whatever's in their heads? I see so many Facebook posts from friends, reporting the hilarious thing that their kids said that day. They don't have a filter, and it creates funny situations.

I see the same thing with my patients. The elderly often are like children. I think it’s a combination of forgetfulness and just not caring about what people think anymore.

Here’s a few things I’ve heard over the years from my patients, because sometimes, it’s nothing but gold.

1.       I told one sweet lady, after checking her vital signs, “No change! Everything’s good!” She looked me straight in the eyes and said, “Did someone take my pennies?” I wasn’t sure what to say, and I asked what she meant. With a gleam in her eye, she grins. “No change. Someone stole my pennies.”

2.       Another sweet lady, who’d been struggling through the night told me, right before I left the shift, “I don’t think I would have made the night without you.” Words like that are a lifeline for a nurse, especially when things get difficult.

3.       After listening to a patient complain about her care, she grabbed my hand, and asked, “You know why I tell you these things, right? Because you’re the only one who cares.” Sometimes it’s hard to show it, especially when I get busy, but I do try to stop to listen. Sometimes, that’s all they need.

4.       I took a pill into a woman who was half asleep one night. As I was leaving, she groggily asked me, “Do you know what I would do if I were young again?” I was curious. She’d lived much longer than me, and I was expecting some impart of wisdom. When I came closer, she announced, “I’d buy one of those newfangled pressure cookers.”

And of course, there’s plenty of comments about me, personally.

1.       “Are you here all night? And you’re Chinese? Oh, Japanese, interesting. Well, we’ll sure enjoy each other tonight.”

2.       “There’s my long haired beauty”

3.       “There’s my little Indian girl.” – Before anyone gets upset, he had Alzheimer’s, and he really, was a sweet man. It was his nickname for me, because he couldn’t remember my name.

4.       “Get out of here… Yoko!” To be fair, we were both struggling with her admission, mostly because the hospital had changed her medications so drastically she didn’t want to take any of the pills I was supposed to give her.

If any of you are nurses out there, I’d love to hear some of the things that your own patients have told you. As you learn quickly in the field, it’s better to laugh than it is to cry. 

Patients that Changed My Life: Billy

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy purposes, I won’t use real names, but I want to tell you their stories.

To read about previous patients, click here

I know I talk about this a lot, but I love working with Alzheimer patients. There’s something so special about them, especially when you can find a way to connect with them.

One of my patients, Billy, was a mechanical engineer. And he was a pretty impressive one at that. He’d gone to school at some Ivy League schools, and had his PhD, and had many, many patents out there. Unfortunately, as always happens with Alzheimer’s, his mind left him, and when I met him, he wasn’t the same man he once was.

That didn’t mean he stopped being himself. He liked to follow our maintenance men around and tell them what they were doing wrong. Sometimes during dinner, he would stare up at the ceiling, watching circuits the rest of us couldn’t see. As he became more confused, he became more vocal, yelling for help constantly.

One night, I was sitting with him, and he started screaming for help again. Every time we asked him what he needed, he didn’t know. Finally, I went into the maintenance closet, pulled out a screwdriver, and handed him that and a broken hole punch.

“Billy,” I said, once he took it in his hands, “I need you to fix this for me.”

And he set out to do just that. He spent hours on that thing, tinkering as he finally had a purpose. That was all he needed. He needed to feel useful again. He wanted to know that he wasn’t just sitting in a chair, watching life pass by.

It’s so easy to see behaviors, especially when they disrupt other people, as something that needs to be silenced. But more often than not, it’s a call for help. It’s a request for someone to see them, and to fulfil their need.

I hope that we’re all listening, instead of trying to silence them.

Patients That Changed My Life: Kathy

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy issues, I won’t use real names, but I want to tell you their stories. To read about previous patients, click here.

Back when I was younger, I had a best friend who died of cancer. To commemorate her memory, every two years, in August/September, I donate 12 inches of hair. I’ve been doing this for years. (Actually, this year will be the 8^th time I do it)

Before

After

I’ve never really thought too much about the recipients of my donation until a few years back. I had a new patient, Kathy. She had terminal brain cancer, and it took us several weeks to get a routine. Part of the difficulty was that because of the tumor in her brain, her personality was wildly different every time I worked with her. We both became frustrated: her because she wanted to do things the way she used to, and me, because I wanted to take care of her, and she kept trying to get out of bed and falling.

But once we got used to each other, and once we began to learn to trust one another, we developed a very strong friendship. She and I would talk at night, when I was done with my med pass, and I would go in to check on her often, especially since she was a fall risk.

One night, after I helped her, I turned around to close the bathroom door, and she commented on my hair. She said it was beautiful, and she wished that she had hair like it. She’d recently shaved her head, and was very self-conscious about it. It was an off-handed comment, one that I’m sure didn’t mean more than a compliment, but it made me stop to think.

For years, I’d been donating my hair to complete strangers, people who I’d never actually met. I started to consider donating my hair to her, as a token of our friendship. Before I had the chance, she ended up passing away, peacefully in her sleep.

She was a special woman, one who made me stop to consider the people I’d been serving without thinking. I’d been donating my hair in memory of my childhood friend, but now, I also remember Kathy, the patient whose entire life had been affected by her disease. A woman who wanted to feel beautiful again, even if she was, at least in my eyes.

Patients That Changed My Life: Berta

As a nurse, I have the chance to meet a lot of people from all walks of life. Some are fun, and some are not so fun. Then there are those that change my life, and changed the kind of nurse I am. For privacy issues, I won’t use their real names, but I want to tell you their stories.

For other stories, click here

One such patient was Berta. She immigrated to the United States when she was in her twenties, and she was one of the sweetest women I’d ever met. She was mobile up until she died, wandering around, pushing her walker. You could always hear her coming because she loved to talk, and she loved to call to everyone around her and say hi.

One day, while I was sitting at the nurses’ desk, she came and sat next to me. She babbled for a long time, and we had a fun conversation while I charted, and all of a sudden, she pointed to one of our signs and read it to me. I was shocked, because she hadn’t ever shown the ability to read. Not that I’d really tested, but she’d never been able to sign her own consents, or find her own room, which had her name on it.

I quickly covered any sensitive information, then pulled out a piece of paper, writing her name on it.

She pointed to it with a wide grin.

“Berta! That’s me!”

I grinned. “Yes, it is.”

Again, she pointed to the paper. “Berta! That’s me!”

I knew she spoke German, and it had been years since I’d taken any German classes (3^rd-6^th grade to be precise) but I did remember a few phrases. I pulled out another paper and wrote a simple phrase. I was curious if she could read German as well.

Ich liebe dich.

She read the words silently at first, and then tears came to her eyes. She read it in German before translating into English. “Ich liebe dich. I love you.” I don’t know if it was reading her mother language, or having someone say those simple words to her. In nursing homes, they don’t get visitors very often, and as much as we care for them, I don’t know that they always feel loved.

Then she got distracted by someone walking by. While she wasn’t looking, I taped the sign right in front of her. Throughout the remainder of the time she sat with me, she would talk to those passing by, and when they left, she’d look down and see ‘Ich liebe dich.’ Every single time, she got excited, and translated it so I knew what I meant.

It’s the small things that make a difference. Sometimes, all they need is love.