Published Apr 2, 2002
I don't know if this has been posted before--but I was just wondering what the best experience with death has been for other nurses out there (or anyone caring to answer). I know we deal with this topic everyday, but I never thought about it until this experience happened to hit so close to home.
I have worked in acute care for many years on a surgical floor. Most of our patients who die--end up coding and go out with many drugs, multiple IV lines, and broken ribs from CPR. The patients that are DNR's usually die alone in the hospital--occasionally with family.
When my father in law developed prostate cancer, I talked a lot with him about his wishes. He chose hospice care. They were very helpful. The day before he died, he began bleeding out. I had just given birth to my second child and wanted desperately to have grandpa meet Sean. He held out and on Saturday, two hours from discharge, I went to the house with the baby. Dad had been in a semi-comatose state, but when my hubby and I told him we had his new grandson, he opened his eyes and held Sean's hand.
He had wanted the funeral arrangements all completed, so mom and my SIL went to the funeral home. They had been with dad most of the morning saying good bye. Joe (my hubby) and I each got some time alone with dad. I was able to say goodbye and ask him to look my brother Danny up (who had died the year before--and who I did not get to say goodbye to). Dad actually smiled and squeezed my hand. He was able to kiss Joe once more.
Mom and Mel (SIL) returned from the funeral parlor--The TV had golf on in the living room (very loud), and the Catholic channel in the bedroom was having high mass, Dad sat up smiled at all of us (who were now gathered around his bed), he lay down and his breathing slowed down (we all told him it was ok to let go) and he took his last breath. It was the most peaceful experience I have ever had. I hope that someday when I die, I can have all my loved ones around me letting me know it was ok to go.
I don't intend to make this thread morose--I just wanted to share this experience with friends who I know will understand what I am saying. Peace.
Death, like life, should be viewed as a perfectly natural event! I hope my own death will be peaceful, and that my family are around me when I pass from this life into the next.
I've had the humble opportunity to hold the hands of many dying patients. Some passed peacefully, some passed painfully. No one should have to die without being surrounded by someone who loves and cares for them. It is a humble privilege and a blessing for nurses to be at the bedside of their dying patients in the way of support for the patient and the patient's family (or lack thereof) -- offering the patient whatever it is they need or want to make their transition from life to death. :)
Last week,I was privileged to witness the best death I have seen in a long time, perhaps ever.
She had fought a long hard and good fight to recover from bacterial PNX and I forget what else. She came off the vent. Then (I don't recall all the details) she went back on the vent. Anyway by the time I took care of her again, she was third spacing, output for 24 hrs was 300cc, BP Systolic was 70 to low 80's and diasystolic 30's to 40's.
We tried fluid boluses to no avail. I called the doc. and he ordered dopamine and I said the family was there so he told me he'd be right in
This family was intensely devoted all through the illness and everyone including the patient were very nice.
I expained everything I was doing and why and what was happening. The Doc arrived just as bp came up to 90.
He explained the severity of the situation and that we could keep her alive indefinately on machines. The family agreed but deferred to the husband. He said he did not want ever to loose her but he knew he could not keep her for ever and beleved it was inevitable that he would loose her at this time. He stated it was not what he wanted but what she wanted and made the decision to withdraw life support measures.
Then a little "miracle" happened. She woke up. This gave them the chance to say their goodby's. Then after some time had passed I explained how the dopamine allowed more oxygen to go to the brain etc. and that I believe that this is what woke her. They took this for the gift that it was. (not a sign that she would live) We put them in 100% control. We would not remove any life support until they desided it was time too.
She lived peacfully for 3 more days with them at the bedside. Her elderly husband holding her hand and declining to sleep in the other bed. They took care of each other and required very little from us even though we offered food coffee beds etc. They spared each other off long enough to go home to shower or get meals from the cafateria.
I was not there at the very last but I understand she slipped very gently into death with her husband holding her hand.
You cannot believe, (or maby you can. you are a nurse) the realease of tension and grief that came over thier faces when they realized they would get to say goodby as they fully realized that she was awake and cognizent. That gift made them relaxed and at ease with all the rest that followed.
