“The oldest trees often bear the sweetest fruit”

The majority of my patients are elderly, so inevitably I have experienced some of them passing away. As their caretaker, I always find it personally challenging when a patient dies. Thoughts run through my head and I wonder: could I have done anything more?

I consider myself a hospice home visit nurse at times. When a patient is dying, I work closely with family members on ways to keep their loved one comfortable during the end of life process. Morphine is not available at the clinic at the moment. The strongest pain medicine we have in our pharmacy right now is Ultram ER (narcotic like pain reliever). Therefore, I encourage alternative measures of comfort as well such as massages, playing comforting/calming music, sponge baths, keeping patients clean and dry, repositioning frequently, and engaging the patient in conversations if possible.

Recently, I was able to attend one of my patient's funeral in town. I learned about the typical process and traditions a family goes through. When someone passes away here in town, their body is taken to a morgue to be identified, cleaned, prepared, etc. Then the family starts to plan for the wake. A wake is a ceremony which takes place at the house of the deceased with the body present. Friends and family gather to mourn, celebrate, drink, eat, sing, and reminisce. This lasts all through the night until the next day in which the funeral takes place. The funeral I attended was an open casket, which I was told is standard. After the funeral, the body was put in the back of a truck and slowly driven to the cemetery across town. Others walked and followed behind in a procession. Once at the cemetery, it was surreal to see the casket placed into a hollow cement grave. Some songs were sung and last words were said, then cement was poured on top of the casket and spread all around. The sun was blazing hot and the family members were sobbing uncontrollably. I was lost for comforting words at that time. I stood and watched as the family mourned and the cement continued to pile on, layer by layer.

I find it amazing how well the elderly are taken care of by family members and the community here in town.  Many times when I visit a patient, they have family members all around--even great great grandchildren are running around the house. In my opinion, no nursing homes are needed here. It’s encouraging to see how involved the family can be with the care of their loved one. For example, I rarely see things like bed sores on my patients who are bed bound. They are turned every couple of hours by their supportive family. I’ve built some strong relationships with family members, communicating with them has helped me provide better care for the patient. The family helps me get to know what’s normal or abnormal during my assessments. It’s been an enjoyable experience learning how to work with a family and the patient as a whole unit.

Celebrating turning 100 years old!

Scorpion encounter

Monday morning started off like any normal morning. I woke up at 7 am, threw on my scrubs, and started to pull my hair up in a ponytail. If you talk to my family or close friends, they might say I can be messy at times. On either sides of me was a heaping pile of clean and/or questionable dirty clothes. As I finished with my hair I turned around and suddenly felt an excruciating pain on my pinky toe. I quickly looked down and saw the culprit--- a scorpion about 4-5 inches long with lobster like black pinchers and the infamous arched tail. It quickly jolted under my bed. I could almost sense that it knew its life would soon be ended. The pain increasingly got worse –like an injection that never ends. I started to scream due to the sharp pain. Two physical therapists came running into my room with looks of panic on their face, followed by a visiting doctor and two medical students. I was in good hands, to say the least. I was carried to the closest chair and ice was applied to my toe. Then, I was brought warm milk by one of the Belizean staff members. I was told this helps decrease the pain, so I drank it without question. Then another Belizean staff member said to take the guts of the scorpion and rub it on my toe. The toxins are supposedly drawn out of the body that way. I politely declined. Another staff member ran into the room and asked where the scorpion was. I forced the words “under my bed” through my tears. I usually hate killing insects or any type of critters. If I find them inside the house, I pick them up and let them free outside. The scorpions on the other hand… they don’t count. I moved down stairs to the clinic and continued to ice my toe. I started to feel like I was coming down with the flu. I decided to take the morning easy. No home visits this AM. Then something strange happened. Around 1 hour after the sting, my lips, tongue, and hands started to get a tingling sensation. The numbness and tingly feeling lasted for over 18 hours! I googled the symptoms while icing my foot in the clinic and found that the scorpion injects a neuro-toxin which produces the numb sensation. The scorpion can actually regulate how much venom is injected as well. Another fun fact about Scorpions is that they glow when exposed to certain wavelengths of ultraviolet light (i.e. a black light) due to the presence of fluorescent chemicals in the cuticle. I might invest in some black lights very soon. On the bright side, I had a great cultural experience, right? Hopefully I won’t have another quite like this one. I moved out of the treehouse, which is now being sprayed, bug bombed, and repaired. There are holes in the roof where insects and other critters can easily crawl inside. I have a family of bats, rats and mice that I can hear at all times of the day running around in the ceiling. And also, of course, my geckos. I usually have around 5-10 in my room at all times on the wall. With all the spraying and repairs, I’m hoping to move back in and live a scorpion free life. I now have learned the hard way that keeping my room clean is important. You were right, mom.