Tuesday, October 23, 2007

Gone Too Soon

Paz was one of my best-mannered patients. She was unquestioning, unobtrusive, peaceful and serene. She rarely makes noises. She never complains every time I visit her in the room. Performing any invasive procedures on her is a breeze. There are no struggles, no resistance, no fighting back. She takes her medications without queries or qualms. She was just plain perfect --- in fact the best patient assignment any nurse could ever get --- except for one single thing:

She was in a coma for the past 7 months already.

Bioethical principles dictate that we should value human life at all cost. Medical ethics, however, makes it a little complicated. Technology is even blamed for its often useless and unnecessary means of prolonging life. Heart-lung-machines, artificial feeding, respirators, aggressive antibiotics --- they have been used indiscriminately that instead of helping the person die in peace, they just prolong the patient’s agony. And sometimes the thin line differentiating murder/euthanasia or a peaceful death is now gone.

Would you remove your dying mother’s ventilator if in case she gets comatose?

Would you stop giving artificial feedings if in case your mom could not eat by ordinary means anymore?


Would you be very much willing to allow her to die? Withhold fluids and not give CPR?

As an ICU Nurse, I have seen patients die. I have seen how their relatives weep outside of their dying loved ones’ room, waiting and praying eagerly that the chest compressions and non-stop pushing of medications would bring their loved ones back to life. I have seen how their eyes and their faces mourn with sorrow. So piercing they need not say any word at all.

But like any other job, for a nurse like me, after every death, and each post-mortem care, the show must definitely go on. Repress the image of death at the back of your head and wear a jolly smile before entering another patient’s den.
And one could only hope that the rest of the day would be a better one.

How do nurses cope with loss, with pain, with death?

My colleagues do it in the shopping malls. They sing karaoke till they finally kill somebody with their horrendous voices. They buy white and light blue rubber shoes to match their cerulean scrubs. They eat like there’s no tomorrow. They take care of their babies, hubbies and sweeties. They do the unmentionables.

I, for one, do it in the arcade shoppes. I race cars while imagining the Reaper chasing after me. I hold fake guns while visualizing Death as just another character in The Night of the Living Dead game. I play those Marvel games and picture my opponent as the Grim Reaper as I pierce him using Wolverine’s claws. I catch toys in magic cranes hoping that the loosened hinges would grasp the weighty bear. I watch young lads play Dance Revolution because I’m too shy to play in one. I surround myself with noise, fun, and company of good friends. I stargaze. I celebrate.

Dare people might say it is discourteous, disrespectful, foul even. But if nurses, and doctors, who experience death day in and day out would wallow in grief and sadness, I bet there’ll be no more medical staff in hospitals anymore.

We try to do the best in life, for life is always mean, cruel, and unfair. And for that reason we cope. We cope and we hope. We hope that the things to come will be better. The load will be easier. The days will be brighter.

I do not seek approval for the way I lead my life. I am proud to live life the way I intended it to be lived. For always in the end, the only person answerable for my life, my behavior, my decisions, my choices, is no one but myself.
Paz died in peace a week ago.
Her grandson who used to have my cell phone number informed me that she has succumbed to the overwhelming infection as her organs gradually fail one by one.

It looks like I’m heading for the arcade in a little while.

Wanna play?

*

Related Posts:
Littlest Things. A triumvirate of strange medical stories.
Dust In The Wind. Another triumvirate of hazing-related medical stories.
Tell Me Where It Hurts. A tragic medical story of a patient's broken childhood.

Listening to Vertical Horizon's Best I Ever Had. Images from flickr.com.

71 comments:

MISTERHUBS said...

Nursing is really a noble profession. Hats off to all nurses, especially you, my favorite nurse. :-)

One of these days, arcade tayo.

Q The Conqueror said...

Sigh. My dad had a worse problem. One of his cousins was in a coma, they decided to cut it na... unfortunately, the mom couldn't do it, she was busy grieving. The brothers and sisters weren't there. Wife... Grieving too. So, since my dad was the doctor, they made him pull the plug. >_< Sigh.

rOckY said...

Dancing games are fun - you're expected to make a fool of yourself in the beginning, and it's best done with friends. =D

I had to learn to deal with death early on. After the hullaballo over my gran's death and how it turned out our side of the family was the only who knew of her specific wishes around her death like the desire to be cremated and how she didn't want them to remove her organs so she'd be buried whole, our family cell (so to speak) all discussed our wishes and it clear this had to be adhered to.

When my dad had a stroke last April I was finally faced with enforcing those wishes. Since he and my mother were estranged and my sister was out of the country, it was left to me to decide on things. After it was confirmed brain activity had ceased, I went over the long and sordid checklist that is the DNR form with a representative of the hospital.

While I feel good that I was able to execute his wishes, I have to admit it was painful and difficult and I don't know if I could consistently do that again in the future.

