Saturday, May 05, 2007

I Know I Heard the Wings....

Wild Angels, Wild Angels,

Watching over you and me,

Wild Angels, Wild Angels,

Baby what else could it be?

I swear I hear the sound of beating wings...

*

("Wild Angels", Martina McBride)

*

*

Lew didn't look good when I got to his ranch.

His wife had called me this morning, since I was the on-call nurse, begging me to come out and "check on Lew", who, she told me, had been agitated all night, throwing off his oxygen tubing, acting very confused---in fact, she described him as acting "out of his head".

She told me that he had finally fallen asleep about 4:30 am. But then she called me at 9:00 am because she got frightened when she couldn't wake him up for his morning meds and breakfast. She said he "looked funny" and was "snoring weird."

"And I ain't gonna let you call the ambulance, Bo," she stated, before I could open my mouth. "I promised Lew that I wouldn't send him to the hospital again. You know that he just got out of the hospital recently--- and he swore up and down that he didn't want to go back. Just please come, nurse. Just please come...."

Of course I would come.

I threw on a pair of sweat pants and a t-shirt, grabbed a car-cup of coffee, and took off in the Jeep. I quickly stopped by the office for the little gadget that you stick on someone's finger that reads their oxygen saturation.

And I tore out to the ranch of my patient, speeding and careening my way down the highway just as fast as I could down the highway, and then finally turning off the main road into ranch country, where the roads turn into dangerous thin, dirt-covered, rocky lanes--- and don't even have identification signs to tell you where you are. Ranch country is like that.

On the way, I prayed to The Lord, like I always do when I go out on an "emergency call".

I asked the Lord to help me "do the right thing and make the right decisions."

I asked him to "show me the way---or else show me some kind of 'sign' of what He wanted me to do."

About 10 miles further, I saw a little country church with a sign which read: "What if God is asking YOU for a sign?"

I kept on driving, wondering how to understand that sign.

When I finally arrived at their isolated ranch, which is way off the beaten path, Lew looked terrible. He looked much worse than his wife had described on the phone. And he wasn't "sleeping"---he was actually unconscious. And his breathing sounded ominously like the dreaded "death rattle" which usually heralds death.

He was lying there completely unresponsive. And I began my assessment, relying on my ER days to help me do it quickly and efficiently.

His oxygen tubing was delivering the correct amount of oxygen that he was prescribed. There was yellow urine in his "foley catheter" collection bag. I quickly calculated in my head his urine output amount from the last time his wife stated that she had emptied the bag (and noted hopefully that the amount of his "output" was normal.)

But his skin was cold and pale--and he didn't respond to any of the painful stimuli I tried on him to arouse him from his unconscious state. I quickly took his vital signs and they weren't good ----in fact, to my mortification, he was in shock.

His wife and adult son stood by helplessly as I worked. I tried to get an "oxygen saturation" reading on his finger with my little meter---but the meter wouldn't give me a reading because there simply wasn't enough "perfusion" of blood delivery to his fingers and extremities to give me a reading. I even tried his toes, hoping to get a reading which would tell me the status of the oxygenation of his body----even though I could see with my eyes and ears that even without such a reading, that things were very bad....

This was all bad.....very, very bad.

"He doesn't want to die in the hospital!" his wife declared again. "I promised him I wouldn't let him die there!"

As gently and compassionately as I could, I explained to her that I needed to call the EMS medics. And I also explained to her that I was bound by the law to do everything I could to help him---which in this case meant calling the medics for transport to the hospital. Now, although there does exist in Texas a legal document, which would be signed by a doctor, called an "Out-of-Hospital Do Not Rescusitate", which allows patients to choose to allow themselves to die at home without resuscitation measures, Lew had not generated one--- and so I was bound by the law to call the medics.

And I also explained to her that even though things looked very grim at the moment, that we should still, at this point, hope for the best---and that maybe something could be done in the ER to help him once he arrived there.