She did not die in pain, struggling or fear. She was with those she loved the most the whole time. They got to say good by. Gee I'm all a quiver thinking about this marvelous family.
I am so very privileged to be a nurse an be able to even witness this let alone have a part.
Thank you so very much for sharing your story of your Dad's passing. You are one of those incredible families that I can only admire.
I have been witness to several deaths that have left their marks upon my heart. One I can think of was with Millie. Millie knew she had Cancer and took it in stride. She went through Chemo and all seemed to be better, then it hit again. This time she told her two very devoted children, I am ready to go, please let me go, just ease my pain. She asked us nurses repeatedly not to let her suffer. Through all of her pain, she never lost her ability to smile or bring laughter to the staff. She was an Angel!!! I loved Millie very much and promised her I would do all in my power to keep her pain free. The end was coming very near. Her children sat on each side of her. They felt her pain was increasing and asked that I call the doctor to increase her pain med, which I did. I cried as I prepared the injection, for in my heart I knew she would take her last breath very shortly. When I entered the room, each of her children hugged me and thanked me for loving their Mom and caring for her so devotedly. Millie was conscious as I leaned down and whispered in her ear that I loved her just prior to the injection. She smiled and told me she loved me and thanked me. Within 1/2 hour, she was gone, one child on each side, holding her hand, reading the Bible. I swear she had a smile on her lips as she left this world. Another death that has touched my heart was this very dear minister, she had been a missionary for over 30 years in her life. She had 8 children and they all lived in various states. It was Saturday morning when the eighth child finely arrived from out of state. They all were gathered around her bedside, gave her permission to go and then began singing her favorite gospel song in the most beautiful harmony one has heard upon this earth. When they concluded their song, they looked at their Mother and she had drifted off to her Heavenly home in the most loving manner I have ever seen. While dealing with death is very draining at times, it is also the most loving last gift you can share is to be their when they pass. I cannot imagine ever changing my field of nursing because I know I give my residents love, they know I love them and I feel very blessed to know them.
jeez, when I die I want to be left alone. The embarassment of my own death would be very depressing. I would not want to die, and would not want anyone to see me die. And I especially would not want to know that people would see me actually dead. please don't comment on what I am saying.
I held my fathers hand when he died. Although he could not speak, I kept talking to him, and the hospice nurse let us know it was coming. Well, I guess if I had wife and kids, they could be near me when I die, but I still wouldn't like it. My dad was crying, along with me, and my mom and sister. I thanked my dad in such a way for everything he did for me. I told him he really wasn't dying, because I was very much alive, and if his heart stopped, mine would keep on going, and my heart is really his. So much crying that my face was soaked.
The memory of that event is hard to live with, everyday. Death can not be nice if it's someone you love very much. For me, anyway. :-)
Over the years being privileged to take part in this holy passage I have come to the conclusion that people die as they have lived.
lonely die lonely, the angry die angry, and the loving die loved. the scared die scared.
The word that has been repeated several times in these postings is one that I use often when talking/thinking about being in attendance at a death--privilege. It is like being that much closer to God, sort of being a part of the Plan. I have often told people that I have gotten the same intense blessed feeling on the birth of a baby and the death of a dear person. And each of those situations IS a priviledge. Thanks for sharing.
The best one I have heard was a gentleman who lived in a LTC facility that I had worked in as a CNA. This man had a brain anuerysm.....he went home for christmas and on Christmas eve he had the best time...the family said it was great and he seemed to really enjoy himself that night he went to bed....the next morning he was gone. Just went in his sleep after a great evening with his loving family all around....and then peacefully drifted off happy and content and fullfilled...that's the way to do it.
I have worked has a homecare nurse for a period of two years and I have to agree, the best and most peaceful way to die is at home with your loved ones at your side. It helps the family memebers to bring closure at the same time.
I have not been as fortunate. My mother and sister were killed in a violent car crash and because there had not been a chance to say goodbye, it was difficult to put closure and for life to go on.
I honestly think that should a person have a choice, I would highly recommend death with dignity at home with your family at your bedside.
