Dementia; Or, the First Time I've Felt the Need to Post Since Graduating

“Do my daughters know I’m here? I need to see my babies, they need me to tuck them in at night. I always tuck them in.”

“Your daughters are all grown. They brought you here a few hours ago. They’re doing very well.”

“Do they know I love them? I need to tell them I love them. I love them so much. I’m so lonesome for them.”

“I know you are, but I’m here for you right now. They do know. You told them over the phone a few minutes ago, and they love you very much too. They told you so, and they’ll be back in the morning.”

“Why are you spying on me? I want to go home to the lake. I should’ve never fallen down that manhole. Why did they leave the cover off that manhole? Do my daughters know I’m here? They need me to tuck them in.”

“Your daughters are all grown up and they know you’re here. They love you very much. They’ll be back in the morning.”

“Why am I in prison like this? I just want to go back to the lake with my daughters. Please can I go?”

That is how the entire second half of my twelve hour shift went. She had dementia and was incredibly sweet, pleasant, and cooperative, but she couldn’t remember anything that I told her and was surprised every time I repeated my stock answers to her litany of questions. I’ve never dealt with someone whose mind was more like a sieve. She was, of course, a fall risk, and I had the bed alarm turned on so that a blaring noise went off whenever she tried to get out of bed without one of us there. For 6 hours, this went off almost every 10 minutes. I do tend to exaggerate at times for comedic effect, but I only wish I was exaggerating about the previous sentence. I repeated the same thing every time I went in and reset the alarm. I sat with her for a solid hour and a half, but she was insatiably lonely and immediately tried to get out of bed as soon as I left. I distracted her with magazines, foods and drinks to nibble, tried to find a show for her to watch, and even asked her to “help” me fold towels and washcloths to keep her hands busy. None worked for more than a few minutes, ten at best.

I can’t imagine being the caretaker for someone with a disease this severe. It’s unfathomable and devastating. When I finally caved and called her daughter after several hours of repeated pleading, I could hear the tension in her child’s voice over the phone. She apologized to me, saying that she wished she could be there, but she needed a break. Just a little break and some rest. I couldn’t blame her for failing to warn me what my time alone with her mother would be like. I had to hang up the phone even though she wanted to tell her daughter that she loved her one more time.

I cried on my drive home, my first time crying because of work since I started in February at my first real career. I’ve been so proud of myself when the other nurses ask how many times the job has made me cry. “None!” I’ve said, and they’ve been surprised. I’ve been emotionally drained from patients before, but never like this. Everything I did for her and said to her was pointless. Hopeless. Irrelevant. She couldn’t remember all the times I’d repeated myself over the past hours, but somehow, her frustration was building and all she could recall was that I was keeping her hostage. “This is America, you know. The United States. I’m not a prisoner. I’ve had my picture taken with the Statue of Liberty. I’m free.” No matter how much I soothed her, hugged her, held her hand, stroked her face, and reassured her that both she and her daughters were safe and loved, she forgot it within 5 minutes. I kept my voice calm and gentle with her, but as soon as I left her room I would lose it. Over and over.

I’m not entirely sure what to make of this day, or this post. It’s cathartic. And depressing. And terrifying that it may happen to someone I love. Terrifying to think I might have to do this for more than a day, way more than a day. I don’t think I’d want to live if I was that way. At what point do you just give up?

New Town, New Job, New Life

It's official (and it has been for some time now) - I've graduated school and passed all the necessary requirements to practice nursing in Texas! In this state, in addition to the NCLEX, there is also the Jurisprudence Test that must be taken to be registered as a nurse. It's extremely easy though, and it's essentially open book (or open browser - it's online and any resources can be used.) It's also official that my husband, The Pug and I are moving! This is a big deal to me - I dislike almost everything about Texas, particularly the conservative rat hole devoid of any concept of social justice where we currently reside. Texas does have its redeeming qualities though, most notably the generally friendly and endearing "Howdy y'all!" populace and the liberal progressive oasis of Austin. We'll still be in Texas, only in an exponentially better location.

I also have a job! As a graduate RN in Texas, many people mistakenly assumed that finding a job would be easy. Unfortunately, at the time of graduation in December, more than one third of my 100+ person class was still jobless, and that included myself. Several hospitals around here even have a hiring freeze, as do several of the places in our new city. When even the job outlook for nurses in Texas is bleak, something must be seriously wrong with the economy.

