The Patients Who Break Your Heart

From the earliest days of nursing school, when we were taught never to become "too involved" with our patients, we nurses find ourselves balancing precariously on the gossamer thread that separates caring for people and caring about them. Nurses Announcements Archive Article

Being only human, of course, we sometimes cross the line despite our best efforts...and the nurse whose restless dreams are unpopulated by the ghosts of past patients must surely be a rare bird indeed.

I'll never forget:

1 ) The 29-year-old mother of four who was dying of cervical cancer. Cervical cancer! How many such ailments are both so easily cured, and so tragic when not caught in time? I cared for her during only a single shift, but something still haunts me about the way her mother sat for hours smoothing her long black hair across the pillow, and the quiet dignity that never allowed one word of complaint, even as the bitter pain of the disease and the heartache of her husband's deportation to Mexico at a time when she needed him most gnawed at her.

Meanwhile, the children played quietly about the room as I performed the tasks which must be done; they seemed to know, somehow, that this was a solemn time, and yet they were polite and curious about what I was doing for their mother. I heard a few days later that she had passed on only a few hours after my shift ended; and my heart cried out angrily for an explanation which has never materialized, even to this day. I think maybe I am not meant to know...only to accept.

2 ) The elderly but still vibrant gentleman who had just been diagnosed with Stage III esophageal cancer and given an estimated six months to live. On the second evening after his diagnosis, he asked my advice on chemotherapy, radiation, and other matters; his mood was genial, and he seemed satisfied after I had presented him with several different options. At that point, he called his family together in his hospital room and talked with them for over two hours, after which discussion he put on his call light and asked me to walk with him around the floor for a short time. This I did gladly, as he was a very pleasant man and I enjoyed talking with him. Then he stopped me short with this six-word sentence: "I'm going to end my life".

Of course, words of caution immediately sprang to mind---"You mustn't think like that", "Don't give up hope, there are still things they can do for you"---but died on my lips as I looked into his earnest eyes. This man meant what he said, and no psych consult, antidepressant drugs, or pleadings would stop him. I knew that as well as I knew my own name. Still, I begged him to reconsider, citing the devastation his suicide would surely wreak on his family and friends. Finally, he said, "All right, I'll think about it...for your sake." I was so happy that he'd decided to hold off on harming himself, I hugged him right there in the hallway, and when I discharged him home the following evening, he reassured me that he would still 'think about it' before coming to any decision.

The next day---or so the local newspaper said---this dignified, self-determined man walked out into his garage and shot himself in the head. And I've never told anyone about the conversation we had that night in the hospital...until now.

These are the patients who break my heart. Who is yours?

There is one patient that has always stayed with me. He had just retired and him and his wife were getting ready to enjoy retirement when he was dx'd with a brain tumor, gbm, and ended up at our facility to be cared for (he was in his 70's as she was too). I had gotten really close to all the family and the patient. He had talked about how he didn't want his wife or family there when he passed away, but the wife kept telling us how she wanted to be there and how she didn't want him to be alone.

A week before he passed away me and another co-worker had gotten a cake and flowers so that they could celebrate their anniversery that day. It luckily was a day that he was pretty with it cognitively. A week later, the night before he passed away a unexpected snow storm came through after the wife went home. That morning I was called into work because I lived close and could get in. I went into work and was working a different unit and as I was walking up the hall I checked on this patient and could tell that he wasn't doing good. The nurse called the wife who then tried to get in, but got stuck, he passed away without her there, but also he was not alone as me and my co-worker buddy stayed with him.

That day has always stayed in my mind. It's odd how things like that happen.

Specializes in LTC, assisted living, med-surg, psych.

A year or so ago, there was one couple in my assisted living facility who were about to celebrate their 56th wedding anniversary. Since both were in poor health, I was concerned that it could be their last; so several of us got together and put on a party for them. And I mean, we did it up right---we outfitted the upper balcony with twinkling white lights and a formal table, then bought champagne, dinner from their favorite restaurant, and cake. Even the administrator got into the act, serving the couple in a suit and tie with a napkin over his arm while the rest of us ran up and down the stairs fetching whatever they needed. It was a night they told us they would never forget........and when the husband passed on a few months later, we all were thankful that we'd made it special for them.

The picture of the beaming couple, seated at the table that we'd set with silver and gold decorations, still sits on the fireplace mantel in the facility. And even though he is gone now, she still likes to talk about how much that celebration meant to them.

And that's why I love geriatrics. :p

What a nice article.

Specializes in LTC, assisted living, med-surg, psych.

Thank you so much!:):nurse:

As a hospice nurse of 15 yrs I have had many wonderful patients who have touched my life in countless ways...but one in particular will remain in my heart forever.

"Johnny" was bright, handsome, mischevous 39 yr old young man who always had a smile and never missed an opportunity to engage me in some friendly banter. His mother once commented that we sounded like two siblings "arguing". "Johnny" agreed and from that day forward I was his "sister".