I may have to - all of us agreed back then that we did not want to be artificially resusitated. Times like those, it pays to have a cold, logical son in the family. It just sucks to be that son.

bob said...

If any member of my family will be put in such a situation, I'd like to think I'd do everything I could to hold on to even a flicker of hope, or even the smallest chance that he'she will be ok. Miracles do happen, you just never know when or how or to whom it will happen.

But if I will be the dying patient, I won't want to prolong their burden (emotionally and financially) baka ako pa mismo magtanggal ng tubes. hehe.

Keitaro Hanazawa said...

Hi Ruff, I know it's tough being a nurse because you're there to help prolong life. But then again, if the patient is really terminally ill, there's nothing you can do but let them live the life that they want until their last breath. Ika nga, Let live and let God.

Reyville of Simply Manila said...

I find this very gloomy. My sincerest sympathy goes out to Paz's family and friends. I hope they've prepared themselves for the worst earlier.

mrs.j said...

sad... ang hirap siguro na lagi mong nakikita ang tao na mamatay.. kaya nga i never liked anything dat deals with medicne e ang hirap...

o well...hay... i just wish i can accmpny u sa arcade.. haha..

ruff anung ym mo?
i forgt it e...remmber ng nagchat tayo tru kloseta?! tc..

philippe said...

this is why i never ventured to any medical-related course. i hate goodbyes..

~*~princess jackie ~*~ said...

this is something to ponder nurse. How true that if u take a nursing course ull be a better man? No doubts. ure an all-in-one set of example.

aCey said...

hi, dear ruff! it must be tough being an icu nurse and all... i used to get hospitalized a lot as a kid and nurses have been nothing BUT KIND TO ME. it must be hard to witness some form of suffering in the people you take care of. but you seem like a very strong person and i'm happy we're blog buddies. hehe. god bless, dear!

pat said...

have you seen ‘talk to her’? the nurse in that movie is this totally sympathetic perv who impregnated his coma patient which may have caused that patient’s recovery. wala lang, you might like it. and you might pick a lesson about being way too sympathetic of your coma patients.

ruff nurse-du-jour said...

@MISTERHUBS:

Thank you misterhubs. :-) I mean it. I really do.

If all people were as appreciative of nurses like you do, this world, indeed, will definitely end up as a better place.

Misterhubs, you are, and forever will remain, as my most-loved lawyer in the whole wide universe! Just don’t get mad if ever I beat you in the arcade though. Nemo me impune lacessit. =)

Thanks for always putting a smile on my face.

ruff nurse-du-jour said...

@Q THE CONQUEROR:

I admire those physicians who have the courage to admit that moribund patients who have the littlest chance of survival despite all the medical interventions available are better allowed to die in peace, rather than those who keep and feed false hopes to the relatives with the anticipation that their loved ones will miraculously wake up and live.

Equally admirable are those relatives and loved ones who dare to make the difference. In our culture that imbibes strong family ties, sometimes letting go of our dearest dying loved ones could be an extremely unbearable chore that we often choose to hold on with things that need letting go.

ruff nurse-du-jour said...

@ROCKY:

I have never danced in public, moreso in those dancing machines. I, however, enjoy it at the comfort of my own home. I would love to try it though. Perhaps with you and hubs?

As a medical professional, I have always thought that I could get used to the idea of death. After all, we’ll all end up in it. I study and work in a place where death abounds. I enjoy studying cadavers. The morgue has become one of my favorite hang-out places. Never a week passes that I don’t deliver a loved one, a father, a mother, a child, or a beloved (in a shroud) to a basement of freezing temperature, in their final destination of subzero metallic plates and doors, I sometimes have thought that I really could be the Angel of Death.

Thank you for sharing that rocky. Sorry if this post brought much too much melancholic memories of yours. Sorry if my misery has caused you much pain. I know how hard it is for you to relive those memories again. In the most inopportune time when we will be remembering our loved ones in a few weeks or so. =(

When my mom fell in a coma in the ICU for almost a week, my sister (who used to be a nurse too) fought the conventional “she’ll wake up if she wanted to” routine and have opted to sign the DNR papers too. But lo and behold, just when everything looks so grim and bleak, she woke up from coma and was revived with no neurological deficits at all. She later recalled a near-death experience that she used to kwento us everytime we’re in a reunion or something.

Removing life support to our loved ones could be interpreted as callous, uncaring and unsympathetic, especially for us Pinoys who have a persistent, albeit a bizarre, sense of hope and optimism. I, personally, consider people like you as strong, and logical, and really caring. I don’t know if I could do that thing if in case such events do happen in my life. Because I am not that strong.

And though it sucks to be that son, rocky, I knew that that incident made you a truly better person.

Thanks rocky. I missed you. =)

ruff nurse-du-jour said...