I tried to sell myself as best I could, and even with the magna cum laude on my diploma and volunteer work on my resume, I only got one bite at one hospital. And holy crap, was that a nerve wracking job interview. I practiced for hours before hand and am pretty sure that I bombed several questions, and then had to wait over 3 weeks for a callback. Luckily I got the job for the only position I was even considered for. There were only 3 positions even available, even on a 64-bed Med-Surg floor. Apparently budgets are pretty tight right now.

Anyway, the hospital is, unsurprisingly, religiously oriented. It does a metric ton of charity work in the area though and is not-for-profit, and that's something that I'll be proud to be a part of. (I don't want to get into politics at this moment, but let's just say that I don't think health care should be a for-profit venture and everyone should have access to quality healthcare.) It'll be interesting to see if there are any signs of the hospital's religious background in my day-to-day nursing experience. Obviously there are crosses on every wall and a point is made to notify visitors and patients of the hospital's mission, but hopefully it ends when it comes to employees. Overall, I think it will be a great place for me to start out and is full of opportunities.

I am excited to be able to continue on relating stories of the amazing people I come across and how they change my thoughts and views. I can't wait to grow as a person and care for my future patients. Next week, I start a new life.

Graduation: The Pinning Ceremony

For the past four years, I have looked forward to the day I graduate. It wasn’t especially exciting for me to graduate high school, because I knew that three months afterwards I would be starting yet another four years of school until I actually was able to start real life. And lo, the time has come! In December, I will walk across the stage and be able to wave adios to college (until graduate school, but I’m going to try and forget about that for now.) For those of you who aren’t familiar with graduating from a nursing program, there is a special ceremony (aside from the typical graduation ceremony) that most schools have – it’s called a pinning ceremony.

I can’t speak for any more than the couple nursing schools I know about, but generally, each student nurse walks up on stage one by one and gets a special pin with an insignia from his/her nursing school pinned on him/her by a special person in the graduate’s life. For example, as a side note, I’m hoping my husband and mom can pin me, but my husband has extreme stage phobia to the point where he needs medication or else he’ll faint and my mom already told me she’s going to bawl her eyes out just looking at me, so it looks like I’ll have to recruit my dog to pin me. Anyway, back to the pinning ceremony. So all the students get pinned by a loved one, some faculty members give a few speeches, and we eat some cookies or something. Oh, and did I mention the Florence Nightingale Nursing Pledge that we all recite (AKA The Nightingale Pledge)? Ahem. Here it goes:

I solemnly pledge myself before God and in the presence of this assembly:
To pass my life in purity and to practice my profession faithfully;
I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug;
I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling;
With loyalty will I endeavor to aid the physician in his work and devote myself to the welfare of those committed to my care.

This is what I am dreading the most – well, besides the fact that the pinning ceremony is going to be held in a megachurch (I’m in Texas, remember?). There are some more modernized and updated Nightingale Pledge variants floating around, but I’m not sure which one my class pinning committee has decided on. I have heard many older nurses mention “the Pledge,” normally in addition to whatever else they’re using to deride us about something or other. “Hmph. New nurses these days… don’t they know about the Pledge?” So at least for older nurses, it is considered something relatively important in the field of nursing; it’s essentially our Hippocratic Oath.

I personally don’t think it’s necessary at all for us to take an oath (or for anyone to ever take an oath, for that matter – it’s not the Middle Ages.) Any licensed medical professional should be competent enough to understand the main concepts of caring for other people: don’t hurt them intentionally, strive to prevent errors and mistakes, and abide by all of the general ethical principles of veracity, fidelity, beneficence, nonmaleficence, etc. It’s common sense, and they should be followed regardless of whether an oath is taken or not – it’s part of the job, and part of the responsibility we bear as health care workers. It’s ridiculous to think that student nurses aren’t going to behave ethically until we robotically repeat some century-old phrases.

I am ecstatic about graduating and can’t wait to actually begin practicing in the field that I have worked so hard for, which will undoubtedly provide me countless stories to retell here. Even though I don’t necessarily look forward to some parts of the pinning ceremony, I understand its symbolism is well-intentioned. Unfortunately, I have the sinking feeling that I might be the only student nurse at the ceremony not pledging myself “before god” and passing my “life in purity”. Instead, I’ll strive to be a rockin’ nurse who treats all patients equally and has the benefit of not being biased toward any religion or god at all. But for now, that’ll have to remain my little secret.