Weekend Hospice Nurse Hits a Wall

I love being a nurse case manager. At hospice, this means you have your own set of patients. I get to know them and their families, their issues and needs and history and stories. Sometimes I start to feel like I’m sort of temporarily embedded in the family. Like journalists in Afghanistan, only with a much lower chance of being blown up. 

I do not love working weekend or holiday shifts. At these times, I’m seeing other nurse’s patients and it’s generally because they’re having an emergency. I don’t know who I’ll be seeing until 8:30 on the day. This could be exciting. It’s not. If I were an adrenaline junkie, I would have become an ER nurse. 

I was scheduled to work last weekend. Working a 6th day after a very full week was not my first choice for how to spend my Saturday. Maybe they forgot to put me on the schedule, I thought hopefully. Or there just won’t really be any calls, and I’ll tool around Marin waiting to hear, yardsailing and buying plants, and being paid?

Not quite how it worked out. When I logged in, I already had 3 visits and a check call on the docket, and I knew there would be more. I took a long draught of my coffee and started reading up on the patients.

I got the check call out the way first. I talked to the patient’s wife, who told me they’d actually had a good night and no, they didn’t need a nurse visit. So far so good! Yardsailing, anyone?

My first visit was a fairly simple one for a tiny birdlike woman who sat so still and poised and dignified on her sofa. All she really wanted was a shower bench so she could safely take a shower. One had been promised, but it had not shown up. How hard could a shower bench be? But it was Saturday of a holiday weekend. I knew if I ordered it through the regular channels, it would arrive Tuesday, earliest. Thousand dollar specialty wheelchairs I can order, but a $50 plastic shower bench I have to get special approval for from a supervisor.

When I went down to my car, I noticed I’d parked in a Passenger Loading Zone. No ticket though: good omen. I also noticed I had left my wallet at home, and forgotten to pack breakfast or lunch: not so good omen. Luckily, my daughter was able to meet me with the wallet outside CVS on her way to the city. They have shower benches at CVS. When I swung by bird lady’s two hours later, I parked in the Passenger Loading Zone again, the only parking space for a mile around. I’m rushing a life-saving shower chair to a dying woman. So go ahead and give me a ticket, officer.

Between bird lady and the wallet pickup, there had been a visit to another severe agitation situation. I had heard about the case a lot, and the patient was on daily nurse visits to control symptoms. So I had some mild trepidation as I repeatedly lost my way trying to find his house.

To my huge relief, the patient was sleeping peacefully. I showed the sweet young caregiver how to administer the scheduled morphine in the side of his mouth without waking him up. She was uncomplaining and perennially cheerful, and her main goal was to understand and be able to pronounce the names of the meds she was giving. Using google translate, she painstakingly typed out each medication I spelled and pronounced for her, and I watched in fascination as google dutifully translated it into the characters of her native language.

As I left the house, she called after me excitedly offering candy. You’re so nice! She kept repeating. Have some candy! We have candy here! I drove away thinking about how caregivers like her are the unsung heroes in our midst. Then I got lost trying to find my next patient.

I even got lost leaving this patient’s house, much as I had got lost trying to find it, only in reverse. At this point, the merits of working a mandatory Saturday after a full week, if there were any, were becoming really dim to me. As I turned onto yet another cul-de-sac trying to find the main road, I yelled I HATE working Saturdays! It really helps me in moments of excessive frustration to yell in my car. There may even have been an expletive in there. After all, it’s a safe space and nobody can hear me. Unless of course it’s a hot Saturday in September and all my windows are down...

They loaded me up with a final late visit. This house I found easily, but parking proved very tricky. I tried to get the jag up their impossibly steep driveway but just spun my tires, creating a burning rubber odor entirely incompatible with a dignified hospice nurse arrival. Finally I parked behind a neighbor’s truck and hoped they would not need to leave while I was inside. 

When I left, the patient’s wife, clearly suspicious of my driving abilities, gave me extensive advice of the best way to get out of my parking spot. On no account was I to make too sharp of a turn and hit their wall. I reassured her that I was used to getting the jag out of tight spots.  Then I promptly made too sharp of a turn and hit her wall.

The wall fared better than the jag, but the minor scrape blends in nicely with all the other minor scrapes. And the little burst of adrenaline was just enough to get me home.