The Most Vital of Signs

By guest writer and Homeland Hospice Nurse, Helen Haddick. This article is republished with permission from Helen’s blog From Saving to Sending, Hospice Isn’t Just About Dying. Prior to becoming a Hospice Nurse, Helen’s journey included ten years of being a Med Surg, ICU, and Perianesthesia Nurse.

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As nurses, we are taught to be number lovers. Blood pressure, pulse, weight, height, time of last meal, distance ambulated….you get my drift… It is one of our chosen methods of communication… Listen to a nurse giving report… it’s a complex word soup of stats, values and findings.

For hospice nurses, it’s a tiny bit different, because while numbers are still important, they are not critical as they might be as say, to an ICU nurse. While we still treat the numbers, the patient and how they feel always take priority. My entire purpose is to make you as comfortable possible in any way I can.

But, what if making someone comfortable had nothing to do with a pill or a lab value? What if it couldn’t be fixed by a bandage or a prescription? Often times, the most profound healing unexpectedly changes both nurse and patient and cannot be taught or found in a book.

She was the type of older lady that we all think we will become. A spunky cross between Sophia and practical Dorothy, she lived in small home surrounded by her artwork and with her very loved, but equally as old dog. When I first met her, I thought she would never warm up to me. But, as my visits grew more frequent, her guard came down and I was privileged enough to really get to know all about her. She would say my visits were a gift, but, getting to know her was the real gift.

One afternoon, I entered, as I normally would have and expected to see her in the oversized brown recliner watching whichever judge show happened to be on. She was in the recliner, but, as she turned to greet me, her face was streaked with tears that glittered like prisms in the afternoon sunlight. “Honey,” I exclaimed and rushed to her side, “What’s wrong?” She brought her soft and weathered hands to her face. Hands that told countless stories and faced so many of life’s challenges. “I just found out that the last of my pinochle friends passed away this morning.” As I reached out to embrace her, she told me that they had been a group of 3 couples and now she was the last person left.

They hadn’t played in years, but my sweet little lady sometimes played the game with her son. “Who is going to ever play with me now? “. It wasn’t about the card game. It was about companionship and laughs. It was about friendship and stories. It was about not feeling alone. It was about feeling safe.

She was showing me a sign. It was a very vital sign, but, it had nothing to do with numbers. More important than a blood pressure, this was a glimpse into her internal emotional world. She was scared, alone, afraid, lonely and felt left behind. If these had been quantifiable vital signs would I have not treated them?

I pulled up a chair next to her and spotted a deck of playing cards. As I handed them to her, the emotions on her face changed from sadness to disbelief to sheer joy. “Teach me to play. And go easy, because I am no card shark.”

For the next hour or so, I got schooled on the game of pinochle. Had an ice cube’s chance in Arizona of ever hoping to win a hand. Truthfully, that game is so confusing that she could have been making rules up as we went along and I would have been none the wiser. That was not the point. Just like before, it was never about the cards.

She laughed, she told stories, told me about how she met her husband, how she adopted each of her dogs, how she started painting and how she raised her children. She would start remembering and a far away look would cross her face but, she would come back, just in time to tell me my hand was worthless. As she started to tire, I helped her to her bed and before she drifted off, she held my hand and just said “Thank you.”

How those we care for are doing sometimes has nothing to do with numbers. In this hurried world where we have to fit so many tasks in a day, so much can be overlooked. Stop and really listen to what someone is saying and hear what they aren’t saying. It’s in that silence that you will find the most vital of signs.