And so she allowed me to call the medics---but I had to give them directions to the isolated ranch on the phone. That particular county is serviced by a different EMS system than that which services Podunk's Hospital. And that particular EMS company is less familiar with that part of ranch country. In fact, the medics stated honestly stated that they had no idea where Lew's ranch area was.

Worse still, that particular ambulance system only employs "EMT" medics instead of full-fledged paramedics. I knew that the EMT medics' level of training would not allow them to perform some types of advanced critical care life support functions which paramedics are certified to do. (And it's not that I have anything against EMT level medics, but I was worried that we might get into a serious and complicated Code Blue situation with Lew and might need the advanced skills of paramedics---and Lew's ranch is pretty far away from the hospital, which would mean a fairly long transport time--- and there was the possibility that he might need desperate, life-saving measures performed during that long transport time to the ER.)

Since the medics weren't familiar with the area of Lew's ranch, the 911 operator patched me through to the medics truck radio so that I could give them the best directions I could for the isolated spot we were in--- and "talk them in".

But it still took them awhile to find the place. Several times as we anxiously awaited their arrival, I could periodically hear sirens in the distance---but then the sounds would fade. I knew the medics were getting lost and probably making wrong turns and back-tracking up and down the dirt roads to find the markers I'd instructed them over the radio. It's easy to get lost in that particular area as the roads fork frequently and don't have identification markers.

Whenever I would again exclaim hopefully to Lew's panicking wife the phrase: "I can hear the sirens again--they must be getting closer!" , Lew's wife would respond: "How can you hear the sirens? I can't hear any sirens. All I can hear is all those birds flapping their wings outside..."

It is rather weird how I can hear sirens before anybody else can. But I have finally come to the conclusion that due to all those years in the Emergency Rooms, my ears just got "trained" to hear sirens pretty well. I can usually hear them about 3 minutes before anybody else can. I don't know why I can do that---it just must be an odd idiosyncrosy of mine that I've developed over the years.

Sometimes I even dream that I hear sirens in the distance....

I asked Lew's son to go out into the road to wave the medics in when they finally found the right road, which thankfully happened a few minutes later. The medic truck pulled into the driveway and two big EMT's came barrelling out of the truck, guerney in tow. They barged into the house and headed towards the bedroom.

At the time, I had thrown my shoes off and was lying up in the bed with Lew, trying to hear a blood pressure in his right arm since I had gotten such a crappy, shocky reading on the left one---and I was also trying to measure another pulse rate on him.

And all of a sudden I lost his pulse completely----and then I wasn't able to hear a blood pressure reading at all....NOTHING.

Horrified, I realized that Lew was dying, right in my arms.....

"Lew!" I hollered at him desperately, shaking him by his shoulders in a vain attempt to arouse him.

"DON'T YOU DIE, LEW! DON'T YOU DO IT! HELP IS HERE! JUST HANG ON FOR A LITTLE LONGER, LEW!"

"LEW! LEW!"

The patient's son, a large, "good ole" prideful Texan man, suddenly got a terrible, pinched look on his face and quickly left the room. I knew that he didn't want us to see him lose it and start crying. I knew that he was like all strong Texan men--- and wanted to keep a strengthful countenance for his desparing mother. Lew's wife got on her knees beside her husband's bed, near his head, and started praying to the Lord. She begged the Lord to do His Will---but yet she also begged the Lord to help her husband.

And when she finished her quick prayer she leaned over and began yelling into Lew's ear:

"Lew! Mama's here, sugar! And The Lord's here, too! And Bo and the ambulance men are here to help you---just hang on, hon! Please just hang on!"

As the medics swarmed into the room, we moved out of their way and I handed one of them the patient's medication list which the patient's son had just printed out from his computer. (I had constructed that list for Lew on the computer just last week, in order that he would have a handy copy of the complicated list to take with him to his various doctors' appointments.)

I quickly gave to the medics a complete report of the patient's medical history and current status as they began hooking him up to their equipment and then began loading him onto a guerney. I helped them transfer him from the bed to the guerney because Lew is a big man and it was quite a task to get him out of a low-to-the-floor home bed and onto a thin medic's guerney.

