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by interleukin

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Posted: Jan 21, 2008 02:11 PM

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Received 624 "Thank You" From 29 Posts

Sometimes, a family member's behavior is so clouded by the grief and shock of a loss that we must be courageous enough to practice outside the box.

My patient had been ejected from his car after hitting black ice. His prognosis for any recovery was a hairs-breath above zero. We knew he would never again walk this earth.

The family was large and streamed in and out of the room. All were polite and respectful. The wife dutifully provided explanations and “stability” for the large family and the throng of visitors.
From the periphery, I observed her. She kept her emotions in check, only occasionally tearing up. It almost seemed she were “hostessing” the “event”. But her slow-motion movements belied a simmering grief that needed to be processed.

Having worked in ICU for ten years, I knew there was nothing humanly possible to change his course. I knew soon his heart--the heart that beat for so many years in unison with the woman--would stop, and the body that warmed her would grow cold, and the soul that united them and breathed life into her, would slip away.

The family and friends were “there” for the wife but they seemed unaware of the need I saw simmering just beneath her expression. And as the people kept calling I could sense a growing need within her. She began seeking my approval about letting anyone else in. I told her these would be the last. There was something we needed to do. The final visitors let the others who had gathered in the waiting room know that visitations would now cease.

I led the woman into the room. I rearranged the mechanical lines of life support and gently pulled the husband over to one side of the bed. I let down the rail.

“You need to lie beside him,” I said.

She looked at me with utter astonishment. It was as if I had just told her I could bring transport her back to the day before when her husband was home and alive and this place never existed. Her tears streamed down her cheeks. She cried and cried as I helped her in beside him.

I assured her she would not be disturbed by anyone, for any reason. She could emerge from the room when she was ready and could stay as long as she needed. I would guard against any disturbance.

I covered her with a blanket and put chairs against the bed as a reminder to her that the railings were down. I handed her the call bell and closed the door and curtains behind me.

Some weeks later I received a letter from her. She had difficulty describing the torrent of emotions that enveloped her while she lay with her husband that final afternoon of his life. But she said that being able to fully embrace him provided her a comfort and peace that would warm her for the rest of her life.

It’s so simple, yet too often we lose focus on what really matters.

Have the courage to let your humanity lead the way.

Jan 23, 2008 06:02 PM - i too, encourage this w/my pts and loved ones.
if unable to lay right beside them, the loved one sitting up w/the pt's head on lap, is also very powerful.
it provides much needed intimacy, expression and closure before the pt dies.

i crawled into bed, next to my mom, as she lay dying.
and it was one of the most memorable experiences of my life.

thank you, interleukin.

leslie

Jan 23, 2008 06:44 PM - I know it's not quite the same but on L&D when we have a baby that is dying (usually extremely pre-term), sometimes the parent simply can't hold the baby. So we do-the nurses, the housekeepers, the assistants. Even when we are so busy we can hardly turn around, even when it takes hours; our babies know they are loved, even by a stranger, until they can let go. That human touch- it is so easily forgotten but so important.

Jan 23, 2008 06:58 PM - Such a sad story. Very touching.

Jan 23, 2008 11:45 PM - Thank you so much for posting this article!
My 9 yo daughter died in 1989, 48 hours after what should have been her third and final open heart repair for a congenital heart condition. My husband was a Pediatrician, and I, an experienced NICU nurse. I had the presence of mind, even in my grief, to ask for what I needed. I asked for an autopsy, but was told "none was needed". I asked what tubes, if any they needed to keep in and told them I wanted to give her a final bath to see all of her for the last time. I wanted to lay with her, but since she returned to us on a cart, I could tell that wasn't an option. Her bed was no longer there. So I asked to hold her. They never brought items I needed to bathe her. This was a renowned Children's Hospital and no one found us a rocker. I sat on a straight chair holding her upper body, my husband sat next to me, he holding her legs. It was awkward, at best. Then we were handed a bag of 'her things' and we left. My unfinished business has haunted me for years! I channeled it into a great bereavement program at the hospital where I now work. Parents have taken their dead infant into bed with them for a few hours and some have taken their baby home to see where he would have grown up. I facilitate whatever each family needs and try to 'see' each family clearly. Still, my hurt remains, that at my time of need, no one did that for me. Though I communicated many times with this hospital and through all the right channels, the nurse in me still has 33 unanswered questions about what caused her death and events of that night.
Death comes unexpectedly, even to those we love, and I applaud all nurses who read this post who go the extra mile for their families. They will always remember you, as I recall the staff who caused me so much heartache. They are forgiven, but not forgotten.

Jan 24, 2008 12:46 AM - I commend you...this quality of compasion you showed is not seen enough..
God bless you

Jan 24, 2008 09:18 AM - Thank you for posting that, it brought me to tears. I have nursed in critical care for yrs and am embarrassed to say I have never thought of that. How beautiful to be able to do that for a grieving family member.

Jan 24, 2008 11:25 AM - iyqyqr,
My heart goes out to you and your husband. It doesn't make it any easier that we are health care providers- I think we just hide the hurt better. What a beautiful way to help others- we have a similar bereavement program here and I know it really helps some parents.
Thank you so much for sharing your story.

Jan 24, 2008 06:10 PM - How beautiful to have such warmth and comapassion towards patients. Im constantly being told that kind of attitude in the not a good one to have in the nursing profession, i start school this year and after hearing that i strarted to wonder if nursing was really for me. After hearing there are nurses out there that share my feelings, it makes me confidant that not all nurses look at it as "just a job".

Jan 24, 2008 06:56 PM - Wow. Very touching. Thank you for sharing. Brought tears to my eyes. I work on a floor where we have a few palliative care suites so I see several pt's at the end of life. I needed to read this. Thank you.