A New Nursing Grad Witnesses a Death

As a young nurse, I stayed and prayed with an elderly woman for the last 15 minutes of her life. I was touched by the holiness of the moment. My nursing instructor's important words were reinforced: "Always talk to your patients when they are unconscious, for they WILL hear you." Nurses Announcements Archive Article

Many times during my career, I'd have a flashback while I went about my daily routines. I would be right back in the classroom, hearing all over again what an instructor had to say...

"Always talk to your patients when they are unconscious. For they WILL hear you," lectured Miss Petit, one of my nursing instructors, with her usual voice of authority.

This advice proved true over the span of my nursing years, as I cared for countless patients. Also, it should be said, with some of my own family members. Many of them while in comas. And some of these had what is now known as near death experiences.

Poets often describe a lifetime as a bridge or a road. If that is the case, then a nurse finds herself walking alongside other people's roads. At both ends. We hear the outraged cries of a newborn baby, and the joy and laughter of the adults gathered around in the birthing room. We are there when a terminal patient breathes his last. It is part and parcel of a nurse's routine to be reaching out to unconscious patients and those who are close to death. It is never a moment to be enjoyed, but being next to a human being as he or she takes that last breath is an unforgettable, and holy experience. The road has ended, and they pass through that final door.

Mildred was dying alone in a city hospital, where I worked as a new grad in 1969. We were not even checking her vital signs-just doing care and comfort and expecting to find her gone at some point.

It was about 3 in the morning when I was making early rounds. I was actually doing this mostly to keep myself awake, for such rounds were officially done at 4 am. Walking helped.

Her breathing was slightly irregular and restless. Her face was covered with wrinkles. I remember thinking that she likely had a million stories behind those wrinkles. Her hair was a thin, ashen gray and pulled back into a bun. She laid on her right side where she had last been positioned by me about an hour before. Not much urine in her catheter demonstrated that her body was continuing to shut down.

I looked at her more closely, and tried to see the person who once lived behind all those wrinkles. The young girl who laughed and ran in the sunlight, full of life and promise. The one who held hands and kissed a fine boy in the shadows. The woman who proudly carried a baby in her arms. Maybe she was a teacher. Maybe she built airplanes during the war. Did she play cards, or did she play a piano? Did she dance on a piano? Did she sock a brash young man in the eye when he got fresh? Or did she snuggle in his arms when he tried for one more kiss?

She wore a single Catholic medal of the Virgin Mary on her neck. I looked her over, up and down the length of that small body under the blanket. She weighed maybe 80 pounds and was about 90 years old. She wore a hospital Johnny. One of the hospital's standard issue. Another sign that no family was around, not even to provide nightgowns for her. Alone, and utterly forgotten. Abandoned. Hospitals have many of these. Nursing homes are full of them.

I pulled up a chair, gently took her frail, thin-skinned hand and squeezed it. As I expected, there was no response. I squeezed again, and I took a deep breath.

"Mildred, I know you can hear me. Remember me? I am your nurse, Andrea. I have been taking care of you tonight. It is about 3 in the morning. Did you know that you are not going to live long? It is time for you to think about letting go. I see you are wearing a necklace with the Virgin Mary on it. I am a Baptist-I hope that does not offend you. I do not know any Catholic prayers. But I do know the Lord's prayer, which I know that you know also, as a Catholic. I hope it is OK that I say this with you now, and also that I am going to pray for you to have peace."

I prayed for her in a soft voice.

I sat with her for several minutes after I finished praying. All around me, the hospital was still and quiet. Her breathing became quieter. Then suddenly, her face became most peaceful. A few of her wrinkles disappeared, and her whole, entire body relaxed. She released her urine, and gradually her breathing stopped. It was a most holy feeling moment. My first bedside death.

There is no question in my mind there is an afterlife and that we will meet people we have encountered in this life. I hope Mildred is one of the first to greet me.

What a beautiful post. Thanks for sharing!

Specializes in Med Surg - Renal.
Very touching, thank you for being with her in her final moments, we need more just like you!

