A journey to continue

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A journey to continue

Registered nurse Wang Liyun continues to gain strength and resilience in her work to journey the last stretch with her palliative patients and their families.

Years ago, when I was a junior nurse, I observed the common occurrence where many patients came to the hospital and were diagnosed with a disease. Subsequently, they travelled between home and hospital for treatment and related complications. Then one day, they were told that the disease had progressed despite treatment and no more options were available. Some patients did not even have a chance for treatment, and those who responded to treatment lived in endless worry and treatment-related pain and disabilities. I wondered how those people and their families had lived their lives and coped with those life-changing events.

One day, a 21-year-old young man was admitted when I was on night duty. He vomited non-stop that night but refused my care and help. He just wanted his mother who was a senior nurse then. I was outside his room, feeling helpless and useless. All of us suffered the long hours that night.
The next morning, when I was passing my report over to the next shift, the young man’s primary physician came with another doctor to see him, and I reported what happened at night.

“I have no more treatment options for him,” said the primary doctor, a familiar statement that I had heard many times.

“There is a limit in treatment, but no limit in care,” said the other doctor. I found out later that he was a palliative care doctor. I was deeply shaken by this new statement that I heard for the first time. Just a few words, simple but powerful.

The next night, the young man was quite settled and sleeping soundly. I offered a foldable bed to his mother to rest, but she declined and said she could not sleep because she was very worried about her son. She started to tear. The feeling of helplessness and uselessness started to engulf me again. I stood there speechless and motionless, just listened to her sobbing and watched her tired face. She stopped after a while.

“I’m sorry, I could not hold it any longer, because today the doctor told us there would be no more treatment,” said the mother.

“There is a limit in treatment, but no limit in care.” The palliative care doctor’s words flashed in my mind, and I repeated them slowly.

“What care?” asked the mother. I told her about the conversation between the two doctors and suggested that she speak to the palliative care doctor.

I returned to work a few days later after post-night-duty rest, the young man had been transferred to an inpatient hospice. About one month later, his mother came to look for me and thanked me for talking to her, listening to her, and encouraging her to seek palliative care. She shared that her son had received excellent palliative care and spent his last journey with meaning and passed on with peace and dignity. The whole family was sad to lose him and they were thankful to be able to spend quality time with him until the end. They managed to talk openly and they had never felt so close as a family. Eventually, they managed to say their final goodbyes.

It is their struggles with pain and suffering, and their search for relief and meaning, that teach me how fragile and yet how strong life can be, how important family and friends are, how equal life is when facing death and dying no matter who we are.

I enrolled in a palliative care nursing course and started to do palliative care nursing. I have encountered different patients and family over the years. I have even been scolded by some of them. Some older patients often said to me that the amount of salt they had eaten was more than the rice I had eaten, but they apologised when they realised what I had tried to prepare them for was apparent while they were going through the deterioration in health. I have cried when young patients or patients I took care of for a long time passed on. I have thought of changing jobs when I felt down and trapped in a dead corner.

I learnt to do reflection by writing journals. I started to practise self-care. Gradually, I realise that every patient and family tells a unique story and teaches me something new and different. I’m able to draw strength and energy from each case encounter to move on.

It is not the thank-you card, chocolates, or letter from patient and family that give me satisfaction. It is the heartfelt peace and a sense of special honour to journey with a person and the family. It is their struggles with pain and suffering, and their search for relief and meaning, that teach me how fragile and yet how strong life can be, how important family and friends are, how equal life is when facing death and dying no matter who we are. I learned to be realistic, humble, and receptive of life changes. Palliative care makes me grow and be resilient in the face of uncertainty and losses, and from witnessing pain and suffering, so I can continue to journey with others I will meet in the future.

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