Being loaded up and slung onto a guerney by medics is never a dignified process---and so I made sure that Lew's genitals were covered and that he was handled as gently as possibly.

My heart began breaking further as I watched the medics attempting to find Lew's blood pressure and pulse----and weren't having any luck getting any readings, just as I hadn't been able to a few minutes before......

The medics quickly loaded Lew into their truck. But they again admitted that they didn't know the area very well and asked me if I would lead them back to the main highway---they admitted that they indeed HAD gotten lost on the way to the ranch and didn't want that to happen again on the way to the hospital.

So first I instructed the patient's son to take Lew's wife to the hospital in their own car--and admonished them to drive safely and NOT speed the vehicle. And then I jumped into my Jeep and pulled in front of the paramedics' truck to get ready to lead them.

And now that I had left the inside of the house, I could hear the faint sound of the beating of the bird wings the patient's wife had been talking about---but, curiously, I couldn't see any birds.

I anxiously watched through the ambulance truck window as the medics got Lew's guerney strapped in securely for the trip. And then they gave me the "thumbs up" sign to go on ahead and lead them to the main highway.

I led them out of the ranch country, up and down the crazy, curvy, rocky, dirt country roads. They couldn't drive very fast because of all the curves. But finally we made it to the main highway and I swerved out of their way so that they could now head for the hospital without me in front of them.

At that point, the medic truck's "emergency lights" switched on and came alive with a blazing array of flashing lights and a subsequent cacaphony of sirens which looked and sounded like a burst of glorious red and white-colored fireworks in a synchronized beat to the sirens' wailings. And then the truck suddenly speeded up and took off down that highway so fast that it was like watching a rocket-fueled race-car take off.

And I was worried.....very worried.

I was thinking about how I hadn't been able to feel a pulse or hear a blood pressure on Lew there at the end when he was in my arms at the house......

In fact, I was so worried that I didn't pay attention to my driving and almost drove my car into a guardrail on a bridge. And all during that drive I kept trying to do things to get my mind off my worries during the long trek back to Podunk's hospital (30 miles)---and I concentrated hard on doing those things so that I could stay calm and not become so distracted by my thoughts that I would stop paying attention to the road and kill myself in an accident. I know it sounds strange, but doing those things while driving is what I'm used to---and it helps me drive calmly. So I did all those "usual" things of mine, singing songs and crazily snapping aimless pictures out the window with my camera. I was sort of like in an "autopilot" mode, just like I always am whenever I'm on long drives on the road. But it was still the most miserable ride I've ever had in my road nurse career....

I just did anything I could not in order to NOT think about the worst case scenario..... I wouldn't let myself think it. No, not Lew. Not one of our company's most beloved, favorite patients....

I kept thinking about how wonderful a man Lew is. Despite his serious illnesses, Lew has always been a jovial, cheerful man---always ready with a joke. And I desperately wanted Lew to get well soon so that he could tell us road nurses funny jokes again and do his favorite thing----which is to roll his wheelchair up to the kitchen counter and make "whomp" biscuits.

Lew can make the best whomp biscuits I have ever tasted---and he always gives us road nurses some when we visit him--- big fat whomp biscuits slathered with creamery butter and Smucker's Strawberry or Peach Preserves....

The medic truck beat me to the ER, of course, but finally I reached the ER myself. I hurriedly parked, jumped out the Jeep, and then ran like hell through the hospital's front door, down the halls (startling bystanders), and into the ER waiting room. One of the nurses at the triage desk recognized me and let me through, into the back area where the patients were.

At the ER nurses' station I asked: "Which room is Lew in?"

The nurse replied: "Uh...Bo, he didn't make it."

"Do what?" I exclaimed, almost choking on my words in my bewilderment.

"He didn't make it," she repeated gently.

I stood there in shock.

Silent.

Unable to speak.

The other nurses stopped what they were doing, a sudden look of sympathy coming over their faces as they realized that I didn't know that Lew had actually, truly died.

"You didn't know?" the first nurse asked. "Bo, he was dead in the truck. There was nothing they could do...."

