1. Zimmerman, Ellen MSN, RN

Article Content

WHEN MY BELOVED DAD died 1 year ago at the age of 90, I found out the hard way that it is difficult to be both the daughter and the nurse. My dad was very intelligent and creative, as well as a prolific joke-teller who had been physically active his entire life. But as time went on, he couldn't remember why he had walked into a room or what someone had said to him a few minutes before. As a nurse, I knew I would have to just repeat what I had said and not make a big deal about it.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

When dad was diagnosed with Alzheimer disease, he was placed on medication. His mental status remained stable for a few years, so we were encouraged. He never lost his ability to tell jokes or his sense of humor. He also still knew who we were even when he could no longer say our names. The difficult part was watching him decline and knowing he would soon need more help than my mom could give him. She was 3 years younger and did her very best to take care of him, but she did not want professional help and it was a huge strain on her.


As the months passed, dad could no longer take his medications correctly or prepare his own meals, so my mom had to do everything for him. He became a fall risk but refused to use a walker.


He developed unilateral lower extremity edema, which was thought to be a deep vein thrombosis. He was admitted to the hospital and ultimately needed rehabilitation. I knew it was the beginning of the end.


It was heartbreaking to watch my dad, who was always a most patient man, turn into someone who was yelling at the nurses, the staff, and his roommate. The nurse in me knew it was because he was frustrated and probably couldn't express himself properly. I also knew it was part of the disease process. The daughter in me cried every time I left him because I knew this wasn't my father talking but his disease.


It was a tremendous struggle being both a daughter and a nurse. While I made all the important phone calls, spoke to the appropriate personnel, and explained things to my family, I just wanted to be his daughter. That was the hardest part.


One night, my mom called me. My dad was in respiratory distress and on his way back to the hospital in an ambulance. I begged her not to let them intubate him and put him on a ventilator. I had been a critical care nurse for many years, and I knew it would not improve his quality of life. Once again, I had to be the nurse and think like one when I just wanted to be his daughter. It was New Year's Eve, and we did not think he would survive the night. He was placed on comfort care only and lived for 5 more days. The nurses were amazing and took good care of him.


I miss my dad terribly. Ironically, I can now just be his daughter and mourn him. It is a huge struggle when you are the only healthcare professional in the family, having to explain things and be the one to talk to everyone because you understand the clinical issues. I was more than happy to do it, but there were many times when I wanted only to be his daughter.


We can't separate the nurse in us; it is who we are and is what defines us. Taking that part away would be like taking away part of our very being, and that's impossible. It is a blessing to have all the knowledge, but it's sometimes a curse as well.