In nursing school
we were told that it can be good to let our patients know we feel with them. I worked all weekend with an 82 year old man who had had his second big stroke and was totally unresponsive. He had secretions in his trachea Friday morning when I first came on, I could hear him in the hall. No amount of suctioning seemed to help, it actually seemed to make it worse. I finally got an order for 2-4 mg MS q 30 minutes as needed. I didn't need to use that much, had him comfortable and quiet with 4 mg q hour by the time his wife came in. His wife and talked for a long time, really bonded, you know how that goes. She was totally ready for him to go, she knew this wasn't her husband and she didn't feel a need to hang around and watch him die. This woman was totally in control of herself and was making arrangements before he died so that she knew everything was done in case she fell apart. But, while she was talking about their life together, she teared up and at that point, I did too. She saw it and was very touched. Sharing my feelings with her let her know that her husband was in good hands and that he would be comfortable.
Overnight there was a code pink and the night nurse was unable (and unwilling, I think) to give him the MS q hour. She felt he was comfortable with it every 2-3 hours, but by the time I came back on he was full again, and I could hear him in the hall AGAIN. I started with 4 mg q half hour at that point and kept him on that schedule. It took a LOT longer to get him comfortable again and I sure didn't want his wife to come in and hear that. By the time she got there he was quiet and she was glad that I was there! It made me feel really good, like I was being a good nurse. The pharmacy decided they didn't have enough 4 mg MS syringes to last and called the doc and got a MS gtt!!!! Thank God. Then I knew he would be getting what he need to keep him comfortable.
I have to say that I tried my best to help him pass quickly, but he was an athletic man and was STRONG. I knew it wouldn't be long as his temp was 104.3 ax when I left and his sat was 69-70. I called today and he died last evening, peacefully and quietly, not pulling for every breath he took.
I put more in here than was necessary, but I guess I needed to vent. I am trying to make the point that my patients wife knew I cared about her husband and that I would do whatever I could to keep him comfortable. She didn't have to agonize over his suffering and I helped make his passing easier for them both. I can't see anything wrong with that.
It also reinforced my desire to do Hospice work when I have enough time in!
Thanks for listening.