A Tough Day

Yesterday was one of those days! I have two patients that are not doing well. They both have very involved families, who are attacking problems from the exact opposite sides. One patient is failing at rehab, is losing weight, not eating, and is rapidly declining. The family is doing everything possible to help make their loved-one well, grasping at every possible option, questioning every medication, requesting every possible test, and trying everything in a desperate attempt to bring their family member back to what she once was. It was very difficult yesterday, when I had to discuss tube feedings with this family. There were lots of tears, lots of questions, and at least 6 different phone calls to address the issues the patient is having.

On the other end, I have a patient with heart failure. She went to the hospital last week, and they were unable to do anything more for her. They referred her to hospice, which means that they have determined that she probably has less than 6 months to live. She is a wonderful lady, who is always smiling and always has a joke or a high-five to share with someone else. We all adore her. She is really in no distress, but she is consistently has dizziness and chest pain that we cannot control. Her family is holding a bedside vigil and requesting morphine at least every hour, to "help" their mom. Now, I am not one to withold pain medication, but in my experience, the amount and type of morphine that we are being asked to give is what we would normally give someone with only days to live, when he/she is no longer eating, drinking, or able to get out of bed. This patient is not at this point, so it is difficult for me and my staff to follow through on their requests. At one point, the patient's respirations were very shallow and less than the 12 breaths per minute, at which point we are not legally allowed to give morphine, as it slows breathing. I attempted to explain this to the family, and offered other comfort measures. The family was not pleased, and several interactions did not go well.

By the end of the day, I was praying: "God, make this stop! I hate this. It is too hard for me!" To which God replied, "Of course it is too hard for you, but this is not about you! You are not in this alone. I am with you. Remember: 'I can do all things through Christ who gives me strength?" (Phillipians 4:13). So, I changed my tune. "God, please give me the strength I need to help these people, and the energy to endure all these phone calls and conferences....And I still hate it! Maybe you can send someone else." Again, God replied, "But I am sending you. This is so hard, because you care. If you didn't have a heart and compassion for these people, it would not be hard. But I don't want them to be taken care of by someone who has no heart. I want you to do it. I am with you."

So, off I go again. I am still praying that God will give me strength, endurance, and plenty of compassion. I am thankful that I have an amazing team of nurses and CNA's that are giving loving, compassionate care to both of these patients and their families, and I know that God will take care of it all in his time, and in his way. So, I am trusting him today, instead of trying to do it myself.