MN-Nurse, you are entitled to your opinions but please don't speak them as fact (especially since you said "but that doesn't matter"), I'm sure you have never experienced the "afterlife" as you are speaking here today, so please show a little more tact in your posts.

Of course I haven't experienced an "afterlife"; there isn't one. Consciousness doesn't survive without a functioning nervous system. This is not an opinion.

And if stating an opinion about supernatural beliefs is, as you seem to imply, tactless, then please admonish all those who state beliefs on the subject either way - negatively or positively.

The reason I pointed out that "It doesn't matter" is that we take care of patients regardless of whether we think we will meet them later in a supernatural realm.

You seem to be confusing the words "fact" and "opinion".

Specializes in Neuroscience/Brain and Stroke.

MN-nurse

I'm not saying that you cannot state your opinion but to state it as fact is TACTLESS! The afterlife is a BELIEF, not something you can explain away. In one of your posts you rediculed another nurse for not informing herself of a patients beliefs before she said it's time to meet Jesus, rightly so, she should have. My point is, the OP stated what her belief was in her post and you dismissed it as if she were foolish, that is hypocritical and tactless, I stand behind my post.

It really is very sad how few people do this. Sadder still, I think, were the number of nurses & CNA's who mocked me when I did it. Several made statements in the room, with the patient, such as "Why do you always tell him what you're going to do? He can't hear you." Some laughed in front of the patient. Although it's been many years since I've experienced this, it still makes me sad to think of it.

I was taught that sitting with a patient who is dying is part of my job, and I was also taught to talk to unconscious patients and tell them what I am about to do. I think most of us were weren't we?

Very very sad indeed if there are some who feel it's unnecessary, I consider it an honour to be present and sitting beside the bed, holding a hand or stroking an arm, or talking softly to a patient, or just being there, when they die.

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I just read the story and it is very touching. Nowadays, because of too much workload, sometimes we forget to really accompany our patients in their bedside. Just for a moment. It is wonderful that by sharing this story, I am refreshed and reminded of what our other job description is, that is, to provide spiritual care. Thanks a lot!

i truly hope this thread doesn't become sidetracked, about whether there is an afterlife or not.

(however, it would be an awesome subject for another thread, yes?)

andrea, nicely done.

it's always heartening to hear of peaceful deaths.

i wish dying and death, was talked about more frequently and openly.

managed correctly, there is nothing to fear.

andrea, just something to keep in mind with future deaths.

when you saw mildred's face relax, to me, that was indicative of her needing more pain mgmt prior to her death.

our ideal, is to attain that *relaxed* facial expression when active dying begins.

clearly, your heart and desire are in the right place and for a first death, you handled it exceptionally well.

bravo to you. (i miss my balloons. :))

leslie

What a powerful example of the kind of nurse I want to be. I was recently really bothered by a very different example of nursing I witnessed in an ICU. The patient was a woman who spoke no english. There was no way to communicate with her verbally in any detail without using the translation phone. But it really bothered me that the nurse I observed didn't say a single word to her. The nurse simply walked in and started "doing" things to her without even a smile, a kind word, or an empathetic touch (even though she might not have understood it). The nurse was not exactly gentle either. Many hours passed during the shift with no attempt to communicate with the patient through ANY means - verbal or nonverbal. It strikes me as odd that people regularly "talk" to their dogs and cats and we all know that these animals pick up emotional meaning from this even though they don't understand the words and yet we don't think that our unconscious patients or those who speak another language need to hear our voices. Not coincidentally, this nurse later told me that the nurse's goal was to complete 2 years in the ICU to be eligible for CRNA school. That was the end-goal for this nurse, not CARING for patients.

