nurses (4)

I Made soup

Last week while preparing for a presentation on listening, I leaned back in my chair at the computer wondering what story I could tell about listening deeply. Not just involuntary hearing but truly listening to the meaning of the words. Listening with my heart as well as my ears.

My heart burst open and I started to cry. I heard my mother say "I made soup."

My mother had severe crippling arthritis, scoliosis and heart disease. Her physician was an osteopath and she combined acupuncture, herbs, supplements and homeopathic medicine in her health care. She never went to the hospital .She would simply stay in bed for days at a time.

Cooking was very painful for mother so friends would bring food or take her out to eat most of the time. This was her program for the last 20 years of her life.

I*n her last few months every time Mother called me she would say "honey, I made vegetable soup. It’s so good!"

My response was always , "Great Mom." I actually remember being somewhat bored by these conversations and not really interested in her soup.

I harbored a well of anger with my mother and didn’t work through that before she died. It clouded all our communication.

Last week, 16 years later I got it. "I Made Soup"meant, honey I’m out of bed today; Im feeling strong and I was able to cut vegetables. It’s a glorious day!"

" I Made Soup" was a statement of mother’s courage and independence and her ability to push through her suffering .

Deep Listening is a practice and a philosophy developed by Pauline Oliveros. It is said in this practice that listening deeply requires the temporary suspension of judgment and a willingness to receive new information. It is a process of learning.

Truly listening allows us to not only hear what someone says and, what they think, but allows us the understanding of what it means to them and why it matters. There is perhaps no greater way to show our respect than to truly listen to someone.

Many blessings and please share your listening stories . Your stories mean so much to the community.

Irene smith

www.everflowing.org

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A Balance To It All



 I woke up excited. I had the opportunity to facilitate an in service about Touch Awareness in Caregiving to a group of hospice nurses in my favorite hospice.

When I arrived I was told by the Nursing Director that a resident had died the night before. She had been with him all morning as staff and friends had participated in bathing his body and preparing him for his journey from the house.

All staff, including the nurses attending the in service, were asked to participate in the ceremony of departure. The body would be carried out shortly before the in service was scheduled to end, therefore I was asked if I could end a bit earlier than scheduled.

 The door bell rang; it was time to come to the dining room for the ceremony.

Once there we formed two lines and a bowl of rose petals appeared. We passed the bowl around and all took a handful of petals. Then we were told the deceased wanted us to sing Amazing Grace.

While singing, two well dressed men came down the stairs slowly carrying a gurney with the deceased gentleman draped in a shroud, bringing attention to the serenity in his face. It could have been the streets of New Orleans!

As they passed through the dining hall between the two lines  we sang as we sprinkled rose petals on the body.

There I was looking into the face of the deceased, someone I had never known, who didn’t know me, singing, welling up with tears, sprinkling rose petals and realizing that the sacredness of the moment transcended personal relationships.

This was honoring the cycle of life; the human spirit; human suffering and the profound ordinariness of this extraordinary morning.

As the gurney proceeded out the door and through the garden we began to take our places at the table; some with bag lunches and me looking in the fridge for leftovers.

The lunch was somewhat silent for a few minutes. We were digesting food for the soul. Our eye contact and quiet breaths together told the story of the blessed honor we had shared. Then, as if a bell had rung, the talk about the afternoon schedule began.

I finished my lunch and left to go down the street to see a client in another residential care facility.

As I walked outside I was aware of people walking fast; wearing black, and looking at their palms with plugs stuck in their ears. I had to be careful as everyone was in some kind of  personal isolated state, connecting with life through cyberspace. The outside world suddenly felt  empty.

I paused. Remembering the gentle aroma of rose petals, I expressed silent gratitude for my morning in the hospice.

Blessings,

Irene Smith www.everflowing.org


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Identifying Pain At The Bedside


How do we identify pain? What denominators do we use to quantify pain? Does our need to be free from suffering play a role in this denominator and how do we separate these fine lines?

These are constant questions for me in working with the dying. I have strong belief systems about how I want to die and what I want and don’t want in the process. Do these “don’ts” interfere with my ability to clearly hear my clients and act as a non-judgmental witness?

As an advocate of alternative medicine, I am a believer in expression rather than repression. When I have pain I want to feel it. I want to be in relationship with my pain so I know how to work with it and move with it without contributing to the physical and or emotional stressors that might increase the level of discomfort experienced.

Louise was in the final stages of her life when I was asked to see her 3 times a week. That was in October. She died in February.

Louise had no control over her body. She could raise her right arm and turn her head slightly to the right. Sometimes in a session she kept her head in constant movement. Louise was grateful, always said thank you for coming and always greeted me with a smile. I consider her level of trust a precious treasure and often related that to her which seemed to please her.

She was moved from the skilled nursing facility to the hospice in December. Once in the hospice she became quite agitated and began calling out for help and moaning loudly. Of course, how to relieve Louise’s pain was top priority and her discomfort was partly assessed through the degree of  vocal expression.

Pain medication would quiet the moaning, however sometimes when I went to see her after being told her comfort had been restored I would find her whispering “help” in a voice that could not be heard. The need to call out was still present. The team was relieved. Louise was quietly resting.

There were also times when Louise would call out that she hurt all over and pain medication subsequently  brought her needed relief. Other times she would decline medication and a volunteer holding her hand was the perfect support.

The agitation and vocalizing lasted for about a month. Arnica and Rescue Remedy were introduced as adjuncts to her pain medication to see if that would help the anxiety beyond the pain.

I am reminded of two visits when Louise was yelling out and I told her the nurse would be in to give her  medication. ”I don’t want any medication” she said.

Through many of our sessions Louise called out for help and moaned loudly, declining medication and stating she was not in pain. Maybe the moaning was pleasure. Sometimes I’d ask if the touch felt good and she’d say yes. Maybe the moaning was bliss. Sometimes she called out “oh” the entire session.

Once, in the last couple of weeks, I arrived and the volunteer with her said Louise was moaning loudly but she did not want any medication.

This is a human being that was unable to move her body for many years. The only movement she could produce was through her voice. Should her comfort be assessed by the silencing of her voice or by the ability to use her voice?

When are sounds pain and when are they a coping strategy for releasing pain? How fine the line.


“When I die allow my voice to fill the temple and the movement of my limbs to be as wind through the trees. Do not silence or still this passion that has been so responsible. Allow me to participate in this dance with spirit, loose and wild and free. Allow me my process.”

Irene smith

I would love to hear your feed back on this topic.

Blessings,

Irene Smith

www.everflowing.org
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The Language of Touch

Greetings,

The attached link is to an Everflowing you tube trailer showing a touch exercise during a Touch Awareness in Caregiving day long workshop . The participants are hospice caregivers . The person being touched is a piece of clay. The sculptor[ the person touching] was creating the upper torso ,face and head. The voice is me, Irene Smith, in a dialogue that has been added. What you hear is not the instruction to the participants.

I would love to hear your comments

https://www.youtube.com/watch?v=jc6DKfXXyZE

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CAREGIVERS STORE

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Those who companion suffering daily, such as hospice nurses and volunteers, will surely appreciate this beautiful work. With 62 original art collages by Rashani Réa, five beautiful chapters by Kathy Douglas, and a foreword by Jean Watson, this exquisite book is a peaceful refuge for contemplation, inquiry, reflection and inspiration for those who traverse the joys and sorrows of nursing.

Kathy Douglas, RN, MPH-HA is a nationally recognized nurse leader, filmmaker and entrepreneur. 

Rashani Réa is a prolific artist and musician, a creatrice of sanctuaries and a respected spiritual mentor.

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