September 6, 2014 - Afternoon Update

In all the time I have spent working in hospice there is one thing that often takes me by surprise. As a hospice nurse you expect through the experience you gain in caring for those at the end of life, that you will be able to manage every patient's symptoms and keep them peaceful and comfortable until the end and that you are fairly good at predicting when that end will be. then comes along a patient that doesn't follow the "rules" of dying. It is not that there are well defined rules, however there are the generally accepted ones. As a hospice nurse you try to figure out why this patient is not following your "rules" for dying......and then it hits you...........

My dad is stubborn, strong, loved life, and wanted to live his way. As a insulin dependent diabetic, we heard him more than once have a snickers candy bar and then just say....I just give myself more insulin. He wasn't one to follow all of the rules, he wanted to do it his way. 

The truth about dying is this.........you die how you live. That is exactly what my dad is doing, he is dying exactly how he lived......stubborn, strong, loving life and doing it his way.

His heart rate is normaly in the 60's. It has been in the 80's most of the week, this morning it was 92 and just now when the hospice nurse came it was 110. This is a significant change. His lungs have wheezing sounds which means that he is beginning to collect fluid in his lungs. 

All of the physical signs are there that his time has arrived, but he is in control now....it is up to him when he is going to leave this world. Tick. Tick. Tick.