My first career in life was as a registered nurse. I graduated in 1978 with a diploma in nursing and obtained my BS in 1980. I was fortunate to have a position that allowed me to learn lots of new procedures that I would teach to others so I had exposure to all types of products, procedures, and knowledge. Though I left nursing after my first child was born to begin a new career, I kept abreast with many of the changes. I even did home health care for a while as a second job. I fully believe that God used those experiences to prepare me for my current role as a family caregiver.
We have had a home health nurse overseeing Lynn’s wound care for several weeks now. I was telling her last week, that we really did not need her anymore because the pressure ulcer is nearly healed. All I had needed her for anyway was a consultation to make sure I had the supplies I needed to care for the wound. I could not get them as a family member but I could if I asked a home health nurse to get an order for them.
It’s been a bit frustrating at times being a nurse but unable to “be” a nurse as a family member. When Lynn was in the hospital I assisted with all his care except managing machines. I was unfamiliar with those so I either left them alone or had someone teach me how to manage those too (not something they would usually do). I would do my own assessments of his body and vital signs and consult with the medical team regarding what they observed. I still do that.
When I call the doctor, I have already taken vital signs, I give sizes and descriptions of skin breakdown, I describe sounds or smells that indicate problems, and I have “home” kits that I use to determine if infections are developing. I do all these things and his doctors trust that I know when something is wrong and they listen to my recommendations. I am truly part of his care team. However, because I am the spouse, I cannot “order” supplies except through home health. I cannot get reimbursed for care provided such as wound care because I’m the spouse. The home health nurses have not once done his wound care. I do it. I tell them what I’m using, what I think is going on, how it’s healing, and what supplies I need, and they go along with what I say.
Not so with insurance companies.
If there is a family relationship, you lose all credibility with them. I get “stripped” of my license when I try to justify care needs. So I’ve learned to get what I need by getting an order for home health (which is a waste of money for the insurance company since I could easily do this without them paying for a home visit). Just another problem that exists in our health care reimbursement system.
…Just like not paying for preventive care….don’t get me started on that!
There’s another time when a nurse is not a nurse when she’s a family caregiver; that’s when she tries to tell her spouse what to do. I have so many times told Lynn he was developing a “condition” of some sort. I would warn him that he needed to go to the doctor to get such and such. However, he won’t go until the situation is so bad he’s in pain or can see for himself that it won’t heal alone. I get no credit for what I know. Yes, I’ve “told him so” a few times now and he even admits that he needs to listen to me but there’s something in his ego that just won’t let him take directions from me.
I also realize that as a family caregiver, I’ve become his enabler. I realize that he would probably have more “abilities” to care for himself if I was not here to do so much for him. When he’s tired, he just won’t “do” for himself. He calls me. If he was in a facility or had someone who was not family caring for him, he would likely have to do it himself or not get it done. He would not be happy and he might have long waits, but I often wonder if I’ve done him harm by always being there to help. On the other hand, I know that if I had not been there to watch over him, he most likely would have not lived to this point because I have caught and/or prevented so many medical issues for him before they became serious.
So, my medical background is a true blessing from God. He’s provided me with the knowledge, skills, and abilities to care for the husband He gave me. Though He has not led me to “be” a nurse, He has led me to “be” His healing hands for Lynn. For that, I am very grateful and we are both truly blessed.
Bill rarely listened to me, either, may he rest in peace. I think it’s a guy thing. Men don’t want to listen to their wives.
Late one night, Bill was running a temperature because he hadn’t been able to pee or poop most of the day. I took him to the emergency room where they gave him two enemas and another treatment Bill said involved using a chissel to dig the fecal matter out of his rectum. Afterward, I said, “You should have listened to me. I offered to give you a suppository, but you said no.”
His nurse must have overheard because a few hours later when he was ready to go home, she said, “Okay, it says here in your discharge instructions that you have to listen to your wife.” I don’t think he bought it.
As for being a nurse, I can imagine how your experience and knowledge would have been helpful to you when providing Lynn’s care. I wouldn’t have known the first thing about wound care. Fortunately, Bill didn’t develop sores until he moved to the nursing home so I didn’t have to worry about that.