And then, as the truth finally dawned, I broke down and started bawling like a baby, right there in the nurse's station, bawling so hard that I couldn't even talk or figure out what to do. So one of the nurses led me into a nearby room where Lew's wife was---and I found her again down on her knees praying to The Lord. And so I joined her there on the floor, on my knees, and we had ourselves a tearful talk with The Lord, Who we knew was there with us.

When we finished, I asked her if the preacher had been called. Just at that precise moment, the preacher walked in wearing a baseball cap with the words "Jesus" embroideried on it. His wife was with him, followed by the patient's son, who had been the one to go out and lead the preacher to the right room.

I simply cannot tell you how comforting it is when a preacher arrives at a hospital room. To me, there is no greater comforting human presence. Podunk's preachers are the foundation of our lives---and they are always there for us whenever we need them.

* * *

Later, after I left the ER and was walking out in the parking lot to my Jeep--- to go home and cry some more--- it happened again that I thought that I could hear the faint beating sound of bird wings flapping, this time beating right over my Jeep. But again, I didn't see any dang birds. And I wondered why in the heck I had been hearing the sound of flapping bird wings all day long....

And then I got to thinking. Ok, I thought, maybe it WAS birds---but it was weird that I hadn't seen any birds. And then I thought, maybe it wasn't birds. Maybe I'm just going crazy. I just don't know. But I DO know that I DID hear something---something like the beating sound of wings. And they sounded like BIG wings....

Maybe you'll think I'm crazy for even thinking I heard that sound---and also for what I'm about to say next....

But....just maybe....just maybe... it was the sound of the Wild Angels' wings....

I came home and cried a lot more. In fact, I'm still crying, every time I think about it. But as I sit here in my home crying for Lew, one comforting thought just occurred to me....

His wife had promised him that he wouldn't have to "die in the hospital". And you know what? I don't think that he did!! Because I had felt his blood pressure and pulse STOP while I was still up there on the bed with him, holding him in my arms while his wife was kneeling beside him talking about The Lord.

And so I don't think that he died in that medic truck. I think that he died right there in his home---just like he wanted to.

(Don't you?)

*

29 comments:

Warrior Knitter said...

Yes. I do. He died at home surrounded by the people who loved him.

Cinder said...

Yes, Bo he died at home with his loved ones around.
I've had a somewhat similar situation where a pt I was very close to "visited me" in the office where I was balling my eyes out over her death and I was aware of a hovering,perhaps with wings, and then she was gone.I know it sounds crazy.
I admire you so much Bo for your compassion for your pts and family,they almost seem like your extended family.
Since I've been reading your blog I've become intrigued with the idea of becoming a home health nurse, I'm sure I wouldn't be the "road warrior" you are but it sounds very satifying.

Bohemian Road Nurse... said...

Thank you so much, you guys. Your comments have definitely helped reassure me and helped me get through this awful day. (And Cinder, I don't think you're crazy at all---I believe you that she was there. You would make a GREAT road nurse.)

As I've said before, I wish you guys lived in Podunk...

Lisa said...

Oh Bo, you are truly a remarkably Texan Lady. You are such an inspiration. I believe that Lew died exactly as he wanted, in his own home and in his own bed. His wife and family are very lucky to have you in their lives. I try to tell everyone about DNR's but sometimes it is just too late. Keep up all the good work, and yes, there are Wild Angels.

Bohemian Road Nurse... said...

Thank you, Lisa. Your comments mean a lot to me.

Cyndy said...

Yes Bo, he did. And I can't think of a better place or way to go. I was with my aunt when she "went": she had been in intensive care on life support for 72hrs following a massive heart attack at home. She had been down for about 10 mins in the company of her elderly partner when the paramedics arrived and re-started her heart. She was taken to the hospital and hooked up. After the life support was disconnected, she was "alive" for about 8hrs, but I felt her move on just before it was all removed. Her daughter, a minister and myself had held hands, and had closed the circle with my cousin's hand on her head, mine on her foot, and with the minister in between. We read the 23rd Psalm, and the Lord's prayer together, and that's when she went, to me, anyway. I felt an incredibly warm feeling rise from my toes to the top of my head. Amazing, it was, Bo. I felt, and still feel privileged to have shared this special time.