@BOB:

They say that when people fall in to a coma, no amount of medication, treatment or medical intervention could bring that person back to consciousness without that person’s volition or will or desire. Sometimes, they’re so enthralled and attracted by the *light at the end of the tunnel they wouldn’t want to go back to the dark anymore. I admire those people who have decided to go back to the latter. For they have forgone the happiness, the eternal joy and peace, just to be back to this earth full of misery and sadness and pain.

Miracles do happen. Only if we let them take place in our lives.

I would not want to be resuscitated too. Pero knowing how my family would react to that bold choice of mine, I think they’ll even think of me as mentally incapacitated for even making that decision. =) Bad, bold, me.

ruff nurse-du-jour said...

@KEITARO HANAZAWA:

Hi kei! I guess you already knew what kiks meant when he told you how lengthy my comments could be. Hahaha. Miss ko na tuloy kayo. =)

I agree kei. Medical ethics taught me that in cases of terminally ill patients, the aim of medical treatment shifts from cure to comfort, even if in providing so, the death of a person could inevitably ensue. For instance, did you know that giving pain-killers are morally justifiable even if giving so could depress the patient’s respirations. And pulling out of (those unnecessary, burdensome) ventilator tubes could be morally correct in such scenarios. I have always believed in the concept of dying with dignity. But I don’t necessarily practice what I preach either. =(

ruff nurse-du-jour said...

@REYVILLE of SIMPLY MANILA:

I know, Reyville. I too have noticed that my recent posts are getting gloomier and gloomier by the minute. I really should snap out of this depression. Seriously.

I’ve known their family for quite some time now and based on my knowledge/observations, they’re not at all prepared for this demise. They really love their mom so much that they have been infected with pointless optimism for the longest time. They have considered eye-blinks and knee-jerks as significant even though they’re just mere useless primordial reflexes. I’m blaming some doctors who keep on telling them to “keep hoping for the best” rather than “to prepare for the worst.”

After all, death is a thing most of us don’t really prepare for, at all.

At least not for me. =(

ruff nurse-du-jour said...

@MRS. J:

Deaths are memorable events for me. I don’t know. In fact, after my four years of nursing practice, I could still recall the names and the clinical history of all the patients who died under my care. From the first one to the most recent. I still could recall their faces. I could recall their dying look. I could recall their diseases and the cause of their deaths. I find it very nihilistic and spiritual at the same time.

Pero as a nurse, life, indeed, goes on. =)

Even in the arcades. When we want to continue, we just have to Insert (More) Coin.

ruff nurse-du-jour said...

@PHILIPPE:

Even as a medical professional, the concept of death never really enthused me. It, however, made me appreciate life better. Made me thankful for every single moment of my life. Every second, every minute, every hour, every day --- they’re all blessings from Him that we should never, as in ever, take for granted.

After all, life is wonderful. And even if nursing means that I have to learn these lessons the hard way, so be it. =) Give me more.

JOSH said...

Nurse rufruf, i hope u'r feeling positive and well now. I must say, those who made their comments in ur posts are a mixture of the best bloggers i have known so far, wow!

Now to post mortem or something, Happy "all holows eve". really, em just waiting for another one of ur ghotst post come all saints/souls day. U're a brave nurse ruff, i guess all those in d medical field have gone these process of patient deaths- "eternal rest grant unto them o lord".

When i was taking up Ethics in my philosophy class in U.P. Diliman and dealt on the topic of euthanasia, we were taught na sometimes the practical side of things is the most moral thing to do!

i have had a share of deaths in our family, 2 grandmas and a 6 month old niece, somehow the most aggravating feeling is at the moment of death.... then comes the wake when somehow one feels a little calm while d loved one still in d casket, and then the very deep stricken atmosphere of last farewell during the burial!

Me, i really wanted to be cremated when i die, dapat pag-laanan ko ng ng budget (approx P60T up)so dat di mahirapan those who are left behind (practicality nga).

So are u free this weekend for pizza? :)

goddess said...

sad.

it's hard to decide when to let go noh?! di mo alam kung dapat nabang taggalin o maghihintay pa.

i don't wanna be put in this situation.

KC said...

This is a nice post. Mapapahaba ang comment ko. =)

Sa pamilya namin, uso ang patay agad. No one had to suffer in making the decision of "do we have to end his suffering?" and who pulls the plug issues. I think it'll be really difficult kapag may na coma.

My mom and dad told us that they don't want to be resuscitated anymore because they still want to preserve their integrity.

As a nurse naman, nung first time kong namatayan, di ako nakatulog. But I learned to deal with a patient's death. After all, it's part of what we deal with: LIFE. Kanya-kanya lang ng coping mechanisms...

It helps the relatives when you present yourself as someone they can hold onto. Emotionally. It somewhat helps take the load off their backs.

ruff nurse-du-jour said...

@PRINCESS JACKIE:

Nursing school taught me some of the hardest, most painful things in life. Without the benefit of anesthesia. I find it brutal, heartless even. But I know these things are the ones I really have to learn.