Diagnosed with Friedreich's ataxia at age 5, Johnny" was in a wheelchair by age 9 and blind by age 20...by the time he graduated college at age20 he was blind His disease progressed very rapidly leaving him confined to bed, his speech severely impaired, his spastic limbs in constant uncotrollable motion and totally dependent.

But for "Johnny" giving up was out of the question. He had a goal - to the be longest surviving person with his severe form of Friedreich's. If he could just make it one more year.

I am now ashamed to admit that when I first met my beloved friend, I was overcome with pity and sorrow for a life so tragic and wasted. I prayed that God would quickly and mercifully release "John" from this horrible existence. Thankfully, that prayer went unanswered.

Over the next 2 yrs I had the honor of being both nurse and "sister" to this amazing man. We spent hours laughing, talking, crying. We talked about God and the angels he believed were all around him. We explored religion, contemplated the meaning of life and talked about death. We took imaginary trips to incredible places, describing in rich detail all we saw. Sometimes we created mythical creatures, even giving them names and personalities. Mostly we talked about what "Johnny" knew best - love. Johnny loved everything and everybody - The God who had created him "special", the family who devoted thier lives to his 24 care and happiness, his friends and all who touched his life.

At the end of each visit I would kiss "Johnny's" cheek and tell him I loved him. Usually he would say he loved me too, but one day he remained quiet for several minutes and then begin to tell me how much he wished he could hug and kiss me in return. Unable to control his facial muscles enough to purse his lips, he was embarassed. Finally I convinced him to try and pressed my check to his mouth - that big wet slobbery "baby-like" kiss was the best kiss I ever had and I told him so. True to form he responded "you havent lived much have you?" It still brings tears to my eyes.

Shortly before "Johnny" left us, we had a long talk about heaven and he was imagining what it was going to be like to walk and talk and see and....DANCE. He had always dreamed of dancing. That night Johnny and I made a deal...he would save the first dance for me. I am gonna hold him to that one. :monkeydance::monkeydance:

Specializes in LTC, assisted living, med-surg, psych.

That is a beautiful story...........thank you for sharing it with us (as I swipe furiously at eyes which are suddenly VERY wet).:flowersfo

Specializes in OB/peds (after gen surgery for 3 yrs).

I was what? 23, maybe? My patient was a good looking 21 year old guy, he had shot himself in the back of the head. His family waited in the hallway. They didn't want to come until he was gone. Then they came in.

The 37 year old woman G 9, P 0, miscarrying triplets. The delivery of those triplets on our unit.

The first maternal demise after delivering a healthy baby girl. Mom had a ruptured cerebral aneurysm.

"My" AIDS baby. He was 6 when he passed. What a smile that kid had, even though he never spoke. The boy with AIDS with the same birthdate as my son. whoo hoo, he's 17 next week! :)

Thank God for the ones who make us smile and not dwell on the ones who make us cry.

These stories are beautiful, heart-rending, and uplifitng. Thank you.

I remember the 3 y/o little girl I took care of who was being molested in the hospital room while she was in a spica cast. I was in the DON's office being told that I would be fired if I kept making these allegations (after a state investigation decided my charges were untrue) when her UA came back full of semen. I remember the young mother who was holding her baby in her lap when the driver of the car she was in broad-sided an 18-wheeler's trailer being backed across the road, and trying to help her deal with her trauma secondary to the baby's decapitation. I remember the woman who was pinned under her dead mother in a wheelchair for hours after being caught trying to get to safety during a tornado. I had to sedate her every time the air conditioner had to be turned on, but I also remember the man whose family was notified of his impending death only to have him turn it around and WALK out upon discharge. I remember the lady whose baby was in fetal distress, but was born healthy because I was in the right room at the right moment. I'll never forget so many people and stories from the 20 years of nursing that have made me who I am as a person and I'm glad I dedicated my life to it, even though there were times I just wanted to go fry burgers for McDonalds instead. I always believed that we as nurses have an obligation to use our strength in the defense of those who are too weak to defend themselves, regardless of any consequences to us. Today I train the next generation to carry the torch and they are already making me proud. :nurse:

Good luck to you, young nurse. Never forget, "I can do all things through Christ which strengthens me." That is the verse that has carried me through so many people's grief and pain, including, at times, my own. If it's really bad, I repeat it over and over to myself, placing the emphasis on different words...."I can do.." "I can do..." etc. Hope this is a tip that helps you stay sane.

Specializes in cardiac, diabetes, OB/GYN.

Wow....Thank you so much....I hope we all try and somehow even remotely achieve the kind of care we would want delivered to us and our families. I can tell that you are the epitome of the kind of nurse we all strive to be...Thank you..

Specializes in MRDD.

I really don't have the words, just THANK YOU. thank you for your stories and thank you for the wonderful jobs you do. Sometimes things happen that are so hard even impossible to comprehend. I tell myself if we had all the answers then we wouldn't be here.