I wish more people would organise the DNR paperwork, but for most, it's just too confronting, so things tend to end up not quite as people would like.

My condolences to Lew's family, Bo, and I'm sorry for your loss. It's hard not to become involved with some clients, but then again, that's what makes you a good nurse. When you get a hard heart, it's time to take a step back.

Love to you. xoxo

Bohemian Road Nurse... said...

Thank you, Cyndy.

Beth in MN said...

I think most of us are bawling with you, woman! G-d bless all of you ... you, Lew, his family, the preacher, the medics ... and here's hoping those big wild angels were taking him "home" on those wings.

marachne said...

Bo, this may not be what you want to hear right now, but please, think about you and your road nurse crew starting to talk to families like Lew's about the OOH DNR forms you mentioned in your post. They sound kind of like the POLST (http://www.ohsu.edu/polst/ ) although not so complete or at the same level of legality.

I know you don't want to loose any patients, especially beloved ones. But if someone has a chronic, terminal condition, and "doesn't want to go back to the hospital" or "die in that dang hospital" it really is a blessing to let them die at home--not go on a crazy ambulance ride (with wife and son--and you--driving after in a distraught and distracted state) when they've already "left the building."

Like I said, I know it's hard to think of something like that as not "giving up" on your patient, but isn't it really honoring their last wish, and not having to have the situation described by cyndy? Why do people have to die twice?

And yes, I too have heard angel's wings, and experienced knowing in other ways that spirit has left that mortal shell and found its way home.

Bohemian Road Nurse... said...

Thank you, Beth!

And Marachne: You're definitely right about what you said. We do have the OOH DNR form for them to use, if they want, included with our admit pack. And we do approach the subject whenever they are told in the hospital that things are appraoching the "terminal" stage.

But for some reason we end up having a lot of trouble with these end-of-life discussions, and it's usually with the older farm & ranch people. The patient usually tries to avoid the conversation so as not to "upset the spouse".

And I've also noticed that they tend to have a fatalistic view of things, which I think stems from their religious views which is kind of a mindset which states: "We'll just let The Lord decide..."

We've only got one patient with an OOH DNR in place. But we have a lot of patients who meet the criteria to have one, if they so choose. It's just that nobody seems to want to talk about it.

But thank you for your suggestion because this encourages me to discuss it with the other nurses and see if we can explore ways to approach the topic with patients who might not know the facts. Thank you, and God bless---

T-Mom said...

Good Lord, Bo, what a superb writer you are--you've got me crying right along with you. You make the people you write about so vivid; I can just see Lew in my mnd's eye.
And yes--I think he left with the angels before he was loaded into that truck.

marachne said...

Bo, thanks for filling in the picture of the struggle you have with this. It's not just country folks that have the problem, or just nurses out there on the road. It's true in the biggest hospitals--if you're used to saving and preserving life, it's hard to change perspective and approach things from a different view.It's hard, and it's scary to talk about death and dying. After all, we're a death denying culture. The difference is that in hospitals, particularly big hospitals, you have social workers and others to do that sort of thing.

Obviously, my prejudices/background as a hospice nurse is showing but...are there any hospice services out in Podunk? Or when someone is hospitalized, can the SW be approached to start the conversation? I know there's an economic piece--if someone goes on hospice you loose them as a patient, and that affects the bottom line. But maybe there are ways that palliative care can be incorporated into your agency's practice.

there are tools out there to help non-hospice nurses to approach these issues: ELNEC is the big program, but there are simpler and cheaper ways to pick up some of these skills. I've done a little poking around (amazing what one will do if you want to avoid doing what what should be doing), and can make some suggestions if you want off-blog...or maybe I should blog about it myself. If you want more ideas, please let me know.

