Mary Markee submitted 2017-07-13

My inspiration to become a hospice nurse

There was an unfamiliar beep that was alarming and uncomforting. The sound was soft but could be heard from the hallway. My father laid in the hospital bed with IV tubing draped across his arm; he was wide eyed and scared. The nurse walked in pressed buttons on the IV pump and traced the IV tubing to fix the problem. He was sent home and within a few short months his health declined. Being his youngest daughter and still living at home, I assumed the position of his care taker. A profession I was comfortable with, yet not wanting my dad to be my patient. His pain grew worse; the cancer had spread and the doses of narcotics increased. I had limited knowledge of medication and it was nearly impossible to accurately access his pain and administer the proper dose of narcotics.

His agonizing moans of pain and discomfort were heard loud and clear. He was not a complainer. He was a tough ex-marine solider who bravely fought in the Vietnam War. He solely provided for a family of five people without a thought of repayment. As the pillows were fluffed and the warm blankets were pulled from the dryer and laid over him, he was in pain. The narcotic of choice was Morphine. I drew up the pink liquid in a dropper, all the way to the top, not a drop to spare. I placed it in his mouth and squeezed. He swallowed, and within about 5 minutes, he was fast asleep. He laid motion less, chest rise, chest fall, nasal cannula in placed sounds of the oxygen concentrator and free flowing oxygen could be heard in the room. The air was still as I watched my father die slowly.

His breathing slowed and a gurgling sound came from his mouth. I nervously shook him to wake him up; he was arousable. One eye open the other closed, he cleared his throat. It was not enough to clear the sound heard with every expiration. He closed his eye and returned to the comatose state he was previously in. Every-once in a while between “death rattles” he would talk to loved ones past as if they were right there with him. He reached out to take things from the air as if he was being handed something. In his comatose-state he was busy. He had work to do and he was working. At the time, I was too young and uneducated to realize what he was doing. The music he heard, the people he saw, he was transitioning into a different state.

I secretly thought for many years that I was the one who killed him with that lethal dose of pain medication. I could not help but feel at the time that the medication put him into that coma. That decision never really reignited well with me. I decided after dad died I wanted to go to nursing school. I wanted to learn how to be a good nurse. LPN school came very easy for me. The nursing entrance test was easy, the interview process was easy. There were over four hundred applicants for eighty spots. Many applicants applied many times before being accepted into the nursing program. I applied once and was accepted on my first attempt. Everything about getting into the program went smoothly. That increased my aptitude about becoming a nurse. Once in the program it became very clear that nursing school was not easy. It felt like I signed up for boot camp. The instructors dictated the way I dressed, the way I wore my makeup, the way I wore my hair, the way I spoke, the way I documented, they controlled many aspects of my life. I made the decision to become educated. I went to school to become a nurse. That was what the instructors were making me into.

I became a person that spoke clearly and had accountability for every action. I realized that the community looked at me for help, a pedestal I unknowing stood on; not a pedestal of entitlement but one of responsibility. I learned accuracy, understanding, patience, accountability, responsibility, kindness, and to control my bladder because there is never enough time to pee. The importance of understanding how a disease process works, how medication works, how to handle, and administer it, is life altering. It can be the difference between a person’s guilt and a person’s peace with death. I now have the opportunity to educate my patients and their family on medications and administration along with a multitude of other tools. I can be the nurse that lets that frightened young girl know that the disease is what is killing her family member, not her. That it is ok to make her dad, her mom, her family member, whoever, comfortable while they actively died.

I now know that the medication was not what killed my father. I could have chosen to let him suffer and die in pain or slow his respirations down and allow him to be pain free while the disease did what the disease does. Inevitably he was going to die. Whether I made him comfortable or not was a choice I had to make. Being an uneducated young woman, I made the best choice for him at that time. He laid in that bed with fluffy pillows, fresh warm blankets, nasal cannula intact and he was pain free when he left this world. That medication decision was the best mistake I have ever made.