A Time to Mourn, A Time to Dance

I have been awake most of the night; drifting off to sleep briefly only to be awakened by painful foot and leg cramps. Leaping out of bed, I walk the floor and pray, reminding my Heavenly  Father that I am only dust; reminding Him that I am not so strong as that. I lie back down gently, trying not to disturb Chuck or awaken another cramp, only to leap up again a few minutes later to repeat the process. Today I am exhausted.

Wednesdays are my day off now; I work ten hours on the other days.  Or shall I say I’m scheduled to work ten hours; in actuality, I work until we are finished and all my patients are taken care of.  Yesterday was hard. Oncology nursing is not depressing, and I feel very blessed to be able to minister to these patients that I am entrusted with, but some days are much harder than others.

My first patient of the day was so sick; he was finished with his chemotherapy and stem cell collection, and was on the schedule  to be discharged home. When Dr. N finished with him and came out of the room, he told me the patient was throwing up. I ran to the room, but it was over; he had grabbed the nearest thing- the trash can- and his wife had his vomit neatly bagged by the time I arrived. He looked defeated and was clearly not well.

I made some phone calls to the infusion center, and put in orders for him to have a liter of IV fluids and some IV anti-nausea medicine. Knowing that it would take some time to complete his discharge orders and instructions, I asked his wife to take him over to the infusion center and get him settled in, then come back to me for instructions. She was most agreeable; neither of us wanted him to have to wait.

My second patient of the day was seeing a different doctor, so I did his pre-assessment and printed out the paperwork his doctor requires. This patient had a lot of questions and a lot of requests; he is suffering from what we call "chemo brain" so he was asking the same questions again and again. His wife kept gently reminding him of the answers I had already given. Truly I don’t mind answering questions over again and I can only hope that someone will be patient with me someday if I should find my memory so unreliable. I printed out the lab results he had requested, wrote his prescriptions and promised I would be back after the doctor saw him. Meanwhile, my third patient was waiting…….

He is a delightful man from Louisiana, and speaks with a Cajun drawl as thick as gumbo. He had finished his stem cell transplant some time ago, but was having some infection issues. I processed his orders and sent him on his way to the infusion center for his IV antibiotics. In between caring for these people, I fling their chart and orders on my desk to be dealt with later. My fourth and fifth patients were gettling restless. Patient number five was early, so I opted to quickly assess patient number four. What I thought would be a quick assessment turned into forty minutes of listening to him and his wife debate as to what medicines they had and what they needed refills on. Promising them I would write whatever prescriptions they decided they needed, I printed out the paperwork for the other doctor that would be seeing him. Then I was literally running to patient number five, but found that my doctor had already seen her and she was ready for her orders to be done.

She is a new patient, and was scheduled to have the large-bore IV tube inserted just above her collar bone, in order to start her chemo today. She handed me a stack of paperwork and insurance cards that she needed copied for her disability claim. "Front and back please," she told me as I run to the copy machine. There is a reason that I am a nurse and not a secretary; let me just say that a stack of papers can bring me to my knees faster than a vomiting, bleeding or unconscious patient. Not really, but close.

Meanwhile, the doctor is finished with patient number four and he is anxious to get his IV line removed and go home to Missouri. But first he needs somewhere in the neighborhood of 14 prescriptions and a unit of platelets. Now I’m torn; it’s 2:30pm, I haven’t had lunch or a break and I really need to visit the ladies room. I have 2 patients that both need to get finished and out the door to Interventional Radiology before 4pm; one needs her IV line inserted and one needs his removed. She can’t start chemo without hers, and he can’t go home WITH his. Decisions, decisions.

I compromise by sending her to IR now, and asking her to come back to me when she’s finished. (If anyone is keeping count, that makes 2 patients that are coming back for instructions.)  I called  transport to come pick her up, and then I  tackle orders for patient number four. I am beginning to feel like a circus juggler, tossing patients into the air while I take care of the immediate problem, praying that I will be there to catch them as they come back down again.

When the wife of patient number one returned, she told me that he had waited for more than 2 hours to get his IV fluids and anti-nausea medicine.  I felt the tears that had been so close to the surface start to sting my eyes, as I thought about him sitting in the full waiting room, continuing to throw up while he waited for a chair and a nurse. It’s no one’s fault; the infusion center is as overwhelmed as we are in the clinic. That comes from being a world reknown cancer center and seeing the volume of patients that we do. And like us, they are never fully staffed. This job is not for sissies, and not every nurse  who comes to work here survives.

My last patient of the day returned shortly after 5pm, IV line securely sutured  in place. I walked her through the complicated medication list and chemo instructions, answered all her questions and made sure she knew where to report for her treatment. I want to make sure that when they leave me, they have everything they need and all their questions answered. I rounded up the manila folder that she asked for to kee

p her paperwork in, and when she complimented me on my beautiful blouse I had to fight the urge to take it off and hand it to her. Meeting people’s needs is deeply ingrained.

Walking back to my desk, I surveyed the damage: charts and paperwork flung everywhere, half-eaten lunch lying beside my ringing phone. Someone asked once, "How do you know where to start?" I don’t. I just pick a place and dive in.

Buy 6:50pm, everything was done. Every piece of paper was where it should be, every chart neatly returned to the cart, all emails answered and my lunch had finally been eaten. I put my "Out of Office" notification on my email, then shut down my computer and snapped off the light. Everyone else had already gone, and I waved at the housekeeping staff as I left.  I felt like crying, but I didn’t allow myself the luxury; I was driving across campus to pick up Summer so we could commute home together. She does not need my tears.

But this morning I’m alone, and I finally allow them to come.  Tears of frustration and tears of grief. I cannot fix everything; I can only do what I can do. I can only be a willing vessel and allow myself to be poured out in this manner. I can only be about my Father’s business. Please pray that I can finish this race.

And so now, after 2 cups of coffee and a gallon of tears, I know that I will go back tomorrow and do it all again. Each of us has been placed where our Creator has need of us; we are not here by accident or by random design, but by His choosing. Thank you for allowing me to come to this safe place, where tears are ok. Thank you for not judging me and for turning a blind eye to my faults and weaknesses. Thank you for your enduring friendship; we are one day closer to meeting.