One way to think of it: by helping people to see with clarity what their situation is, you're not turning your back on them or giving up on them, or denying them hope, but giving them a different kind of hope, and the tools to live to the fullest they can for as long as they can...and keep control over their lives. I know that you probably have a lot of fierce individualists on roster and this is a way of assuring they continue to have control (hmmm, that doesn't jive with the fatalist part, but I think you know what I mean).

Good luck, god(dess) bless and let me know if I can be of any kind of help.

Runs With Scissors said...

This story gives me chills, Bo. You write so vividly.

I concur with you and other readers about the angels being right there with y'all. I have always looked upon it as a great privilege to be with someone as they transition from this world to the next. I don't think that anyone deserves to die a cold, clinical death, nor should anyone die alone. You had the honor of being with Lew and preventing him from experiencing both of those situations. How awesome for Lew, for his family, and for you.

Like Lisa said ... you're remarkable.
~RWS

Bohemian Road Nurse... said...

Thank you so much, T-Mom and Runs With Scissors---your comments mean everything to me in this awful weekend.

And Marachne, thank you again for your understanding of this issue. It's one that I've discussed both home health companies that I've worked with in this rural area--but my discussions were met with indifference from management or the owners.

You hit the nail on the head when you said we're a death-denying culture. And it occurs with both the home health company and the patients.

As for the area here in Podunk, it's difficult here to get anybody to consult with this particular facet of patient care. even though Medicare would cover the cost. Currently, I'm unable to find a social worker to do home health care, not just for this sort of thing, but for other community resources. I have had a hard time getting people on Meals-on-Wheels and other things. It's the same with Occupational Therapy and Speech Therapy. And we've only got one Physical Therapist to cover a 50-mile radius. (And I shudder to think what'll happen if he moves territories or something.)

It never was like that in Austin, Dallas, or Kansas--those types of disciplines were plentiful. Don't know why Podunk doesn't have them.

We've got one established hospice company and one brand new one (as the other established company went out of business.) I've had a very difficult time getting both my current home health company and my last one to learn about what they do (as they have both offered inservices) or keep a close contact with them for patient coordination. And you guessed it right---company owners don't want to lose patients.

Also, for some reason many of the patients are frightened of hospice. It seems to just send them over the edge no matter how the issue is approached. I've seen families stay in denial right down to the minute that the patient was dying---even though it had been obvious for weeks that something needed to be done. So the usual thing that happens is that the family finally agrees to hospice---and the patient dies within a day or two. Which is sad because the family could have benefitted from the hospice service could have helped a lot sooner.

It happens both in home health and also in the assisted living centers, where we have a lot of patients. The assisted living centers are ruthless about not losing patients. And they also keep accepting nursing home patients to fill beds---patients totally not appropriate for that level lof care---and yet the assisted living center doesn't provide the "total care" that nursing homes are for. And thus, the neglect and things we see would curdle your blood...

Lew's wife admitted to me that the doctor had approached her about the hospice issue but she refused it, thinking that "if only she could get him home with her cooking" and all that he would get better. She thought that doing hospice meant that the staff of such a company would "give up" on him and not take care of him, just "letting him die"---and she had an unrealistic hope that he could come home from the hospital and use regular home health care and "get better"---even though it was so obvious that he DID need hospice. I do understand her denial--they had been married forever and were such "buddies". But I think her denial blinded her to the reality of his condition. She, too, is a frail diabetic, and the day we brought him home from the hospital she had neglected herself, hadn't taken her medicine and her blood sugar sank to 47.

My co-worker and I were hoping we'd have a little time to get him settled down and then again approach the hospice idea, as she trusts us pretty much, but we just didn't get the time.

Thank you so much for understanding, because this is a topic isn't usually a welcome discussion in the home health business. I don't know why, because it is a really important one. But as you said---it's that death-denial.

But you've given me a lot of food for thought and a new outlook (and some more determination.)

God bless you---

And thank you so much, everybody, for all of your comments!---I haven't slept well this weekend but your support has helped me as I face this upcoming week. Belinda (who was also close to Lew and his wife) and I plan on going to Lew's memorial service at church on Tuesday. So this morning, when I get to work, I'm going to adjust the visit schedule in order that we can do that.

