a strong working relationship with the caregivers and the patient. At some point the patient would likely lose the ability to participate in his/her own care. A satisfying hospice experience blossomed from establishing good rapport all around.
Kayla was good at working both sides of the bed, and that made her an effective hospice nurse, a fact she’d realized during her first years in the North Country. One of her hospital patients had brought her to faith, to hope, and eventually to her present gig.
She raised the container. “Effective for moderate pain. Side effects generally ease after a few days.”
“Side effects like…?” Marc’s look sharpened. He glanced at his father, then back to her.
Kayla addressed her patient. “Sleepiness. Confusion. Dreams.”
Her list relaxed Pete DeHollander’s features. “All of the above.”
Glad to have relieved his mind, Kayla offered a proposal. “Since you just started this, I’d like to see if the side effects level out. They usually do as the body acclimates. Can we try that, Mr. DeHollander?” She posed the question with a look of inquiry. “I don’t want you to think this is an automatic trade-off. Less pain for a state of confusion. We have lots of things at our disposal. Your care will be based on what works for you. Adjustments in meds are common.”
He contemplated her words, then looked at Marc. “I’m not thinking too clear,” he admitted. He fiddled with the uppermost blanket, nervous. “What do you think?”
Kayla met Marc’s eyes across the bed. She read the look in them. His expression offered resignation and little else. He’d do what he had to do, but it was plain he didn’t like the choices. Whether his unease stemmed from the question or the situation, she had no idea. His gaze narrowed. “If we keep Dad on this medicine, the side effects might clear up?”
“Yes. If they don’t, I’ll call the doctor and we’ll modify the meds. Our goal is to provide sufficient pain relief with minimal side effects.”
“And it can be done?”
She scrunched her face and offered Marc a firm nod. “Absolutely.” She hoisted her tote onto a side table. “I have an amazing bag of tricks, gentlemen.”
The old man smiled. When he did, his gray-green eyes sparked with life. For just a moment, Kayla envisioned the man he’d been before his long battle with cancer.
Her throat tightened. She controlled the impulse to sympathize too much by dragging a chair alongside the bed. “You boys could at least ask a girl to sit down.”
The old man looked affronted by his carelessness. “I don’t know where our manners have gone,” he exclaimed, surprised.
Marc’s look hardened. He kept his eyes trained on Kayla, studying her. Fighting the rise of negative emotion, she addressed them both. “We should talk. I want you to know what to expect of me, what kind of care I’ll be giving and what choices you have.”
“Do those choices include a nurse who isn’t afraid to get dirty and knows enough to wear sensible shoes midwinter?” Condescending, Marc swept her pert, polished nails and well-fitted blazer a look of disdain, his expression intimating she didn’t have enough muscle to get the job done.
Ouch. The young farmer’s cutting appraisal hit home. Striving to remember why peaceful conflict resolution was a good thing, Kayla faked a look of calm. She’d dealt with antagonistic families before. His anger wasn’t all that unusual. Death managed to bring out the best in some people, but that wasn’t a universal reaction.
She kept her voice confident, but didn’t negate the hint of challenge in her reply. “We have a group of hospice nurses, male and female. We work individually, concentrating on specific cases. But—” she added, strengthening the note of reassurance “—someone is always on call so there’s no lapse in service.” She addressed her words to the older DeHollander. “If your nurse is off or away, you’ll still have help regardless of the day or the hour.”
“Makes sense,” the older man agreed, his expression serious but accepting.
“Of course you can request a different nurse,” Kayla continued. Her gaze encompassed father and son. “That’s not a problem, because your nurse acts as your case coordinator, overseeing all aspects of your care.” She turned and met Marc’s eyes, unflinching. “Facing the loss of a loved one is difficult enough without personality clashes making it worse. Our job is to make things easier for you, Mr. DeHollander.” She shook her head. “Not rougher.”
Pete struggled more upright. “Why would we want someone different?” He glanced from one to the other before his gaze settled on Marc. His voice lost the fog of confusion. “What’s going on?”
Marc squared his shoulders, eyes narrowed. “Nothing, Dad. I just want to make sure your treatment is taken seriously, every step of the way.”
Kayla stared him down. He didn’t squirm. She lifted her left brow. “Laughter is the best medicine. Haven’t you heard?” Deliberately slow, she winked at the older man. “It aids in pain reduction, increased glucose tolerance, emotional bonding and vascular function.” She gave Pete a perky shrug and a smile. “All for the price of a belly laugh. Fairly cheap, I would say.”
“The price is right, sure enough.” Pete grinned back at her, restoring the twinkle in his eyes. The smile made him look more vibrant, more alive.
Marc’s expression noted that. His look softened. He reached out a hand to his dad’s head in a gesture of comfort. “I’ve got to take care of some things in the barn. My cell phone’s on.” He patted his side clip. “Call if you need anything.”
“I will,” Pete promised. “Sorry about that business last night.”
Marc frowned. “You remember that?” At his father’s look of surprise, he added, “You were pretty confused, Dad.”
“I’m not dead yet,” the older man retorted.
“But definitely incapacitated,” Kayla inserted. She kept her tone helpful and amused.
Pete DeHollander joined the game with a look Kayla’s way. “Under the weather.”
“Down, but not out.”
“Rounding third and heading for home.”
“And the crowd goes wild.” Kayla raised her arms and widened her smile.
Marc stood, glowering. “I’m glad you two find this so—” Face tight, he drew a sharp breath, his jaw rigid. “Whatever. Some of us have work to do.”
He strode out, his footfall decisive against the wide-planked floor.
Kayla watched him go with regret. She’d hoped a little humor might lighten him up, but no. She’d only angered him. Obviously the tact and diplomacy she’d been praying for needed fine-tuning.
Fine tuning? Her conscience prodded. How about major structural repairs? Run after him, Doherty. Maybe the guy’s got a paper cut. You can apply a salt-water rinse followed by a splash of fresh lemon. Really make his day. Kayla sucked a breath and sighed.
“He’ll be fine.”
She
