Print Version

Email Entry

by End Game RN

Reader Rating:

Posted: Nov 25, 2007 11:07 PM

Views: 910

Received 27 "Thank You" From 13 Posts

Beginnings and Endings

Through the glazed windows of my soul I watch as the scene played out before my eyes. I stood quietly observing the final hours of my patient and her family. Throughout my career I have supported and counseled families facing the prospect of losing someone they love or whose family member is facing pemanent disability and loss of independence.

Shadows danced on the walls in the room where she lay. Sun light filtering in through the grated window brought into focus the few scattered orange freckles sprinkled across her nose. Crystalline tears dotted her cheeks. Her pale grey face glowed with the promise of another day, in another time and space, outside the drab existence of those of us who remain.

Colorful wooly animals were packed on a shelf nearby, their warm comfort more for the family and friends standing vigil; waiting for something they will not openly express; perhaps fearing that somehow the words spoken aloud would be the final truth.

Now exhausted, her parents sitting in chairs positioned close to the bed on either side of their daughter, rest their heads on the still soft form of this woman child, inanimate and heavy in physical death, wearing the accouterments of the true church. Scapular placed around her shoulders and head by the faithful. Wrists entwined with Rosary beads and bracelets. In a moment of whimsy a package of her favorite pop-rocks were placed along side the religious articles. Two stuffed animals were tucked neatly in the crook of her left arm appearing as if the girl was holding them.

Some of those present beg for a miracle, challenging their G-d to intercede. They become insistant and demanding in their prayers, unanswered by a seemingly uncaring deity. Some cannot understand that G-d does as he pleases.You may ask but cannot compel G-d to do your bidding. His decisions are not that of a capricious child but part of a greater plan outside our scope of understanding.

I witness this with two nurse acolytes who stand with me quietly observing this scene. This experience foreign to them, sharing this private moment, grieving with the family, seemingly embarrassed when I see the unshed tears in their eyes, choking back soft, near silent cries in sympathy as the scene continues to unfold. I position myself between these nurse interns, speaking quietly to them as we stand as silent witnesses, watching as dozens of lives are forever altered, some destroyed by this tragedy, knowing that nothing will change what happened to this girl and her sister one early morning in a split second; a series of poor choices forever altering the lives of another family, the friends and colleagues of the deceased in the other car; struck down in a foolish moment, just blocks away from his home.

I explain to these young women their responsibility when caring for both the patient and the extended family when death is expected. I explain how to be a silent yet comforting presence, gently touching the closest family member, turning off the alarms on the eerily glowing monitor as vital signs fade; encouraging the grieving to gather around the bed, sitting or standing, touching the patient or her bed, being sure that each person who wants to do so can.

I encourage those strong enough to talk about this girl to share the humorous stories of her short life, acknowledging her uniqueness by speaking aloud how she impacted her lives.

Her father bragged about her skills as a fisherman, catching a large parrotfish in a canal that should never have had any fish in it. How she learned to bait her own hook, bragging about her ability to cast her line far out into the water; first demonstrating this skill at a very young age; enjoying this time with her father. He told us how he would clean her catch and cook it for her.

There were photos of her dressed for a formal with her sister and her friends and a photo of her getting a kiss from a horse. He stretched his head and neck far out over the stall door, she was leaning in to allow him to kiss here. There were other photos as well, numerous cards and letters from her school friends and family.

Her father had been playing a song for his daughter repeatedly over the last few days of her life. He explained to anyone who would listen that his daughter had told him this was their special song. He said that they had danced together to this music. Father and Daughter. Now realizing that this would be their final dance.

I recognized the song, it was Butterfly Kises, he held her face with both hands sprinkling her with dozens of gentle tiny kisses, unmindful of the endotracheal tube, gastric tube and the soft rythmic sounds of the ventilator. He cried while sharing with us how special she was and how his life was complete for having had her for such a short time. Her mother clung to her child, sobbing her grief, unable to speak. Grandparents, uncles, aunts, cousings and other extended family members and a few friends from school stood as sentinels in her room surrounding the parents with love and sharing their pain.

There was soft laughter with occasional humorous outbursts from some of those who sat by the bed relating their own experiences with this girl. There were those sobbing intermittently while listening to the others, unable or unwilling to understand that this sharing was also a part of the grieving process. The cadence of their cying and wailing rising then fading echoed in this small room, spilling out into the hallway as unbearable grief was expressed.

