All week I had anticipated today, but then I didn’t remember the significance of the day when it arrived. I didn’t remember until my mom mentioned it on our group chat and even then I thought, “Nine months when it feels like nine years or nine minutes.”
My dad used to tell me, “Write about what you know Gina. Write about nursing.”
“I can’t write about nursing, Dad,” I would say. “There are privacy laws. I would always be on edge that I was breaking the law, and I can’t risk the penalty.”
I’m glad that today, while preparing my patient for discharge, I didn’t think about the time of day or the date. Other than a delay in receiving orders to send him home, everything went unusually smoothly the entire time I took care of him. I was cautiously optimistic that he would get out the door without any awkward blunders on my part.
Casual conversation passed between us as I wheeled him to his ride home. There was no occasion to mention anything of my personal life except that they asked if I had children. Ours was a brief, professional encounter that lasted approximately 24 hours with a break between my shifts. Nursing is a strange profession in that we discuss and see the most personal aspects of our patients’ lives while remaining entirely serious and aloof. Even our banter carries an underlying tone of control and authority. It’s not that we want to control or lord authority over our patients, but we want them to know we are confident, and they are safe in our care.
On Tuesday January 16, 2018 my dad sat up on the side of the bed as he came out of a heavy sleep. It was the one time he had a prolonged period of confusion induced by a sleeping medicine. He had not been able to sleep, and this medication had finally let him rest for two hours, but when he woke up he couldn’t place me. He knew I was two people to him. I was his daughter, but I was also his nurse. In his confusion he was trying to place me in one or the other role and not both.
He wanted to stand up, but he needed assistance. I placed myself in front of him bracing my back and planting my feet. I held the walker and prepared to help him raise up off the bed.
“You’re helping me like this,” he stated. His voice was clear and strong.
“Yes, I only help the special ones,” I said thinking of how incredibly special my dad was to me, and how strange and difficult it was to need do this for him. However, it’s a remark nurses sometimes make to lighten the atmosphere when a patient has found himself in the position of a child or an infirm person when he is used to being in full control of himself. We try to offset the gloom of requiring assistance with the idea that we’re only doing it as a favor, not because there is no other choice for the patient but to accept help.
“You’re a nurse!” my dad exclaimed. “You’re a nurse!”
I was alarmed.
“She’s my nurse,” he said to my mom who was sitting at the other end of the bed. “I knew it! Do you know how I knew?”
My heart was plummeting, my upper back and legs felt weak. A great, new weight began to settle on my shoulders. He barely knows me I thought, and now I’m his nurse. This rapid spiral from cancer diagnoses to tests to hospice. And now confusion. Is this how it’s going to be?
“I knew because of the way she said, ‘I only help the special ones.’ That’s what my nurse in the hospital said. ‘I only help the special ones.'” My mom, listening quietly and watching, murmured something in response.
I backed up from him. I felt lost.
Am I his nurse?
I’m his nurse?
Of course I am, but I’m his daughter first.
Does he know me? Is he making fun? His dry humor could catch even us off guard.
I’m not ready for this. This confusion. This not knowing me.
“You see, they always maintain professionalism,” he went on. “The nurses do. They talk like that, calling you special, but they are always in control of their emotions. They can walk out the door and not remember you–not because they don’t care, but because they are professionals.”
I had heard this before. My dad, never a professional by education or degree, understood professionalism and how to use it. He recognized it in others as well, and had respect for a professional’s time and learning.
I wanted to be nowhere but at his side caring for him, and I was grateful for my nursing training, but I was his daughter first, and this speech was suffocating me. Was this the end of lucidity? We didn’t know what to expect when we brought him home, and so far there had been very little confusion.
But the drug had worn off sufficiently, and he saw me sitting there and realized what I was thinking. It usually isn’t handy to be read like a book, but this time it was helpful.
“Come here my girl.”
Embraces followed, tears, full recognition.
Fear, acknowledging the horror of the situation, more tears, gathering of courage.
Four people in a tiny bedroom, in awe of the gravity of our circumstances, quietly encouraging each other, and silently pleading with God Almighty for fortitude to handle well whatever was coming.
None of this was passing through my mind as I pushed my patient right up to his vehicle. Pleasantries had begun and would continue, but I heard him saying as he stood up, “The care has been excellent,” he turned as I began to withdraw the wheelchair slightly. “And it was delivered with confidence.”
He turned to face me as he finished his statement, but only briefly and in that fraction of time I caught his eyes and the form of his mouth. And the smile showing in his face was my dad’s smile…even though the man’s face was still fully his own and was quite unlike my own dad. I didn’t stop moving but continued to back up with the wheelchair and yet, there was nothing on earth in that moment except the smile and reassurance of my dad.
It was like seeing a light flash in the dark between the trees as you’re driving down the road. I know what I saw, but it was gone immediately, and I didn’t fully realize what it was until I’d moved on.
I went back to the nurses’ station to write my discharge note, but tears were coming. I wiped them away and kept trying. I gave up though and fled to the break room where I cried and thought about that day exactly nine months ago. Nine months and 20 minutes after the time of his last breath, an encouraging and appropriate word came from a man who resembled my dad not at all, until he paused to smile and gave me that message.
“..and delivered with confidence.”
So often I am striving to walk in confidence overwhelmed by the responsibilities, the unfulfilled goals, the blunders, the needs of others. And there is no Dad.
And yet, here he was on this day.
At this hour.