Remembering Lady Jane: Whenever I smell the scent of roses, this remarkable patient springs to mind

Nursing, Dec 2003 by Barreiro, Maria G

Despite an emergency colostomy to remove an obstruction from a malignant colonic tumor, Jane maintained an air of nobility and class. She'd had only 1 week to absorb the diagnosis when she became my patient.

As I entered her hospital room for the first time, I was overwhelmed by the smell of roses. Everywhere I looked, I saw either a floral arrangement or a dish of potpourri. I knew that patients with colostomies often surround themselves with strong fragrances to cover any odor from the colostomy bag, so I didn't comment. Instead, I introduced myself and explained that I'd come to change her dressings and teach her to care for her colostomy.

No plain Jane, my patient was a striking woman with salt-and-pepper hair and intense gray eyes. Every hair was in place, and she was beautifully dressed in an ornate nightgown and robe. She politely informed me that I could change her dressings, but she had no intention of learning to care for her colostomy. "My daughters will take care of that," she said firmly.

I encouraged her to watch me anyway. As I changed her dressing, I explained each step. But Jane wouldn't even look at the wound. I repeated this teaching ritual every day that week, but Jane never paid any attention.

Fortunately, her daughters did. As the week wore on, they became adept at caring for their mother and dressing her wound. Under their attentive care, Jane was soon ready to go home and begin radiation and chemotherapy as an outpatient.

Meeting again

One year later, Jane was readmitted to my unit with a serious infection. I learned that radiation and chemotherapy hadn't worked; now her bones and lungs were affected too, and her prognosis was poor.

As I entered her room, I immediately recognized the scent of roses-but I wouldn't have recognized Jane. No longer vibrant, she was frail and emaciated, and her eyes were dull.

When I reintroduced myself, I could sense that she felt anxious about having to explain her needs to yet another person. Remembering how she liked things done her way, I assured her I'd do my best to follow her wishes. Over the next few days, I memorized the way she preferred her care, because I knew a time would come when she wouldn't be able to speak for herself.

Some of the nurses found Jane demanding. After all, hospitals run on routines, with set times for everything-when to wake up, when to eat, when to get out of bed. But Jane would have none of that. She slept in, awakening only briefly for juice and medication. At 10 a.m., her devoted husband would arrive with coffee, a muffin, and the morning paper. They'd chat until lunch was served. Jane would graciously take a bite or two, although she had little appetite.

At about 1:30, she'd call me to perform colostomy care. This was inconvenient for me, but I recognized that this was one of the last things she could control. When I finished, she always wanted the room freshened with a spray of rose-scented deodorizer.

As the weeks passed, Jane's spirit faded and she slipped into a coma. Although she could no longer request it, I continued freshening the dishes of potpourri in her room.

I knew the end was near and I wanted to see her through, but Jane had other plans. She died late one night when I wasn't working.

Leaving her mark

After learning of her death the next morning, I immediately went to her room; I don't know why. It was empty and sterile, the scent of roses wiped away by hospital disinfectant. I sat down and mourned the loss of Lady Jane, a woman whose dignity and spirit left a lasting impression.

By Maria C. Barreiro, LPN

Maria G. Barreiro is a staff nurse at Muggins Hospital in Wolfeboro, N.H.