What a powerful example of the kind of nurse I want to be. I was recently really bothered by a very different example of nursing I witnessed in an ICU. The patient was a woman who spoke no english. There was no way to communicate with her verbally in any detail without using the translation phone. But it really bothered me that the nurse I observed didn't say a single word to her. The nurse simply walked in and started "doing" things to her without even a smile, a kind word, or an empathetic touch (even though she might not have understood it). The nurse was not exactly gentle either. Many hours passed during the shift with no attempt to communicate with the patient through ANY means - verbal or nonverbal. It strikes me as odd that people regularly "talk" to their dogs and cats and we all know that these animals pick up emotional meaning from this even though they don't understand the words and yet we don't think that our unconscious patients or those who speak another language need to hear our voices. Not coincidentally, this nurse later told me that the nurse's goal was to complete 2 years in the ICU to be eligible for CRNA school. That was the end-goal for this nurse, not CARING for patients.

So sorry you had this experience. Starting in 1979, I worked 12 years full time in ICU--in charge for 6 years. Some nurses were what I called technical nurses who got more involved using the new toys which ICU had than for delivering personal, touching care. Some had a high opinion of themselves because they were ICU nurses, and a few were less than cordial to other nurses. That exists in every profession.

I always talked to patients--especially when they coded. The team loved to tease me about this but I never stopped. In my book, I detail an event where one patient unexpectedly straightlined, He was a gruff man, not a believer in any faith. He reported "I was in this dark tunnel. Something holy was calling me but I did not want to go yet--so I kept walking in the direction of your voice. Then I found myself here back in my bed." He lived another 15 years. No one poked fun at me after that.

So KEEP ON TALKING!! The patients hear you! I have the impression you will be a wonderful nurse.

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I understood what you meant. No offense taken on how you worded your remarks.

We each have our own beliefs. Mine are unshakable. I respect every person I was priveledged to be with at the end of their life. I prayed silently for each one--but I never ever pushed my personal beliefs on them nor their families. I can not recall, in fact, that I ever prayed aloud again with a dying patient

I did my best to support their faith --or lack of--despite my personal urges to share my thoughts. My personal observation is that those with no faith tend to be the ones who fear death the most.

There is no question in my mind that there is an afterlife, either. My son died on the operating table twice. He was bleeding out. The surgeon turned grey when he was told, by my son, of the events that he experienced. My son described to him, in great detail, everything he saw and witnessed regarding the surgery, even though he was completely under. The surgeon had stopped the surgery, and closed, because my son was at "the point of no return." So he believed what my son told us, as he knew he had lost him twice.

My mother in law shared a similar experience to your son's. She was having her kidney removed--about 1947--and could clearly hear the conversation in the O.R. She thought this was strange--then she realized she was breathing funny. She said to me 'But then I was looking down on myself to see I was not breathing but what I heard was the doctor trying to get a BP on me" Then she related that she thought about wanting to raise her 3 so she made herself get back into her body.

She had 3 other near death experiences--a few years apart much later in her life when she coded for different reasons. Her lifelong faith was very stong but she did not report seeing anything holy or un natural in any of her events. She did describe a feeling incredible peace during one event.

She lived until 1985 and died at age 73.

It really is very sad how few people do this. Sadder still, I think, were the number of nurses & CNA's who mocked me when I did it. Several made statements in the room, with the patient, such as "Why do you always tell him what you're going to do? He can't hear you." Some laughed in front of the patient. Although it's been many years since I've experienced this, it still makes me sad to think of it.

Do not let anyone stop you from talking! Absolutely people hear you! Patients are in such a fog--they need to know what you are doing before you touch them.

My first ICU lesson was sitting in the classroom with the lights out, and the instructor tape recorded all the sounds going in in the ICU. I will never forget the voices, remarks, laughter and off things I heard. Another lesson I never forgot.

My dad was injured and comatose with a high fever in WW2. Penicillin was brand new and in very limited supply. He heard the MD telling the nurse he was unsure if he should waste the medication on him. The nurse told the mD that she saw a ltter dad had on him from my mom telling him she delivered their first child--a son. My dad said he was thinking : "You *&!*#@!, you better give me that stuff". The MD finally said--"OK one shot--if he does not respond, then let nature take it's couse"

Were it not for that nurse, I and another brother would not be here! GO NURSES!!!!

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