LakefrontRN

You are not weak just because your heart feels so heavy

[ashtronautincyberspace]

Death & Dying & DNR

I do not know who gets the credit for this.  If you do, please message me.

“In cardiac arrest the heart is the first organ to stop working and full cardio-pulmonary resuscitation may work.  If there is a delay in starting effective full CPR the other vital organs swiftly become damaged, particularly the brain.  When full CPR has been successful the body is only restored to the state of health and illness that existed one second before the heart stopped.

In all other deaths other vital organs have stopped working first and the heart is the last vital organ to stop working.  Full CPR cannot reverse the situation and it is futile and damaging to everyone involved.  There is no place for full CPR in ordinary dying.”

[whiskyandwonder]

[new--tomorrows]

Sealion Cave south of Heceta Head, Oregon. 13 October 2023.

[maureen2musings]

jayroyusa

[wayfaringmd]

Cardiac Rehab

This week on nursing home rounds I saved Mr. J for last. I like him just fine–he’s actually pretty entertaining to talk with and is a “good patient” who is trying hard to make the most of his rehab stay. But he likes to talk a lot. So I save him some extra time so we can chat it up. I started our conversation the way I do with a lot of my nursing home folks, whom I see monthly. “So what’s new?” I asked. 

“Oh I got big news,” he said. “I joined the Lord’s family two weeks ago. I’m a church man now.”

This guy was the burliest, nastiest redneck you’d ever meet. I’m talking filthy Duck Dynasty lookin dude. Says what he wants, does what he wants, and doesn’t care who gets in the way. He told me that his whole life he avoided the church whenever possible. He didn’t like dressing up or being told he had to do to be good to get into heaven. When they had church services at the nursing home (they have them like 3 days a week) he would always head to the lobby, which is the farthest room from where the services were held. 

But he went to a service that was just gospel music because ALL of the other residents love it and encouraged him to go. He got hooked and kept going every week. He now is the first guy in the room for every service, sitting on the front row, singing hymns at the top of his voice.

He told me, “they told me being a Christian was simple. You just tell God you’re sorry for what you done and ask forgiveness and open up your heart and he comes in. And I done that. And he forgive me, I know it. But being in the Lord’s family is hard! I know God done changed me though. Because I used to didn’t care what I did or what I said, but the other day I cussed and I felt bad about it for the first time ever. And I asked God to forgive me for it and I believe he did. And now I’m trying to stop cussin.”

His seedling faith is growing already. None of his family members are churchgoers and he has resolved to make them take him to church when he goes home. I overheard him telling another resident today that he would pray for him. This guy would have cussed out someone for saying the same to him just a few weeks ago. 

One thing he told me particularly struck me. He said, “you know, doc, I prayed for one of the other fellers here to get better in the hospital and he got better and came back. And I prayed for my daughter to get a job and she finally did. But I haven’t asked the Lord to get me out of this wheelchair yet. That’s what I really want him to do and I think he can do it. He’s already changed my heart. I don’t think I really deserve for more than that. But I want him to take care of the people I love.”

I told Mr. J that if God was willing to come into his heart and forgive him and change his life, he surely would be willing to listen to his prayers for healing. But Mr. J reminded me in his statement of something I’ve done many times: I see myself as unworthy of grace, unworthy of God’s love. My years of Bible study have taught me that it’s absolutely true; that on my own I am completely unworthy. But God gives me grace and love despite my unworthiness, and I don’t have to be afraid to approach him with my needs. If he was willing to die for my sins, surely he’s willing and able to take care of my little hurts and physical needs. 

Earlier on the same day that I talked to Mr. J, I wrote in my prayer journal, “give me opportunities today to share your truth with my co-workers and my patients”. I had no idea that it would end up being the other way around.

[cranquis]

But God demonstrates his own love for us in this: While we were still sinners, Christ died for us. (Romans 5:8)

Beautiful.

[calumet412]

Summer in the City

1) Oak Street Beach, 1930

2) VJ Day, State Street, August 14, 1945

3) Summer Concert at the Band Shell, Grant Park, 1943

[calumet412]

Looking north on State at Lake, December 1965, Chicago

[cosmonautroger]

Blondie - Heart Of Glass

[sighinastorm]

[lakefrontnurse]

Beware

[favedump]

Mr. Rogers had an intentional manner of speaking to children, which his writers called “Freddish”. There were nine steps for translating into Freddish: 

“State the idea you wish to express as clearly as possible, and in terms preschoolers can understand.” Example: It is dangerous to play in the street. ​​​​​​

“Rephrase in a positive manner,” as in It is good to play where it is safe.

“Rephrase the idea, bearing in mind that preschoolers cannot yet make subtle distinctions and need to be redirected to authorities they trust.” As in, “Ask your parents where it is safe to play.”