Better man? Hmmm, not really. Though I’m trying really hard to be one, I know that I still have a long, long way to go.

Thanks atejackie! =)

@ACEY:

Hi Acey! Sakitin ka palang bata. =) You should start taking care of your health now. =) Hehehe.

In cases like these, I keep on thinking of the 4 Noble Truths, that, 1) Suffering exists, 2) Suffering arises from attachment to desires, 3) Suffering ceases when attachment to desire ceases, and 4) Freedom from suffering is attainable. In my opinion, if I keep on holding on to such memories, the more attached I become, and it’s bad. And apparently, I really have problems letting go.

I’m not really that strong. I’m just coping. =)

ruff nurse-du-jour said...

@PAT:

I really have to see that movie then! I don’t really get too close to my patient’s family that much, but the emotional part of me seems to get too attached readily. I guess I’m *that sickly compassionate. Empathy, they say, is healthy. To put oneself into other person’s shoes. But as a part of the medical staff, I think it’s uhm, conventional to consider the patients' suffering and pain as our own, and consequently care for them, even more than we care for ourselves.

The medical/nursing profession is one, hell-of-a tricky thing.

ruff nurse-du-jour said...

@JOSH:

I know, Josh!! =) And that includes you! All of the comments have been really insightful I’m starting to feel a little better now. And besides, I wouldn’t even know what to do if not the wonderful insights (they and) you have imparted in this dilemma of mine. For that I’m really thankful. =)

We were taught that euthanasia, in any perspective, is morally evil. Allowing to die peacefully however, is not only morally uplifting, but is the morally imperative thing to do in cases when the patient is terminally ill and the life-saving measures have become useless, burdensome and are just prolonging the patient’s agony. Plugging off life support, therefore, is just moral and practical but patient’s families would think otherwise.

I’m not really comfortable with the concept of death, theoretical or otherwise. I don’t know how to console dying families. I tend to be a bit robotic in their presence. I don’t show too much emotion in public. I rarely cry in the presence of my co-staff. But in my lonely private nights, and in the arcade slots, then I start ruminating on those ideas. And I wouldn’t know what to do in case I encounter one with a close relative involve in it.

As for my case, I want a happy wake. I don’t want to see my loved ones crying. For me, death is a celebration --- the end of suffering and a beginning of a new life, with happiness and joy written all over it.

ruff nurse-du-jour said...

@GODDESS:

Me too. I just hate it when relatives ask you the same thing. Of course you would want to give them hope and optimism, and words like “some people do emerge out of the coma eventually” could be comforting but it could be wrongly reassuring too. And sometimes telling them to “expect the worst” could be honest, but it could be interpreted as really insensitive and uncaring. It really is a double edged sword. Human life, or death for that matter, could really be a bit too complicated.

ruff nurse-du-jour said...

@KC:

We share the same sentiments KC. Deaths in my family are sudden and unexpected. They mostly have fatal strokes and heart attacks. The grieving part, though brief and quick, is the least intolerable. After all, with strong genes like that, we’ll all eventually have heart attacks sooner or later. It’s a thing we’re just really un-proud of.

My parents are not really that accommodating of that idea. Mas gusto nila yung ma-coma ng matagal and be hooked to extraordinary life support measures than to prepare for a DNR status. I’m really sure they’ll go berserk when they knew my stance, though I’m really planning to live a long life pero diba, death comes in the most unexpected ways and I just want to be prepared medically in case I’m faced with it, right?

My first death was due to liver cancer, then from a fatal MI, then end-stage renal disease and lastly from internal hemorrhage due to purpura. They all happened when I was still a student. I almost lost track when I got assigned in the ICU. The deaths were plentier and the cases were a tad more complicated. But just like back when I’m still a student, the same kind of depressing feeling in me was still stirred.

Denial, done. Anger, done. Bargaining, done. Depression, almost done.

I’m getting into the Acceptance phase right now. Kubler-Ross must be really proud of me.

Thanks KC. =) This too shall pass.

mrs.j said...

i tagged you! visit my blog btw... ym mo? mines jheydelacruz

rOckY said...

I'd be glad to take you "dancing" although I doubt it would be Misterhubs' cup of tea, haha.

As for the other bit, it's no problem. Towards the end we were somewhat estranged - hadn't talked in years - and despite that it seemed ironic that I would be the one left to care for his affairs. I've had a lot of time to think about all this so it's no major issue.

I've long come to accept the fact that I'll always be the practical one, very left-brain-dominated if you're into that sort of thing. It truly is a strength and a weakness at the same time. I wonder at times how I even manage to remain to be a writer despite such dominating logic.

Missed me? I never left. Just haven't been commenting.

