How Far Can You Nurse?
Nursing is everything, as a whole but we can never draw a line between science and religion for an ill patient's will. This is a story of a patient whose religious belief matters most for his preparation towards death that between science and religion, he chose the faith from his Creator that no matter how difficult it was for him, considering that pain he is having, he neglected to acknowledge it for him to fulfill his religious responsibilities as a believer and a follower.
It was the first time for me to be far from my family. I decided to work as a nurse in the middle east since 2002. It was a new experience. Particularly in Riyadh where the center for muslim religion can be found. I was not the religious kind, but as I stay longer I fully understood the importance of faith and belief especially during time of despair when a person is about to meet his Creator. Hospital is not a nice place to die, well, considering that dying is not an event to look forward to, but, really the hospital is not the place.
I nursed a patient who is fully aware of his disease - advanced stage colon carcinoma placed under palliative's care with 3 signatures for NO CODE. You see, the culture in the middle east is quite complex if I will pattern my practice from the place where I come from - Philippines. In the middle east, the family take a big consideration of the patient's feelings. The family would know the disease of the patient and the patient will be the last person to know, but with my patient's case, he firmly stood for his right to be informed. There were other complications involved as my patient is 95 years old with diabetes, colostomy, pressure sore on the sacral area, bedridden and skin and bone but because of his educational attainment as a lawyer who practiced outside middle east, it was easy for me to communicate.
I had my last 3 day shifts with him that only with me he revealed he feels he is dying. He asked me if I could be a GINNIE granting him his last 3 wishes to enjoy life. I agreed telling only to the possible ways as I told him I am not a real GINNIE, then he would laugh out.
Wish number 1 is to place the position of the bed towards the direction of the QIBLA - direction of the holy mosque since he is occupying the whole room as he is for contact isolation. Without hesitation I granted his wish. Then he said that will be for that day as he knows I am still having 2 more days for him.
I didn't realize that he is already starting to recite the SHEHADA - a part of the Holy Quran consisting of a powerful prayer for the body to be cleansed as the spirit is preparing to leave earth. He became quiet. The family, ob visiting hours were worried that he does not have the appetite for his meals.
The next morning, he greeted me with a smile although he is looking pale, I did not tell him so. I still want to make him feel confident like the old lawyer that he was. He told me his angel reminded him of his second wish. He asked me to tell the doctors to discontinue the medications as he knows there will be other patients that may benefit from the medications that will be issued to him, instead. Right in front of him I paged the physician and the physician knew why and second wish has been granted. He told me, tomorrow I should prepare for his full bath. Then I knew that his time will come.
He was becoming restless that night as he knows the night shift will be giving him a bath. The night shift was so ashamed to hand him over to me as she could only change his diaper and the rest of the cleaning he said will be done on my shift. The whole shift, I was so patiently waiting for him to tell when I can start bathing him. He said, "I am waiting for my daughter who is coming from the eastern part. Of all the children that I have, she is the only one who cannot tolerate seeing me this way. I want you to wash me the best wash I could have so that when I die today, at least she will see me as handsome as I was. She will be with his MUTAWA (muslim priest) husband who will see me then will pray over my soul. Then you know that my time will come."
It was almost 3pm when I finished bathing him with his wife. I never saw the wife crying at all. She was even telling jokes, which some I am not well versed of since they were in arabic, but the mere fact that the laughter was so loud, I just laughed along believing it was really that funny.
He asked me to place him under a white sheet only. Few minutes after preparing him for his visitors, the call for prayer is announced. Then he started to gasp breath helping himself to wait until the daughter arrives. When his daughter came, my patient greeted her. Telling how he became happy for his last 3 days with me and how patient I was with all his wishes. I was asked to leave the room, then the MUTAWA started to pray over. The male relatives were all waiting outside the room. And when I heard the daughter's cry, I knew he already passed away.
I have learned that it does not matter which part of the world we may be, death is a phase in life where we all need to be prepared of. It was a challenge on my part trying to understand and adopt on what my patient is trying to tell from the wishes he asked, If I have become the kind of nurse who will only think of what the doctor orders, what due medication is to be given and how long I can only stay with him to attend for my other patients, dying for this particular patient may not be as easy as it had been. I have to coordinate with my charge for a lighter load for my other patients as I relayed to my charge nurse his wishes that might consume considerate time for me to handle him. I knew I had done something great for him and his family.Last edit by Joe V on Jul 26, '13
Jul 26, '13 by NurseDirtyBirdDeath happens everywhere in the world, and I'm glad you were able to help this person have the experience they wanted.Jul 26, '13 by NRSKarenRN, BSN, RN ModeratorThank you for having open ears to hear this man of a different culture. Helping a patient attain their final wishes, dying with peace and dignity is one of the greatest experiences a nurse can provide. We learn so much from the lived experiences of our patients, growing and adding another skill to our bag of nursing tricks.Jul 26, '13 by jerolezIndeed, dear colleagues. It was an experience that changed my views towards ill patients. Thank you.Jul 26, '13 by bebbercorn, BSNActually got a little misty. Thanks for sharing, what a lovely experience!In NURSING, the books are not enough for the experience. The worthwhile will be the patients that will change our skills more often. Thank you.Yes, it was. The tough part is I have to pretend I am not affected for him to identify me as a strong cane as he walks through death and dying.I believe a lot of nurses could relate onto this. That we are handling lives and that our creativity in dealing with critical things towards patient care depends mostly on how we wanted to be treated, as well. And there is nothing more important than to receive the care we could provide if we were our patients.