2011/02/25

Hair today - gone tomorrow

I am fortunate to have a job & even better a profession that I love. This job allows me to interact with people of all ages & share in very important moments in people's lives. During these moments some funny things can unravel & here is one such story from early in my nursing career.

I had only been an official RN for about 2 months which brought with it a certain naivety in addition to my above average for my age ignorance about the facts of life in general. Anyway, I had been taking care of this poor man in the hospital who had been dying for two weeks. During this time I had gotten to know a couple of his family members. However, I worked nights so I had missed the majority of family members & guests during the day.

Well, this night started much like the others had that week with me going in to assess my patient at the beginning of the shift and finding the same grim results as the shift before me had which was that this patient was quickly approaching his celestial discharge. I was hopeful though that it would not happen this evening & I spoke with his daughter about the TV show she was watching & the events of her day. I straightened up the room & re-positioned my patient like a good nurse but headed out of the room hoping this would not be his last night with us.

An hour or so later I went back in to check on him & his condition had deteriorated greatly. I spoke with his daughter & encouraged her to call any family members who wanted to be near the bedside. In a short period of time his wife, son, daughter-in-law, and a family friend had arrived. I left the room after explaining that it could be quick or over a few hours but death was imminent. I had barely closed the door when the daughter came and got me saying he was not breathing. I went to the room in disbelief & took the patient's blood pressure 4 times & listened for his heart for at least a minute while the family members watched me. I finally told them he had in fact passed away & told them they could go to the waiting room while I got him ready for the funeral home to pick up & then they could come & wait with him.

As a new nurse nearly every experience is a first-time one & this was no different. The family had been expecting this death & were weary from two weeks of a beside watch which was notable as they quietly and stoically walked to the waiting area through the dim halls. I on the other hand was teary thinking about how this was the last thing I had thought about dealing with when I started my schooling as a nurse.

I found my nurse's aide down the hall & we headed back to the room to prepare the body. Now in nursing school we had been taught VERY basic post-mortem care which was in a nutshell - take out all the lines, clean them up, & make them look like they were when they were healthy, so we began our work. I removed every line (catheter, IV) and we changed the patient's gown & linens.

Unfortunately if one is in the hospital for very long they begin to lose muscle tone all over their body & this is especially true when a patient is dying. The body simply isn't profusing so one begins to look sunken in and ashen. This patient was no different but I was determined to have him looking a healthy as possible.

I found his dentures on the sink & began the work of putting them in. As mentioned above muscle tone fades while in the hospital and upon death it is completely gone. This would include the tone around the lips & in the mouth which help hold dentures in. I was not thinking about this at the time though & slid the dentures in to place as best I could but quickly noticed they were protruding like those of a chipmunk but thought they looked better than his mouth looking drawn & actually came to the conclusion they were suppose to look like that.

The patient also had a prosthetic eye which I brilliantly decided would make him look more peaceful & less sickly if it was in place. Due to the fact I had no experience with inserting a glass eye it is no surprise that as soon as I put it in it fell back in to the patient's eye socket with an actual "thunk!" I did not remember at the time that most prosthetic eyes are held in place by the eye muscles & since this patient no longer had any use of his muscles there was no way this one was going to stay in position like it should. Try as I may I could not retrieve it & only managed to wedge it in a way that was bulging at the top of the eye & completely sunken in at the bottom lid.

This was the best the aide & I could do and we hurriedly straightened up the room so it would be neat when the family came back in. Hospital experiences are strange for everyone. Especially when you come in with a patient who will not be leaving with you. Families & friends have a tendency to kind of "move in" as they spend restless days waiting for the end. They generally become temporary friends with the staff & make themselves at home in the rooms & waiting areas. They bring in various items from home, changes of clothes, toiletries, games to occupy themselves, etc....
This family was no different with the cramped space of the hospital room having an array of clutter & personal items.

 As we were gathering linens from the windowseat I found a toupee. Kumbyyah! No one looks better than when they have their hair perfectly coiffed & in place. I rushed to put it on having a hard time deciphering what was the front & what was the back but eventually deciding I had it in place correctly. As I stepped back for one last look my nurse's aide told me, "Uhm, I don't think that is his hair." I dismissed her asking why would anyone take their toupee off in a public place?

The room was now ready and so was our patient. A once over showed a man resting in a reclining position in bed with buck teeth, an eye that looked like it had been punched by a heavy-weight belt winner, & artfully arranged hair. I felt he looked the best he had in awhile & even thought to myself he probably even looked like he did before he was ill (mind you I had never seen him in a healthy state). I went to get the family.

As they entered the room to view their loved one I stepped in behind them and I heard the son speak first saying in a questioning quiet voice, "why is Dad wearing my toupee?" to which the mother/wife replied in a slightly wistful tone "he hasn't had hair in years." I then angled myself over to the body, removed the hair piece & handed it to the son saying, "I'm sorry for your loss." Before making my escape I told the family the funeral home would arrive in less than an hour and walked out of the room completely mortified.

Lessons learned:

1. Good intentions go a long way & leave a positive impression. While that family had every reason to be angry at the state of their loved one from the past experience they had with me they were grateful & could see that a great deal of care that had been taken with their family member and even left a thank-you note.

2. Never assume fake hair is anyone's unless you see it on their head.

1 comment:

  1. I have always loved, loved, loved this story! I'm glad it's recorded for posterity! That family (and all your patients) were lucky to have you.

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I'm blessed with fun days, happy moments, & precious memories...this is where I store some of them.