In Bed with Dying Patient

[interleukin]

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 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.

[Elvish, BSN, DNP, RN, NP]

I hope that when it is my husband's time to go (if he goes first), that I will be given that chance to hold him too. Thank you so much for a beautiful article. God bless you, interleukin.

[sharona97, BSN, RN]

My very young cousin with triplets died after her bilateral dx of breast ca. This story really brings home the importance the immediate family needs for closure.

Thank you for such a beautifully painted reality of what really matters for this closure and good-bye's to loved ones every one of us need to experience.

Whether a family member or a nurse, compassion with all it's power somehow can prevail. Compassion has a purpose.

[VikaRN]

greats story, thanx for sharing it with us.. very touching and sad... yet endearing:redpinkhe

[KelRN24]

my daughter was an infant when she was diagnosed with her first brain tumor. by the grace of god she survived a mis-diagnosis and 15 hour surgery, but it was a difficult time filled with difficult decisions; she was not expected to survive. i was new to nursing and being a mom and all i could think of was taking care of my child. i was surprised at the range of help i received in both preparing for her possible death, being able to be with her as much as possible and even help with her care to being talked to like i was an intruder and not being able to touch her.

it cannot be over-emphasized how important it is to allow families to participate and be present during the end of a loved one's life or during a healthcare crisis. the outcome was good for my daughter and i truly believe that being there and touching her and lying in her crib with her helped her even when he was unconscious. but for some that suffer loss, what we can do to help them say good bye and have the time they need is imperative for their grieving.

thank you for such a good article and subsequent posts.

~kelrn24

~ caring is the essence of nursing. ~ jean watson

[nursey_girl]

My dad died at home under the care of hospice 2 years ago. I was the nurse/daughter and was called upon a lot by family members for medical type questions so it was kind of hard to be the grieving daughter. I do remember watching different family members and how they said good byes in their own private way. My neice laid in bed silently with her papa and just held his hand, my son confided his wives pregnancy, others would carry on complete conversations even though my father was unresponsive, others just sat by in silence.

It moved me and helped me process my own grief by remembering how everybody had their own way of saying goodbye. I know it helped them, and I like to think it helped my dad. Death can be so painfully sad and traumatic, but I believe there is also a certain beauty that can be found in the outpouring of love.

[aileenve, ASN, RN]

I worked in hospice for 5 years when I first started my nursing career; this story brought me back there to several patients and families I remember....no one with the exception of nurses really know how much we matter in these situations. We provide memories and perceptions of the end of life that last a lifetime to the surviving family and friends.

[harley007]

Thank you for showing all nurses that it is more than acceptable to care about the emotional needs of a family. Sometimes I feel that after the initial flurry of emergency and intensive care many drift away from what is an equally important part of our profession. I have been in similar situations and provided unusual care to give closure to a family member. But you had the insight and courage to share this with all of us. Thank you doesn't seem to say enough in a situation as special and moving as this. You being the nurse you are is what Florence Nightingale fought so hard for nurses to one day become.

[farmgirl_dee65]

interleukin,

this is a great article. i wept as i read it.

my husband and i lost a 7 yr old son several years ago.

two months of chemo led to lowered resistance, and c-diff set up housekeeping

in his gut, leading to pseudomembranous colitis, septicemia, etc. the nurses in

the children's hospital icu were awesome, and they suggested that we hold him,

even while he was hooked to ventilator and other machines. i was able to hold

that child in my arms the last couple hours of his life, singing to him.

they provided a rocking

chair, and with family gathered round, he managed to leave this world with many

loved ones at his side. doctors and nurses who had worked with him during his

illness were there, also. needless to say, it was a night full of anguish and fear,

but also a night that made me realize how fleeting life truly is. the thoughtfulness

of those nurses has stayed with me all this time, and i am thankful that our son

was able to spend his last hours in my arms. thank you so much for your input.

it will help me to be open in my suggestions to families with a dying family member.

p.s. (((hugs and blessings))) to all who have dealt with similar situations.

dee

[DDRN4me]

Thanks so much for this beautiful article. It truly reminds us that we need to help care for family members as well. they were blessed to have you care for them and we are to have you share with us.

[Neveranurseagain, RN]

When my husband was on a ventilator after a medical mishap, I knew by day 5 that I was going to have to dc life support. Before his family arrived, I wrapped my arms under his shoulders and across his chest, turned him over toward me. He was cradled in my arms when I told him how much I loved him, and that it was alright to die and that I would take care of the kids. The nurses left me alone to say goodbye and the physical closeness we had is something I will treasure forever. It was a peaceful time and I think it helped him slip away in peace.

[dragonfly33]

so the first time i have ever posted to a thread..but i have to say this was touching..taking care of a patient with similar conditions. very good idea

[interleukin]

Many of us, early on in our nursing careers, tend to focus so much on the many technical challenges we ignore or forget about the emotional needs of patients and/or families. We are ‘wowed” and intrigued by the drama and complexities of it all and so very eager to take our places among the nurses who already “walk the walk.”

But those feelings pass for many of us, substituted by a need to better understand ourselves and others. Yeah, I know, this sounds so touchy-feely, so get-your-head-out-of-the-sand type of sentimentality. Sure, it’s not sexy or cutting edge so this perspective is an easy target for the “thrill seekers.” But, as nurses, it is no less a part of what we do--a skill set that we must develop-- than knowing how to manage/control/interpret drugs, machines and complex vital signs.

For me, I feel when we can shut out the “chatter” of our world, and we re-prioritize all the pretty ornaments that surround us, we are left with the human touch—that exquisite need that feeds our very core.

I think the wisest people know that the more they shut out the noise, and the more they focus on what makes them fundamentally more loving human beings, the closer they come to real contentment.