“Rephrase your idea to eliminate all elements that could be considered prescriptive, directive, or instructive.” In the example, that’d mean getting rid of “ask”: Your parents will tell you where it is safe to play.

“Rephrase any element that suggests certainty.” That’d be “will”: Your parents can tell you where it is safe to play.

“Rephrase your idea to eliminate any element that may not apply to all children.” Not all children know their parents, so: Your favorite grown-ups can tell you where it is safe to play.

“Add a simple motivational idea that gives preschoolers a reason to follow your advice.” Perhaps: Your favorite grown-ups can tell you where it is safe to play. It is good to listen to them.

“Rephrase your new statement, repeating the first step.” “Good” represents a value judgment, so: Your favorite grown-ups can tell you where it is safe to play. It is important to try to listen to them.

“Rephrase your idea a final time, relating it to some phase of development a preschooler can understand.” Maybe: Your favorite grown-ups can tell you where it is safe to play. It is important to try to listen to them, and listening is an important part of growing.

Mr. Rogers Had a Simple Set of Rules for Talking to Children - The Atlantic

[mswyrr-deactivated20181203]

Rogers brought this level of care and attention not just to granular details and phrasings, but the bigger messages his show would send. Hedda Sharapan, one of the staff members at Fred Rogers’s production company, Family Communications, Inc., recalls Rogers once halted taping of a show when a cast member told the puppet Henrietta Pussycat not to cry; he interrupted shooting to make it clear that his show would never suggest to children that they not cry.

In working on the show, Rogers interacted extensively with academic researchers. Daniel R. Anderson, a psychologist formerly at the University of Massachusetts who worked as an advisor for the show, remembered a speaking trip to Germany at which some members of an academic audience raised questions about Rogers’s direct approach on television. They were concerned that it could lead to false expectations from children of personal support from a televised figure. Anderson was impressed with the depth of Rogers’s reaction, and with the fact that he went back to production carefully screening scripts for any hint of language that could confuse children in that way.

In fact, Freddish and Rogers’s philosophy of child development is actually derived from some of the leading 20th-century scholars of the subject. In the 1950s, Rogers, already well known for a previous children’s TV program, was pursuing a graduate degree at The Pittsburgh Theological Seminary when a teacher there recommended he also study under the child-development expert Margaret McFarland at the University of Pittsburgh. There he was exposed to the theories of legendary faculty, including McFarland, Benjamin Spock, Erik Erikson, and T. Berry Brazelton. Rogers learned the highest standards in this emerging academic field, and he applied them to his program for almost half a century.

This is one of the reasons Rogers was so particular about the writing on his show. “I spent hours talking with Fred and taking notes,” says Greenwald, “then hours talking with Margaret McFarland before I went off and wrote the scripts. Then Fred made them better.” As simple as Mister Rogers’ Neighborhood looked and sounded, every detail in it was the product of a tremendously careful, academically-informed process.

[lakefrontnurse]

One day after making hospice death visit, I walked out in the hallway of my patient’s duplex after pronouncing him, among dozens of crying family members. Outside the door was this little girl. It was a busy week, I was tired & hungry, & the great granddaughter of the patient looked up and asked me what my stethoscope was.

I looked at her for a few seconds & just kneeled down and took it off. I put the tips in her ears & showed her how to listen to her own heartbeat.

That was a while ago. No matter how busy & rough a shift gets for me, I hope I never forget how big that kid’s smile was.

[lakefrontnurse]

At my father’s bedside 2am

My dad doesn’t understand when or why I am here. He exists in a fog that rarely lifts, a boat in a storm that rarely docks at port.

He only knows I am here because he knows I will always know when he needs me, in the same way that someone knows they need air.

Because I know him like I know the hands on a clock. I am his constant, the unmutable force that he can set his breath to. I am here, and he rests easy despite his infirmity, his breath unlabored, his dreams unencumbered by anxiety.

His breathing will ebb and flow like the tide, his soul drifting off to play and run where he worries or wants for nothing. I am his watchman tonight, the moon that hangs low over his shoreline.

[lakefrontnurse]

I think about this night, back in January of 2020, & I had no idea now much things were going to change over the next two years.

[lakefrontnurse]

[lakefrontnurse]

I am a psych nursing professor at Grand Valley State University in Grand Rapids, Michigan. I want you to know that I use the beautiful story you wrote about your uncle every semester as an online discussion assignment with my undergrad students. (https://www.freshrn.com/when-my-alcoholic-uncle-died/).

Your words never fail to impact them. One thing I ask them to do is reflect how what they learned from your story will impact the way they care for people, and their responses often bring me to tears. Thank you so much for sharing this story, and please know that it continues to impact nursing students in a very positive and powerful way.

