the hospital world according to aaron

Aaron had day surgery IMG_6304today at our children’s hospital.  In an effort not to be a ‘secret shopper,’ I try to take off my family centred care hat when I’m in the hospital with my boy.  I focus on him as opposed to critiquing every single interaction.

Yes, the experience wasn’t perfect – the clerk calling me to confirm Aaron’s time didn’t mention that the entrance to the day ward had been moved in the midst of renovations (so I got a bit lost), I was called ‘mom’ an awful lot, one of the nurses said:  it is so good he’s so high functioning (!?) but overall, the clinical care was exceptional, everybody was respectful towards Aaron, and we were able to go home five hours after we arrived.  That looked like success to me.

My youngest son has had four surgeries in his life, and this was the first time I did not push the pre-sedation request.  Aaron was relaxed and joking with the nurses, so I thought – let’s just see what happens if he doesn’t get sedation before he goes into the OR.  I warned him there would be lots of people and bright lights in the OR, and he was perfectly fine.  (I now wonder if the pre-sedation request was more for me?  Mom needs sedation).  It is fortunate that our hospital has parental presence at induction, which means I was able to go into the OR with him until he was asleep.  I teared up a bit when he was put under, as I always do – and the kind anaesthesiologist said to me:  we will take good care of him.  And that they did.

What is more interesting about this brief experience in the hospital is Aaron’s perception of it:

He was annoyed that he had to wear a dress (see photo above).  Apparently the hospital switched to gowns for kids and don’t use pajamas anymore. He had to wear a mask because he had a cough.  Sensory-wise, that was not great – it was scratchy and bothered him and he kept taking it off.

Despite the fact we explained the going to sleep thing, the first thing he shouted when he woke up after surgery was:  I AM NOT DEAD!  I’m horrified he thought he might have died – I am constantly in awe of how this kid’s mind work.

The day surgery unit was BUSY and unfortunately, some of the kids didn’t wake up well after surgery, and some children were crying. There was also a considerable amount of construction noise – hammering and drilling.  I don’t like hospitals, Aaron told me.  I asked why.

I don’t like these screaming kids! he explained.  He added, the food is disgusting.  I want to go home.   Ask him about his own patient experience, and this is what you get – he is a fountain of truth.

I’m grateful for his uneventful experience.  I’m also thankful for the folks at the hospital who cared for him:  the clerk at reception, the LPNs, the RNs, the porters, the surgeon, the OR nurses, and the anaesthesiologist.   They all had smiles on their faces, spoke to Aaron directly, and did their jobs quickly and competently.  I feel fortunate that Aaron’s experience included such caring health professionals, and that he is home safe and sound.

remembering henry

poppiesLong ago, when I was twenty and still in university, I worked in a Veteran’s Home as a Nursing Attendant. I’d often work mornings helping the staff get the men up and ready for the day – and then run across campus to my English class, dressed in my nursing uniform and white nylons.

I’m remembering that experience today. Nursing Attendants are true bedside workers. We were the ones who worked directly with the gentlemen on the nursing unit – many of whom required extensive care. We cleaned up things that the housekeeping staff wouldn’t touch. But we also had the luxury of time to spend with the veterans, as we helped them get dressed, or patiently helped feed them meals.

Nobody talked about the War. At the time, there was even a World War I veteran at the Vet’s Home – but there were many veterans from World War II and Korea. While the war was in the distant past, it lived with these men every day.  These were just ordinary men who had found themselves in terrible circumstances. The scars from those war-time experiences often were manifested in estranged families, whispers of abusive behaviour and alcoholism. I remember helping men to bed after their return from the Legion, reeking of whiskey, and slurring their words.

But that wasn’t the whole story. The wars had affected a cross-section of the population of men, and there were many dignified, lovely residents at the Veteran’s Home. They enjoyed the company of the young nurses who where there to support them, and many of them reminded me of my own grandpa. It was important for the staff to remember that these ‘residents’ were also fathers, granddads, brothers and sons.

There were many stories of kindness at the Vet’s Home. My clearest memory was one winter, when I was working nights. On night shift, there was a lot of sitting around at the nursing desk, waiting to respond to call bells. Every few hours we would have rounds, where we would quietly walk through the unit, checking on the men, emptying urinals, and turning those who were immobile so they wouldn’t get bedsores.