_davenport_ said...

i loved your blog.. it is basically experience.. thank you!

bananas said...

nakakalungkot. ang dami-daming nakakalungkot na bagay ngayon...siguro dahil malapit na matapos ang taon

yoshke said...

ruff! finally makaka-comment na ulit ako, hihi.

anyway, pareho tayo. Arcade din ang diretso ko pag nase-stress ako. At simpleng stress lang yun ah.

Kaya ayoko mag-nurse or doctor eh, bukod sa hematophobe ako, e mabilis ako maapektuhan ng mga ganyan. Kahit anong intellectualization ang gawin ko, feeling ko, iiiyak ko pa rin.

JOSH said...

nurse ruffy, do u have an email where i can send my cel no? tnx,or better ask Mrs. J for it! :)

ruff nurse-du-jour said...

@MRS. J:

Thanks for the tag mrs j. Will do the meme as soon as I’ve got some free time. I’ve added you na nga pala sa YM ko. Just waiting for your approval. =)

ruff nurse-du-jour said...

@ROCKY:

Dancing in public would be a very first one for me. I was forced into one before and right at the very moment, I just flee right there and then. I really am shy rocky. Trust me on this. Hahaha.

Whoa! That was the first laugh of the day! =)

I think it’s because your dad really knew that he’ll be in safer hands with your care. Maybe he wanted someone stronger, and he found that person in you. Someone who will not let his emotions affect his decisions. Someone who will make the hardest, most unbearable decisions, no matter how unforgiving or vindictive that might appear.

As for my case, I have always considered myself to be a person of contradiction. I could be logical and irrational at the same time. I am cerebral inasmuch as I’m extremely emotional. I’m ambivalent and at times firm. Loving and hating the same person at the same time. When my doctor diagnosed me as a potential case of bipolar disorder a few years back, thence I knew that somebody must’ve really known me. =)

Yeah rOckY, I missed you. You have become one of my closest bloggers ever since I resume blogging a few months ago. It’s nice to see old friend’s comments again..

ruff nurse-du-jour said...

@DAVENPORT:

Thanks davenport. Hospitals could be really ruthless you know. Good thing I have this blog, and some good friends, to ventilate these depressing feelings to. =)

@BANANAS:

Oo nga eh, we could only hope that the year to come will be a good one. =)

PS. Kasi naman ang mga elderly nating kababayan, mahilig kumain ng marami at mag-loving-loving pag –ber months eh, hayun tuloy, nai-stroke at naghe-heart-attack. Joke. Konting ingat po sa pagkain at lifestyle everyone. =)

ruff nurse-du-jour said...

@YOSHKE:

How’s our future ambassador to the UN Yoshke Dimen? =)

Arcade games are pure stress relief. Very cathartic ang maglaro. Especially when you have pent-up depression or rage inside. You’ll walk right out of that noisy shop extremely refreshed and invigorated. Kaya siguro lagi akong nananalo sa Marvel vs Capcom. Nase-sense nila Wolverine at Ryu yung inner angst ko. Hehehe.

I know that dealing with patients is a part of my job description. I just don’t know when that relationship is supposed to end.

So very Isobel “Izzy” Stevens-ish. But I’m not gullible enough to cut whatever does not need cutting. :-) I assure you that.

ruff nurse-du-jour said...

@JOSH:

I'll post my contact details in your comment box. Wag mong i-publish ha! =) Okay, my number is 0916-406-xxxx. Gets?

(Scratch the screen to reveal the remaining numbers).

JOSH said...

nyehehehe... :)

KC said...

It's true that death is a normal part of one's life. But I think dapat talaga we should accept the existence of death so it wouldn't rip us apart really bad.

Actually, yung first time kong namatayan, fourth year na ako at taga-AMBU bag lang ako for my classmate na talagang may handle sa kanya. Wala siyang relative kasi napulot lang si Patient from the street. He has long standing leptospirosis and he had ESRD na rin due to lepto. Na-bother ako kasi wala siyang family nung namatay siya...as in John Doe ang status niya. Never akong namatayan sa shift ko. Laging sa ibang shift namamatay...at kung may post-mortem care ako, dun sa hindi ko handled. But the emotional effects are pretty much the same.

I too know that this will pass. Good luck with the acceptance phase. =)

coach said...

nakakalungkot naman ang kwento. lalo tuloy ako humanga sa mga nurses and doctors.

Kiks said...

sana me tv series on nurses. we have grey's anatomy for the interns, house for the doctors, meron ba tungkol sa mga nars?

sana meron.

Phoenix said...

What an insightful post. If I remember Bioethics correctly, it is legally permissible to "allow a person to die" by not keeping them by extraordinary means. Sometimes the medical bills keep piling up and this hurts the family financially. Sometimes they have to decide when to let go.

We must always remember that there are a lot of things that are beyond our control- we can't give life to the dead, and we surely can't tell when one's number is up. As health professionals, our role is simply to do our best to facilitate recovery, administer care, and perhaps empathize. But you shouldn't get too involved with patients, because it will consume you.

