Ok Ok So maybe not the exact day and it was more like a whole six months that reinforced the idea that I wanted to become a nurse!
Last year I hit a rough patch and decided to take a semester off of school. While I was home I got a unique opportunity to be a caregiver for my grandfather and grandmother. Prior to me coming home they had an agency called the Caring Companions who cooked, cleaned, and helped with their daily ADL's. Twice a week a home health nurse came in to check up on VS and to fill medicine boxes.
My Grandpa had been diagnosed with Right Ventricular Heart Failure which is associated with symptoms like COPD so he had a lot of trouble breathing, a lot of edema, and basically a rough quality of life. He also had multiple co-morbidities including Diabetes, Hypertension, Depression, Kidney Failure, and on and on. The poor man, however he never once wanted to give up on life-- he loved living.
So around May 2010 I started "working" there at their house about 3 days a week. Prior to this I had been away at college and rarely was able to see my grandparents. They were thrilled to have me and sometimes I think they were more taking care of me than I was of them. Soon I came to the realization that my grandpa needed a lot more care than the agency could legally provide. (Important segway: My grandpa is actually my step grandpa, my grandma divorced my real grandpa and married Don my step grandpa. Unfortunately I didn't really get to know my grandpa because he passed away when I was about 5. I know my dad and his brothers loved their dad dearly and were sad to hear about the divorce. It happened after they were all grown and soon they welcomed my step grandpa into the family.) My dad and I took over the care for the summer and that included all cares except bathing which a home health aide came in and did. So basically we were doing catheter care, peri-care, skin care, oral care, etc. As well as cooking and cleaning. It was a big job and the reason I mention that my dad did all of these cares too because imagine how hard it would be to do all of the cares for your step dad especially the more private cares. I was amazed to see how much empathy he displayed.
He was in and out of the hospital about every two weeks with exacerbations of his condition. He would swell up with 10 pounds of water weight overnight and we headed to the hospital which became a routine. It was hard to watch him suffer so much but after a day or two in the hospital and IV lasix with lots of steriods he would feel better and so ready to come home!
After talking to a dietitian in the hospital we implemented a new diet for him which brings me to the point of interdisciplinary collaboration. It is important to get at all sides of a disease and as a nurse we need to advocate especially hard for this!! This diet really worked keeping him out of the hospital for months at a time and it seemed like he felt much better. He felt good enough to get in his scooter and go around the park a couple of times-he had not done this for months. He went like this for a couple more months.
Then the inevitable happened... One day I was at their house and he had just gone to the toilet. At this time he could only walk from the living room to the bathroom and back while resting in between. I tried to get him up and off of the toilet and he was struggling to breath (imagine how scary it is not to be able to catch your breath, imagine the anxiety that causes, and then imagine how the anxiety adds to the problem) I felt very odd about the whole situation. I left him on the toilet and went to get him a breathing treatment. I watched him do the breathing treatment and his color was dusky and as I realized the treatment was not working I immediately called 911. They arrived in seconds- thank goodness because as soon as they walked in he stopped breathing and foaming at the mouth. He did have a DNR and that was the scariest part because they could not resuscitate him, all they could do was yell at him and try to calm him so that he would breath. In the mean time my grandma was watching all of this with wide eyes from the picture window. She thought he was gone and was terrified. We hopped in the car and followed the ambulance to the hospital which luckily was right around the corner. This would be the last time my grandpa would be home.
In the ER we were told that he had started breathing again in the ambulance but the nurse told us that he was really sick. We were allowed back to see him as they admitted him to the hospital. At this time I made a phone call to my dad and then he spread the word. Family came in from all over Colorado to see him.
This hospital stay lasted awhile and one day when he was feeling better they got him up to the shower with a sit to stand lift. They got him all spiffed up and brought him back to his bed on the lift because he was too exhausted to walk. About a foot from his bed all of the sudden he slumped down and stopped breathing again, he was blue. The nurses got him down on the floor and waited for him to breath. I threw them his CPAP which he wanted to wear constantly, and grasped my grandma and we left the room. Soon a nurse came to tell us we could go back in. He was still on the floor when we came back in but those big blue eyes still had a twinkle in them. He did fine after that, just a little tired, the doctor told him he could go home anytime. The doctors we were working with were hospitalists and worked for a week and then a week off or something like that. A new doctor came on and told him he would not make it to Washington, she then spoke with us about Hospice Care. This all happened at the beginning of November. We got in touch with a Hospice Nurse on a Saturday, whom I loved right away, she walked us through the process and helped us prepare to bring him home. The plan was to bring him home that Monday and a hospice nurse would be there to help us.
We went back to see him that afternoon, my grandma and I, we told him about coming home on Monday and he was excited. He wanted to go home that day and kept asking if he could and in a way I really wish we had tried to get him home. My grandma was sitting on one side of his bed and I on the other, his son and his wife were also in the room. He was restless and confused, he kept saying take me home, take me home. I took his hand and said on Monday, on Monday. I helped him eat a snack and he calmed down a bit. His eyes were off and it is hard to explain what he was like that afternoon, except that something was weird. I got up to go get a nurse when he seized and stopped breathing again. I yelled out into the hallway and a team came running. We left the room...
We waited in a room off to the side as I once again made phone calls. Then a nurse came in looking devastated she took my grandmas hand and said you can go see him now but we do not think he will make it. She told us to talk to him and touch him. When we walked in, his breaths were far and in between, his heart rate was incredibly low. They turned off the monitor per my request and we watched him take his last breath and end his struggle. It was November 6, 2010. My grandma was distraught and was overcome with grief but was glad he did not have to suffer.
She is doing extremely well now though!
I have been wanting to write down this story for a long while now and while I left things out as to try to stay brief I included all of the important aspects of his story. If I could thank him for everything he taught me I would tell him that he has made me a better student, a more patient person, and in the long run-hopefully an excellent caring nurse. In a way I do think God intervened at a time when I was struggling and put me in the arms of my grandparents who needed me as well. So, thank you Grandpa for enriching my life and allowing me the opportunity of a lifetime.