Time passes. To swiftly for some, too slowly for those who have stood vigil since the first day. Minutes later, just before noon, she is finally freed from her mortal self. More family and friends arrive to comfort the two sets of parents who claim this girl as their own. The "first" Thanksgiving, Christmas and New Years without this daughter will weigh heavily on the family.

Soon the family leaves. One of the nurse interns remains with me learning the care of the deceased patient; preparing her for her next journey to the medical examiners office, the funeral home, her final resting place yet to be determined by her family.

I explain everything to this new nurse as we perform post mortem care. As required by law all lines and tubes remain in place awaiting removal after the medical examiner finishes with her. A young man arrives with a stretcher. There is an orange backboard and a neatly folded purple velvet cover lying on it. We assist this young man as he pulls her onto the stretcher. He positions her gently, carefully before unfolding the puple velvet cover, symbolic in its resemblance to the receiving blanket of a newborn. As he covered her he showed both compassion and respect for this young girl.

Beginnings and Endings are an integral part of our lives as we march forward. There is the beginning of the journey to be traveled by these young nurses' as they continue to grow in wisdom and compassion; practicing and perfecting their art and newfound skills, never forgetting a father's Butterfly Kisses in a room of dancing shadows on a clear November morning.
And the ending of a young life never fully realized yet loved beyond measure.

Eeka End Game RN
November 2, 2007

This is for Valerie and Jillian, two nurse interns who were my inspiration for sharing our story.

This is also for this child's family, extended family and friends and her school who provided so much love and support. It was an honor and privilege to care for you.

Dec 21, 2007 11:04 AM - Eeka End Game RN.... Wow... you write beautifully. In addition to being able to picture the scene, I could also hear it. I will always think of this story whenever I hear the song, Butterfly Kisses. Thank you for letting me be a part of this story.... I too will say a prayer for this family.

Dec 24, 2007 01:55 AM - This Is So Poignant For Me. We Had A Fellow Employee Who Lost His Youngest Daughter This Novemer Also. He Has In His Grief, Started A Parents Of Deceased Children Support Group Here. Your Story Almost Completely Mirrors His. Thankyou For Sharing This Story And Your Gift For Telling It So Well

Mar 10, 2008 11:10 AM - That was beautiiful. It was almost too much for me to read. You see, I was born October 20,1966 but I had another birthday, January 21, 1987. I was where she was. The only difference is I was forced to come back and she was able to stay. I did not want to come back mind you. I was in a great deal of pain. There are not words that I know to describe to you how I hurt. I was ice cold and empty. I heard my family all around me and I wanted so much to reach out to them but I did not have the strength. I screamed as loud as I could but no one heard me. I heard the beeping of the monitors and the whooshing of the vent but they seemed so far away. My groin was on fire from the medicine that was infusing. I had no clothes on and I was freezing. My mother, that was who I was told later the lady holding my hand and crying was, on one side and my the man I was told was my father was on the other side. He was repeating over and over again how it was his fault that I was there and how sorry he was.
And then,... I was drawn back and upward toward a warm light and while I could see that my room was full of people in scrubs hurrying about and I saw the measures of resusitation that were bravely executed on me...I was drifting away from the scene and thanking God that the pain had gone away and I was warm again for the first time in what seemed like an eternity.
I was not alone though I could not see anyone I knew someone was there. I looked down to see my mother and father crying over me and I longed to tell them that I was ok and they could go on now, I could not.
I moved, I did not walk as I could not see or feel "legs" in the way we think of them, I still moved forward with my "companion" at my side. I had never been so much at peace and so content and I never have had that feeling since.
I was sure that time had stopped and I could not watch the drama in my"room" anymore and I did not want to look back and remember. I did not know at that time who those people were but I felt drawn to them nonetheless.
I heard words in my mind though no one spoke. " I want to stay", "it is not your time yet," no matter how I pleaded, the voice would not waver.
My aunt was there waiting for me. I knew who she was. She had died of a massive brain tumor years before but she looked as if time had stood still for her. My body, what that there was of me was beautiful. All my life I struggled with my weight and low self esteem and poor self image, but not anymore. I was beautiful, whole, and glowing.
In a flash of light I was in searing pain again and back in my body. The nurses were bustling about around me turning off machines and writing furiously in my chart. I have never been so cold. Still to this day I am always cold. Tears came to my eyes and I could not stop them. I tried to cry out but no sound came out. " I am here!!" A nurse looked up at me and saw my eyes open and that I was crying and I think I frightened her to death, or maybe it was joy, I still do not know.
My journey had just begun.