The best thing to do is to surrender it to God.. He has all the answers and we may never even know this in our lifetime. Know the limits of what you can do for the patient..

Nyak, ang haba na ng comment. Basta cheer up = ) We all get a little down sometimes. Perhaps you just need to hang out with a crazier bunch of friends ; )

Smile!

McRey said...

Grabe!

Nakakaiyak...

One reason why i hate "tuesday's with morris and five people you meet in heaven" is that, the whole story makes me wanna burst to tears...

Euthanasia is niether a good idea nor a bad one. But why do we have to kill someone's hope of reviving their love ones if those medical apparatus is the only way for them to save themselves from breaking into million pieces?

No one can ever hear the sound of one heart breaking...for it is the person feeling the solace can explain it.

"Would you remove your dying mother’s ventilator if in case she gets comatose?" - I always say yes during debate for i believe that it will end her sufferings. However, I just can't if that will happen to me...i know it. You see, i love my mother very much and if seeing her in that kind of situation is hard, seeing her slowly dying out of oxygen is far harder.

Hay, natatandaan ko pa yung lolo ko na nacomatose.

He could have been saved if only he hadn't heard the doctor offered his siblings this so-called "mercy killing".

Narinig niya na papatayin na siya, kaya even before God could take his life, he lost all his hope and gave up...

Condolence for Paz.

I suggest you play the DRUMS at timezone.

dean said...

how stressfull... pero kakaintriga life mo as a nurse... how come walang rufffles' anatomy or nurse ruff?

ruff nurse-du-jour said...

@JOSH:

Gotcha! Thanks for the SMS. =)

@KC:

I honor death, no matter how unpredictable, random, or arbitrary that might come. But it seems that the feelings and emotions kept do not die with it at all. I could let go of the person, but the memories, I doubt it. That’s when the real problem begins.

Staying with the patients almost 1/3rd of your day almost always makes you emotionally attached to them in one way or the other. Nurses are endowed with emotions too. We could also feel. Whoever thought that a nurse does not care is seriously debauched. Even if the person is a John Doe, just like in your case, a death is always an emotional experience. And after that experience, you’re never the same.

But I’m getting more optimistic KC. I have tonloads of things to divert my attention to. So no more mortal thoughts for me. =) Clap. Clap.

ruff nurse-du-jour said...

@COACH:

Thanks coach. Hospital life is ideally a very rewarding experience, but it could also be really brutal at times. Sometimes I just hold on to the happy days, so I won’t get affected by the blues anymore. =)

@KIKS:

Hi kiks! Miss na kita. And your voice. And your overwhelming presence. And your stories. Haaay. I could just hold on to your green tea (to which we really love and enjoy so much). Thanks for everything.

I used to enjoy Scrubs before. That show portrayed a nurse’s real life to a little extent. But then again, doctors pa rin ang bida. And it’s a comedy so it doesn’t really count.

Peter Petrelli is a nurse, right? And so is Belize in Angels of America? Sana nga merong shows for nurses. =) And I’ll get to play the role of the kinky one. Haha. Kidding.

ruff nurse-du-jour said...

@PHOENIX:

Hi phoenix. Thanks for the equally insightful comments. I really appreciate everything you’ve said, or written. =)

Oooh, you surely know your Bioethical principles phoenix ha. =) The weird thing about the concept of peaceful death lies in the confusing transition where ordinary measures end and extraordinary means begins. For us Pinoys, we are extremely willing to endure everything, and by everything I mean, uhm, everything, for the benefit of our loved ones. No matter how burdensome, futile or useless the extraordinary means could be, we still make use of them for our sick loved ones, with that *hope and unbearable *optimism that they might soon recover, or they’ll be back to life again.

On that second part, siguro, that was my huge drawback as a nurse. I could get attach too quickly. I gave out my (personal) number out of compassion when I know that it is ethically immoral to do so. I cry with them. I show emotions readily, especially when the patients’ families are congenial of me. I let myself get overwhelmed at times.

But now I know better. I’ll start my November with a renewed viewpoint and a more logical perspective. And of course, a trip to the chapel, wouldn’t hurt… at all.

Thanks for the tip phoenix! Worry not, though. I have a wacky bunch of friends. And they’re very crazy too. Heheh. And oh, you’re a medical professional too, thad?

For all of my personal pains, this is me, lifting up everything to Him. =)

Now, how refreshing was that!!! =)

ruff nurse-du-jour said...

@McREY:

We share the same sentiments mcrey. Nakakaiyak nga talaga ang feeling ng namatayan… =( especially when you’ve gotten to know the person and they’ve gotten to know you well too.

As for Mitch Albom’s works, I revert back to Shonda Rimes’ Grey’s Anatomy. There were quite some scenes when I don’t know what is real from what is fiction anymore. It’s like we’re in a charade, and we’re just the mere players.

