Nursing Lessons From Tuesday With Morrie … Essay
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Tuesdays with Morrie by Mitch Albom is a non-fiction book that centers around the relationship between Albom and his former professor Morrie Schwartz. Schwartz was dying of ALS during the time of the book. The narrative is that Albom and Schwartz had been reconnected and Albom began to see Schwartz every Tuesday until Schwartz passed away. The book is focused on the perspectives and life lessons that Albom gained from these visits, and his subsequent reflection on them. These are the only two main characters in this book.
The role that these two play in the book starts with the student-professor relationship, but after they reconnect they do so more as adults on equal terms. There is still a mentorship aspect to their relationship, however, as Schwartz is conveying a lot of life lessons to Albom. The book highlights this experience of reconnection, of dying and death, and life, and what Albom learned from this experience of meeting someone who was dying of ALS and had to come to terms with what that meant for his life.
Lou Gehrig's Disease
Lou Gehrig's Disease, as ALS is colloquially known, is a rare degenerative disorder. The ALS stands for amyotrophic lateral sclerosis. It attacks the nerve cells that are responsible for controlling the voluntary muscles, so its victims gradually lose control of their bodies. The disease is progressive, and progresses rapidly, leading to death in all cases (ALS Association, 2016).
The prevalence of ALS is 3.9 cases per 100,000, which equates to around 12,000 cases active in the U.S. at any one time (NIH.gov, 2016). This makes it one of the more common diseases within its type of motor neuron diseases. ALS can affect anybody of any background, but is more common in white males, non-Hispanic, aged 60-69 (NIH.gov, 2016). Morrie Schwarz was 78 when he died from ALS. The disease is said to occur randomly, with 90-95% of cases having no known precursor for the disease. Only around 5-10% of cases are inherited (NIH.gov, 2016). In those, around a third are known to have a defect in a specific gene, representing a fairly small percentage of the people who get ALS (ALS Association, 2016).
The pathophysiology of ALS is that the disease first begins to take away control over voluntary muscles, but will continue to progress until involuntary muscles are affected. Schwartz died when the disease caused his lungs to cease functioning. The prognosis for ALS is always death -- it kills 100% of those who get it. As the body degenerates, increased levels of care are needed for its victims, as they lose their ability to take care of themselves. By the end, they require round-the-clock care.
ALS can manifest usually in a limb or in speech. As it progresses it will take other body parts' functionality away. People often have trouble swallowing, have exaggerated reflexes, cramps, muscle weakness but the disease progresses and manifests differently in different people. This makes for a challenge in diagnosing ALS. Generally, where it is found that there is damage to both upper and lower neurons. However, at this early stage usually a number of other tests are required to rule out other diseases, some of which are also awful but some of which are treatable.
There is no cure for ALS. There are drugs that can reduce damage to neurons, which should increase life and quality of life for those who contract the disease. This can prolong survival by many months. In many cases, there are medicines taken to deal with specific symptoms, but they cannot reverse or undo the damage that has been done, and they cannot stop the progression of the disease. This is why ALS is always fatal. Drug therapy is usually the only response, to minimize the impacts of the symptoms of the disease, and such interventions are always temporary.
Nursing care associated with ALS will vary with the progression of the disease and the specific symptoms of each patient. In its early stages, nurses can assist with pain management, and helping the patient to function better. Nurses play a valuable role with the family during this stage as well, since the family needs to contribute to the care, and they have to understand some of the things to look for. Thus, there is an educational role for nurses when dealing with ALS patients.
As the disease progresses, the patient will be able to do less and less. This decline in functionality increases the need for nursing care, and ALS patients invariably end up needing round-the-clock care. The risk of infection is greater as the disease progresses, including pneumonia. Patients will often lose bowel function, a loss of mobility and dehydration (ALS Association, 2016). Another nursing diagnosis is that patients lose their ability to support their own weight, and this creates posture issues that make defecation more difficult, and many ALS patients require assistance with that (ALS Association, 2016).
Spirituality is a difficult concept to pin down, and it has a lot of room for personal interpretation. In general, many people believe that there is something greater than ourselves. This can take the form of religion, but it could just reflect a wonder at the nature of life, the vastness of the universe, or the quest for meaning in our existence. It is only natural that a book like this would discuss spirituality, not only that of Schwarz as he faces death but that of Albom as he is forced to do some examining as well.
In one instance, Schwartz talks about spiritual development, saying "I do know we're deficient in some ways. We are too involved in materialistic things" (Albom, 1997), which highlights that he wishes to contemplate a greater meaning. The point of mentioning materialism is that is contradicts with spirituality in a sense, that the desire for greater meaning and understanding is something to be valued, not ignored while we engage in material pursuits. Another example from the story is when Albom discusses death in different cultures. His reflections on death highlight the diverse range of human spiritualty, the different ways that we can resolve the cognitive dissonance associated with living short, physical lives in a universe that seems boundless.
There is also a scene where Morrie says he talked with God, to quote "I'm bargaining with Him up there now. I'm asking Him do I get to be one of the angels" (Albom, 1997). This quote shows that Morrie is thinking about life after death, about the existence of God and what might happen to him when he dies, all key elements of spirituality and our quest for understanding.
Caring in the nursing sense is offering compassion, caring for one's needs both physical and emotional and providing support to a patient in need. There are many examples of caring in the book. Albom is actually caring in his visits to Morrie, providing the man with some emotional support and structure during a time of illness. This kind of support from family and friends is important for patient outcomes.
There are other examples of caring as well. Nurses are providing round the clock care for Morrie's physical symptoms as they administer drugs and work with Morrie to make him more comfortable. This is a basic type of caring that nurses provide, attending to the medical needs of patients with ALS as their symptoms accelerate. In the second chapter, Connie the aide helps Morrie with going to the bathroom. This assistance with daily living is important, because patients with ALS lose their ability to do things like go to the bathroom unassisted.
Grief and Loss
The characters struggle with grief and loss. Morrie thinks about the grief and loss his family will feel, what he would feel if he was in their situation, and tries to understand these emotions. The experience is difficult for them, and Morrie seeks to understand what sort of loss they will feel when he is gone, as a means of understanding the situation better
The other characters have to deal with grief and loss as well, since they are losing Morrie. His wife continues to work even as he is dying, perhaps as a means of minimizing her grieving by maintaining a distraction in her life, something else to think about. The sons travel frequently to visit with Morrie as his disease worsens, knowing that they do not have much time left with him. These characters are finding a way to get the most out of their time with Morrie but also to manage how they will deal with his death when he is gone.
There are a lot of lessons that can be learned from this book. One of the biggest ones is the nature of life, and what we value in it. Morrie teaches Mitch about what is important in life, from the perspective of one who is coming to terms with his pending death. Facing mortality has a way of highlighting what matters most, and this… [END OF PREVIEW]
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