Thank you,

Dave Vander Ark DNP

That is one of the most beautiful things anyone has ever said to me.

If they ever want to share their stories with they are free to message me. I would be honored to hear them. It’s amazing the impact one life can have on strangers so many miles away.

[lakefrontnurse]

[lakefrontnurse]

Grief Olympics

This memory I could do without. Last November I lasted a month back in the ICU. That’s when I realized I don’t want to work with nurses who worked through the pandemic. Sounds shitty but they got beat down by Covid & I got beat down watching my dad die from Lewy Body. I can’t compete in the tragedy Olympics with pandemic nurses because I cannot relate to them, & they can’t relate to me. I still don’t want to hear the Covid healthcare hero war stories even if it’s my long time friends. I just don’t have the space in my head or heart to care about what you guys in the ERs and ICUs went through because I went through a different kind of pain. It’s odd how nurses have mentioned they would have loved to take off two years during Covid like I did, as if I was on some all expense paid vacation to Europe. Try burning through your savings, while taking care of a dying parent 24/7 & then tell me what is harder; watching strangers die every day or watching your favorite person die every day. I don’t regret it for a minute, but it wasn’t a luxury. I would have worked Covid ICU with no PPE just to have my father back for even a little while longer. Now if I walk into a hospital, I hate everything about it. The smells, the alarms beeping, the miserable faces of the burned out staff. The conditions suck so I know why staff is miserable, but I’m honestly numb to their struggle. I’m glad I left & followed my heart. I love hospice after hours call & maybe it’s because I’m so comfortable with grief & dying at this point but it works for a loner nurse like me. I’m not built for the unit anymore. I had so much fun in the ICU back in the day but now I’m glad I moved on. Maybe grief is the space I exist in now. I don’t really know, but its familiar to me. It’s strangely comforting to navigate sorrow & mourning all the time because lives on the same block of the home I wake up in every day. I think of God a lot, & I think of this poem. I don’t have much in common with Bukowski but I read those lines over & over & I smile & I cry & sleep & I pull myself out of this darkness every day & I figure it out.

There is a light somewhere

It may not be much light

But

It beats the darkness

There is a light somewhere

[truintent444]

[issasideblogbruh]

THIS.

[jabberwockypie]

I reblogged this a few hours ago, but I will reblog it again, because I just feel this SO STRONGLY.

[fantasyamazon-deactivated202605]

[id: screenshots of tiktok captions. the images say, “but the only reason we still love princess diana is because she did not have the time to disappoint us.”]

begging queer kids to read up on princess diana’s involvement with the community. yes, she was a rich, pretty monarch. yes, she died young.

but the reason why queer people love her is because she used her privilege during the aids crisis to advocate for sick queer men, when very few others would - much less someone of her status.

diana spent years advocating for the health and care of queer people with hiv/aids. in 1987, at the height of the epidemic, she opened the first specialist clinic dedicated to treating aids patients (the first clinic of it’s kind in the uk).

she also fought public hysteria by hugging and shaking bare hands with aids patients, at a time when aids was thought to be spread by skin to skin contact. not only that, she visited patients in the clinic regularly and even comforted them through their sickness.

and when queen elizabeth told her to try focusing on “something more pleasant”?

diana ignored her and kept fighting.

and this is only her work towards the aids crisis. she publicly called out the royal family, brought attention to numerous world issues, and was known as an advocate for empathy and kindness. she’s known and loved as the people’s princess for good reason

[sepdet]

Diana also literally walked across a minefield (through a lane cleared by the humanitarian organization HALO Trust, which she was promoting, but there was still some risk). She used the paparazzi who always followed her around to raise awareness of the plight of landmine victims in Angola, met with survivors who still talk about her visit, advocated on their behalf to the UN, and then went to other places suffering the same problem.

Her advocacy was instrumental in helping push forward a treaty to ban the use, production, and export of land mines. She was attacked by British politicians for meddling in government policy, but the Ottawa Treaty was signed by 122 countries including the UK three months after her death. One of the anti-landmine groups in which she'd been involved received the Nobel Peace Prize.

Diana's support was 'turning point' in landmine ban effort

The princess's backing brought the campaign wider attention, says the founder of an anti-landmine group.

I remember the photos of her holding hands with dying AIDS patients, of her sitting by them and listening to them like fellow human beings, at a time when tolerance was radical and most people feared AIDS was transmissible by touch.

I also remember her holding HIV-positive babies, when most people were paranoid about fluids from AIDS patients— and let's face it, babies leak. (There was a brutal subtext to criticism of Diana's AIDS work: was she neglecting, even endangering, the heir(s) to the throne?)

Like Carrie Fisher, Diana wasn't a perfect human being. But she did indeed use her privilege to advocate for and amplify the voices of those with none.