One night, my patient assignment included an elderly man named Henry. He was in the last stages of life, and his breathing was increasingly noisy and laboured.  He had no family or friends to visit him in his final hours. After our first set of rounds, I excused myself from the desk to sit beside his bed.  Henry had yelled and sworn at me in the past, but all that didn’t matter now. His hand had paper-thin skin, and I held it softly through the wee hours of the night. It was a long shift. When I left at 7 am, I said a quiet good-bye and gave him a gentle kiss on his forehead.  I did not look back when I left the room.

I read Henry’s obituary in the paper a few days later.

I learned many things from working at that Vet’s Home. One was to duck fast if something was being thrown at you.   My other realization was that health care is really about acts of kindness.   And that no man should ever die alone.

Lest we forget.

(Originally published on the Bird Communications blog on November 11, 2013).

a kiss on the forehead good night

Purple-Butterflies-butterflies-17473487-1024-768When David Sheard spoke today, the sky opened up right into the dark ornate ballroom at the Delta Edmonton South Hotel, and the sunlight fell in.

David spoke about the heart of nursing and care.  He stressed that the best nurses wear their hearts on their sleeves and don’t hide behind the mask of professionalism.  Sitting there in that room, I had a sudden realization.  I didn’t drop out of nursing 26 years ago because I was a bad nurse.  I wasn’t too soft to be a nurse, as I’ve always said.  A soft nurse is exactly the kind of nurse that the world needs.

The epiphanies in that ballroom continued.  David’s talk was about the Butterfly Homes for people with dementia in the UK.  He sprinkled his presentation with beautiful images and stories of humanity for the room packed with LPNs and health executives at the College of Licensed Practical Nurses’ Think Tank.

It was a relief to hear David talk.  He said it took a full 20 years for him to see culture change in the world of dementia care.  TWENTY YEARS.  (I’m 11 years in my preaching about compassion and love in health care, so I can now see the light flickering at the end of the tunnel).

He said 35 years ago, it was just him sitting at his kitchen table with an idea that things could be different in his workplace of dementia care.  Nobody was asking him to be a plenary speaker at conferences, and nobody wanted to publish his articles.  That has been 30 years in the making.  But he didn’t give up.  He spoke in terms of the uphill climb he took to be standing behind the podium in a room full of hundreds of health professionals, thousands of kilometres away from his home in the UK.

And what is the great change he referred to?  That care should be about people, not about profit.  He encouraged the nurses to be people first and nurses second at their workplaces.  He hires nurses in care homes who wear their hearts on their sleeves and are willing to share their personal stories.  He says that nurses should be attached professionals, not detached professionals.  And working in continuing care means becoming someone’s friend and becoming part of their family.

He wants nurses to cry with the people they care for, nurses who sing with them, nurses who share meals with them, and nurses who hug often and freely.

I was reminded of my own mom, a good nurse, who worked in a Veterans Home in the 1980’s.  I asked her recently what were her favourite memories of her time there.

‘Oh, I remember working evenings, and tucking the guys into bed, and kissing them good night on their forehead.  But I shouldn’t say that!  I would have gotten thrown out of nursing if anybody found that out.   Good thing I’m retired now,’ she said with a smile.

If that had been my grandpa at the Vet’s Home, I would take great heart in thinking that the nurses cared for him so much that they tucked him in bed and kissed him good night.  I want those kind of people caring for my loved ones when I cannot.  Nurses like my mom are the ones that need to be hired, celebrated, and nurtured.

My daughter Ella received notice that she’s been accepted into nursing school next September.  I’m so very proud of her, not only for her academic achievements to get into university, but also for her big open heart.  She’s the kind of nurse that we so desperately need.  I only hope she can protect herself, not from the people she cares for, but from a system that currently cares more about efficiencies than kindnesses.

The revolution that David Sheard spoke about is a revolution in compassion and love.  As his tag line says, feelings matter most.  And I believe that love always wins.  We cannot give up on these ideas.  It turns out that my mom (retired nurse) me (half a nurse) and my daughter (future nurse) are on the right path after all.