Nurse in the Family A Cautionary Tale

A man and woman laying in bed smiling for the camera.

Becoming a nurse is one of the most selfless acts a person can undertake. In a society of so many different races, cultures, customs, and beliefs, nurses are a universal gift to all, and the dedicated work that they do and kindness they deliver on a daily basis should serve as a reminder of the fundamental humanity inside us all.

~Unknown

Aging in Place

This morning I was watching the sunrise over the top of a grove of tall swaying trees, it was quiet, the silence is broken only by the songs of tiny birds as the mist gave way to the penetrating rays of soft light. I was savoring a cup of steaming coffee and my dog Halsey was guarding the periphery for any potential wild intruders. This has become a summer of 2020 ritual for me since out-of-town trips are not on the agenda any longer.

I drive to the edge of town where the pavement ends, and the dirt road begins. If early enough, this can be a solo pursuit before the sweet isolation is disrupted by others. My special place has potholes so deep small cars could get lost in them, it is where unscrupulous folks go to dump old lounge chairs, black glad bags of Sunny Delight bottles, Pringle cans, diapers, and bullet-ridden Big SCREEN TVs. Broken glass and shotgun shells are sprinkled haphazardly along the road and an occasional abandoned mattress rests precariously among thick blackberry vines. Given all this human-generated debauchery the scene is not as bad as it sounds–there is beauty in near-urban nature and it is luxuriant to sit alone, if only briefly.

These days when fortunate enough to carve out moments of peace in the “outdoors”, thoughts inevitably turn to what dominates my life at this stage–caregiving. For the past 8 years looking after the seniors in my life has been my mission, outside of work and trying to maintain all that modern life requires, including a marriage. My best analogy is what most baby boomers will recall, on the Ed Sullivan Show (circa 1960s) a frequent guest was the plate spinner. A man in a dark suit would have thin wooden support poles and a long table which he worked behind. He began by sometimes twirling white dinner plates or clear bowls on the top end of thin twisting poles–and suddenly like magic he would have a long row of plates/bowls all spinning at various speeds. This caused him to have to run franticly from end-to-end of the table keeping the plates/bowls all spinning at once! This made for riveting black/white TV and a fitting analogy of exactly what my caregiving experience has been like…The running from inevitable crisis to crisis putting out fires and then beginning the process all over again with another loved one is much like the Plate Spinner–only the stakes are higher.

Nurse in The Family

Caregiving statistically falls on the females in the family, males have traditionally been out of the caregiver loop–however, that is changing. Ironically in my experience being a male and a nurse, I have been called upon to take up the central role of caregiving. This is something I have done without question and I often volunteer for services with family and friends in need. This is just what nurses do…And it can take a heavy toll.

I want to caution new nurses about their role in the family. As a nurse other family members will call on you to be there at doctor’s appointments, ER visits, falls, feedings, bed changes, medication administrations, grocery shopping, meal preparation, medical billings, calling and making appointments, and the list goes on and on…It is stringing beads without a knot on the other end. You may suddenly find yourself in “mission creep” where you stepped in to help and now because you are “the nurse in the family” the caregiver role will default to you. It makes perfect sense to other family members, after all you speak the privileged code of the medical establishment, you know the questions to ask, who to call, and what to do in emergencies. And this is all true, however, beware of becoming the only one doing the heavy lifting. This happens quickly and almost organically; especially if you are female and live closer to those in need.

Healthy boundaries and duty sharing are the keys to your survival. Set limits on your time availability, delegate if necessary, to other family members and try to play to their strengths. If someone is talented with setting up appointments and organization have them do clerical duties like paying bills. If another has a strong back let them do the physical aspects of caregiving, for example, transportation needs or clearing the house out. And if time is available to yet another family member, ask them do the shopping. Perhaps a member of the family isn’t geographically compatible with caregiving but can cover the cost of a role needed to be performed. Get creative in support, this requires INTER-dependence. You will be tempted to do it all to keep control and get things done, trust me you cannot do it all.

Shared responsibility may mean letting go, often things will fall short of expectations, tempers can flare and feelings will get hurt (and yes there will always be that one who doesn’t help no matter what); this is all part of the process. But do give others the opportunity to step up and appeal to their better angels. C.S. Lewis noted, “Hardships often prepare people for an extraordinary destiny.” Do not deny them this. It is helpful to remember the goal is to keep your loved one in need safe, cared for, and experiencing some level of quality of life. Caregiving is not the path-of-least-resistance, it will call on your deepest reserves–you will be required to answer the call time and time again, do things unimaginable, and most of your victories will go unnoticed and often unappreciated by distant others (the accolades are not coming)–do them anyhow. In the end, you can take solace in knowing you did the best you knew how. I also suggest you get your best friend (dog), a cup of steaming Joe, go sit and watch a sunrise somewhere on the edge of town. You have earned some time for yourself to reflect, re-energize, and remember why you became a nurse…

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I’m Dying to Care For You: Nurses and Codependence / Breaking the Cycles / Jan 1, 1989 by Candace Snow, David Willard (issue is not new)

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