I just don't know how to thank y'all for all your support---but please know that it has helped me so much.

Bohemian Road Nurse... said...

(I just noticed that my writing and grammar/punctuation was terrible on my last comment---I apologize but it's probably because I just haven't slept very well for 2 days. I'll probably be walking in my sleep at work today...)

RN Someday said...

Yes - I think he did have his last wishes honored and was able to die at home. I am sorry I know it is hard to lose a patient.

Brewgal said...

Great, now I'M crying too!

gypsygrrl said...

Bo,

this was an amazing post... my heart was breaking that you were obligated to call the EMS... but i was happy that Lew got to die where HE wanted to, home in his own bed, with the people he loved around him - on his own terms.

i got here via May & "aboutanurse.come"

i look forward to reading more of your stuff...

gypsygrrl

Medblog Addict said...

I am sitting here in front of my computer bawling my eyes out. You are truly a gift to your patients and their families. And like I've said before, you are one of my heroes. Thank you for sharing a part of your life with us.

And I agree with everyone else. Lew died at home surrounded by his loved ones. Just like he wanted to.

scalpel said...

That was a touching account. Thanks for sharing it.

Taueret said...

I just wanted to say that I think you're right, Lew left the building before the EMS arrived, waiting til you were there to take care of his wife and son. A good death.

poody said...

I do think he died in your arms and that is why she heard the wings of the angels in the room with y'all. When my sweet auntie was dying in her bed she kept saying can you see them and hear them all aren't they beautiful and when we would ask who she saw and heard she said the angels.

poody said...

one more thing though don't y'all have air ambulances out there in the sticks??

Cate K said...

Yes, I do. And I think you and his family now have a new angel watching over y'all.

danielle said...

Bo - I am sitting here crying along with you. It has been an emotional last couple of weeks - with the worst of it this weekend. And I jsut cannot get back on level again.
I truly believe you did hear the Angel wings - and they wanted you to hear them too.
I was on vacation when a very special patient died. And I knew it exactly when it happened -I even mentioned it to my husband. Sure enough - got back to work and found out he was gone - and when they told me when - I knew he had said goodbye to me on his way cause the time and day he died - was the time and day that I 'knew" it.

ERnursey said...

Bo, what better way to die than at home, in your own bed surrounded by people that love you and are holding you and praying for you?

The fact that you are grieving just shows how much you cared. He died as he wished.

I don't find it hard to believe at all that you heard angel's wings.

Cyndy said...

You know, Bo; I don't think we can ever do enough... we just do what we can. In my Nursing Home situation, we act as God's waiting room, and we seem to have a regular turnover of oldies. But I guess it's the nature of the job. I can accept that, but in most cases, I feel that it was not personal or peaceful enough. But hopefully, numb-ness will never take hold. Most people that I know who work in the industry state that they will "go" at home under different circumstances. Who knows?

Thanks again Bo. xoxo

danielle said...

I think that Hospice has a bad rap. So many people think that hospice = death rather than easing the life for both the patient and the family for as long as possible. Even my mom - an RN - didnt want to discuss a DNR for herself when things became bleaker and bleaker. And before that she had always stated that she did not want to be resuscitated if it was obvious that things were not looking good...

But Bo honey - I am right there with you - I will trade you 2 little babies from Sat and now today who never had a chance to draw a breath in this life...with one elderly man who led a full life and left behind so much love that he has so many people grieving for him!

Too much...too many tears this last few weeks...almost becoming unbearable..but we go on- cause if we dont, who will?

Ronda & Ben said...

Oh dear, this post should come with tissue warnings.
I do believe you are right, Lew died at home in his bed with those that oved him (including you!) around him.

We are going through something simular with my FIL, who has stage 4 lung cancer. He, too, wants to die at home and we will do everything we can to give him that wish.
Nurses like you are a special breed... and I have no doubt that you heard Angel wings.