Euthanasia and a peaceful death are two very different things, but the concept is almost the same, to save the person from experiencing the agony of dying. It, indeed, could be a double-edged sword. Do prolonging life-saving measures outweigh the benefits of a having peaceful death? Does letting go means you are caring less or you are caring more? Dying could also be a very rewarding experience. In fact, it is a very rewarding one. It reunites us to the Creator, and brings us back to His presence.

Na-trauma naman si lolo. “The spirit indeed is willing, but the flesh is weak.”

My condolences for her family too. And sure, I will very much try that one. =)

ruff nurse-du-jour said...

@DEAN:

Stressful is probably the understatement of the year. Kaya siguro wala akong personal life (and by personal life, I mean lovelife, hehehe) ay dahil sa work na ito? Don’t you think? Hehehe. =)

Fulltime commitment to the nursing profession is a gratifying, meaningful and rewarding experience. Sabi nga ng idol Meredith Grey ko:

“I can't think of a single reason why I should be a (nurse), but I can think of a thousand reasons why I should quit. They make it hard on purpose. There are lives in our hands. There comes a moment when it's more than just a game, and you either take that step forward or turn around and walk away. I could quit but here's the thing,

I love the playing field.”


I really do. =)

Phoenix said...

Hi Ruff,

Totoo, prayers help a lot! I'm sure God feels for you = ) perhaps that's why he gave you a great bunch of friends..

Ako? estudyante pa lang hehe. You must really have great bedside manners, ang swerte ng mga patients mo sa'yo.

Go ruff! Carry on, I'm sure God has already lined up your rewards up there

akosikai said...

it's part of the package i guess, of bein' a nurse.. =)

kalansaycollector said...

grabe. ang hirap sigurong magcope kapag namatayan ng patient ang isang nurse. wala akong masabi, masasabi ko lang na ang tapang ng mga nurses. kudos.

***

ako may mga nakita na rin akong namatay live via satellite no commercial break...

yung tita ko...
yung nasagasaan ng truck sa dapitan...
yung mamang pumasok ang motorcycle sa ilalim ng bus. ayun pisak.
....

ang lagim.

Kiks said...

Thanks Ruff.

And yes, you should play the kinky one.

You seem like it. Hehe.

kingdaddyrich said...

mahirap talagang mapagdesisyunan yung mga ganyang klaseng sitwasyon. lalo sa lipunang pinoy na malapit sa pamilya.

kahalintulad ng sitwasyon ngayon ng ina ni erap na nakaratay na sa karamdaman at ang tanging tumutulong na lang sa kanyang paghinga ay mga makina. at nang mapag-usapan kung tatanggalin ba ang makinang sumusuporta sa buhay ng ina agad na tumutol si erap.

katulad ng ibang pinoy, mahirap para sa atin na mawalay sa mahal sa buhay. at sa isang banda, hindi naman natin inaasahan na hahantong sa pangyayaring makina na lang ang bubuhay sa mga ito dahil noong una pa lamang ay sinisikap nating maisalba ang buhay ng ating minamahal.

may disadvantage rin ang teknolohiya.

pero para hindi tayo malungkot, nurse ruff, sasamahan kita mag dance revolution. ha ha ha.. o kaya maglaban tayo sa marvel superheroes at tuturuan pa kita ng ibang laro!!

kahit karaoke game ako jan...

;)

stay happy nurse ruff *mwah*

ps

hinahanap ko ang ym id mo.. he he he.. sana makita ko para makausap kita kahit minsa. :)

Bryan Anthony the First said...

mabuhay ang mga nurses...

best bud ko is medtech/nurse...he sometimes share similar stories


woof!

bob said...

okay naman ang "tuesday\s with morrie and "Five people you meet in heaven| di ba? affected ako sa "five..". heheehe. dunno why.

ruff nurse-du-jour said...

@PHOENIX:

Hi thad! Thanks for following through! =) You have no idea how wacky my friends really are. We're a whole bunch of crazies I'm telling you. I'm really blessed to have them though. Hahaha.

Oh you're still a student but you're already the team trainer. Gawd, you must be really good with your job! =)

As for the bedside manners, I'd like to believe that I, actually, have a good one. Though blunders and boo-boos have become a part of my usual repertoire. Hahaha. As for my patients, I'm equally lucky to have them too.

Thank you so much thadie. Linked you up as well. =)

ruff nurse-du-jour said...

@AKO SI KAI:

I agree. And I'm loving the entire package, too kai. Nursing is the one most important thing I definitely can't live without.


@KALANSAY COLLECTOR:

Na-invite ako minsan sa wake at burial nung isa kong pasyente. Buti na lang duty ako kc I was contemplating on attending the rites. Feel ko, attending it will bring me to a certain closure. But that's just me. Wala rin namang masama diba? Hehehe.

Naku ang tragic naman nyan K. C. Pero meron nga akong nabalitaan na ganyan sa Dapitan. Baka yan yun? =(

Malagim nga iyan! Walang tatalo.

ruff nurse-du-jour said...

@KIKS:

You must be really laughing with the lengthy comments posted here kiks. Remember what we've talked about at Starbucks? Hahaha.

And hmmmm, do I look *that kinky to you? Hahaha. I was thinking I'd play the silent, conservative type but I guess I'd be just fooling myself then.

You'd play my kinky patient then. =)

ruff nurse-du-jour said...

@KING DADDY RICH:

Tama ka dyan king daddy. Naging bahagi na ng kulturang Pilipino ang pagiging malapit sa ating mga pamilya kaya't umaasa pa rin tayo, kahit gaano ka-desperado o kasama ang kalagayan ng ating mga mahal sa buhay, na sila ay bubuti sa tulong ng makabagong teknolohiya.

Isa lang ang punto ko dito: may mga pagkakataon na hindi na natin kayang isalba pa ang kanilang buhay. Minsan mas importante at mas nararapat lamang na hayaan na natin silang mamayapa sa kabilang buhay. Dahil baka sa mga pinag-gagagawa natin dito sa kanila eh mas pinahahaba pa pala natin ang kanilang mga paghihirap.

Sa ngayon naman ay hindi na rin ako masyadong malungkot. "Phase" lang siguro ito at unti unti na rin akong nagmo-move on. May pagka-sentimental at emosyonal kasi ang nurse niyo dito sa blogosphere eh.

Basta ba tuturuan mo akong sumayaw, okay tayo diyan. Mukang suki ka ng mga arcade shops ha! =) Hehehe. DOTA gusto kong matutunan. Hahaha!!!

Ipost mo na lang dito yung yahoo ID mo king daddy at ako ang personal na magdadagdag sa iyo sa aking YM list. =)

Stay happy rin kingdaddy. Mwah Mwah too. :-)

ruff nurse-du-jour said...

@BRYAN ANTHONY I:

Salamat bryan. Sana okay ang kalagayan mo dyan sa Papua New Guinea! :-)

Sabi ko nga kay KC, basta Nurse, Sweet Lover. =) Swerteng swerte ka dyan kay best bud mo.

Don't let go of him/her. Hehehe.


@BOB:

Hehehe. Actually hindi ko pa sila nababasa. Haha!

I've watched Tuesdays with Morrie like almost half a decade ago na sa Holy Week marathons ng Studio 23. And his medical condition, Lou Gehrig's Disease, is a classic example of a neurological disorder. Laging si Morrie yung example pag Lou Gehrigs/ALS yung dini-discuss. Hehehe.

Sige nga try ko basahin. Baka maiyak rin ako. Hehehe. =)

Reyville of Simply Manila said...

Ruff, THANKS for coming back. I wonder where all the bloggers have gone. Were they in vacation? Akala ko wala ng magco-comment sa blog ko forever. HaHaHa.

But anyway, I'm just hoping that one or two of our teams will last up to the finale. Before kasi I stopped watching TARA right after Aubrey Miles and Jac got booted. Sana hindi sila maagang matanggal. HeHe.

THANKS again. U save my day.

With regards to your response above, well, I hope the doctors learned a lesson this time. Giving a person with false hopes is just one stupid way of keeping empathizing, they should have acted more honest and just tell the truth about this patient's status. Ayan, nag-suffer tuloy ng sobra.

And u, still under depression? I hope yung arcade nyo ni Misterhubs helped u ease the pain. ^_^

chase said...

so u got the job papa ruff??

na move talaga ako sa post nito.
hahay...
wala akong masabi.
hahay...

Philippine said...

Kudos! Very informative article, keep up the good work!
This blog will be one of the many that I visit everyday.

Best of luck,
nursereview.org

ruff nurse-du-jour said...

@REYVILLE: Vacation would be my most probable guess. I became an avid The Amazing Race fanatic ever since Reichen and Chip made the debut on the 3rd (is that 3rd?) season. I just love Reichen. He could father my child at any given moment.
~Saving the day? That's my job. :-)
~Thanks reyville! Really appreciate your concern and unprecedented support. Hope we could play sometime too.

ruff nurse-du-jour said...

@CHASE: First of all, I missed you. Where on earth have you been! Alam mo naman na "distance makes the heart grow fonder diba?" :-) Yun lang.
~And yup chase, I got the JOB! I'm at loss for words. I'll start my work on Monday scared shitless that god forbids a patient wouldn't die under my watch. It's such a huge a responsibility chase. The last thing I would want is being mediocre at my job and settling for 2nd best. Especially at that crucial place and time. Pray for me chase ha. Or better yet, SMS me. :-)

ruff nurse-du-jour said...

@PHILIPPINE NURSES: Proud to be a Pinoy Nurse :-)

Gian Paolo said...

I hate goodbyes :(

ruff nurse-du-jour said...

@GIAN PAOLO: I'm not good on goodbye's either. :-(

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