I worked as a hospice nurse, and witnessed not only the actual death, but the process of dying. What I came away from that with, was, people get real when they know they're dying. You really see people at the core of who they are. The other, and most important, is people who have a strong faith in God usually die peacefully, and those that don't are filled with anxiety, and terror.
I had a patient who had been in hospice declining for quite some time. One day when I visited, she was in a coma for about 2 days. When I started to do vitals, etc., I preceded to tell her what I was doing. She opened her eyes, and in horror she began crying out to God, "I'm sorry", etc. She was wailing in fear, and screaming out to God. I began to pray with her, and told her if she asked for forgiveness, and meant it, it was done. I expected this to be the last of her coherency, and she would die shortly after. Do you know this woman then recovered. She was outside within a day or two, playing bingo the following week, and within a couple months was discharged from hospice, and placed in a LTC facility. (prior to that, she was at her niece's, also a nurse, as she waited to die) I watched several patients speak with their dead relatives, prior to their own death. I watched patients reach out to heaven, and I knew they saw people, and spoke with them. Don't underestimate where you are at in your spiritual life. We never know when our number is up. Also if you're a person of faith, don't pass the opportunity to assist a patient in need as far as their spiritual life goes.
I am an Infection Control Coordinator now, and out of patient care currently, and have just sent out resumes to return to the hospice environment. There really has not been a nursing job I've had which is more rewarding than that. I have an interview next week. Wish me luck
Okay Angus, how do you die if you have lived a very proud life? Is it possible to die proud? Is it possible to die with a normal fear of death? There are many ways of looking at death, and not all ways involve imagined continuations. NativeAmericans wandered off to die alone. They didn't live in fear. And Vikings liked to be set on a boat and know the boat would be sunk, sometimes on fire. They didn't livein fear, but, they also didn't want to have people around them when they died. Those are just two examples of death that doesn't involve people moaning.
Bedside death is strong stuff. To see life=5...1..(0.5)...(0.25)...(0.05)...(0.00125)...(0.0008)...(zero)....and all the numbers in between.
If I caught a cancer, or something, and would be dying now, it would annoy me. I'd be angry, of course. There is no way I could roll over and play dead with a smile :-) And, Mario at age 75 might have a different take on things. I would want people to remember me alive, and not remember me dead, which is what they would do, if they watched me die. If I was 75 or 85 years old, and dying in a home, still, people would remember a helpless man that they watched die. That is the opposite of life, and, although many can not avoid this end, I'm saying that I would not like this type of farwell. I wouldn't want anyone to remember me as being put to sleep or anything. In no way does this subtract from any of your experiences, because, reality is reality and people die in hospitals here in America, and they die in homes, surrounded by loved ones, and it's a sacred event, no doubt.
It's just my opinion right now, that I would not want to die in such a way.
What I was saying Mario, is that People don't suddenly change and become wonderful people at the time of thier death, if they have never been wonderful. If they lived a lonely life loved ones don't suddenly appear to love and comfort at this time. And if they do the person still doesn't feel love. On the other hand a loving person whether he is surrounded by family and friends or is totally alone dies with a loving attitude.
Some people spend their whole life angry, resntful, bitter or what ever. There is no magic transformantion during dying that changes this.
Your spirtual view seems to me, to say that death is not on a continum with life. But the basic biological fact is until death is complete you are still alive. I agree death is not life. And I would never challenge your spiritual take on death. However, the process of dying is not the same as being dead. You do it while there is still life in you body. Feeling this part of life is "not living" does not change the fact that there is life in that body and mind. It may be not how you would choose living to be, though.
Mario I agree there are those who go out defying death. Who refuse to lie down with a smile as you say. It has been my observation that these same people live thier life this way as well.
I don't view this as a negative. I am a fighter myself.
People do die proud and I have been there when there has been the normal fear of death as well. I can understand wanting to die in privacy and and seen where this choice was also made. I have see where a private death was chosen without precluding what I have already said. (i've see very loving people choose to die this way. But they did it with a loving spirtit. I've see pople surrouded by other thier whole life and choose to go this way. I dont see this as lonely)
When a person is in such a position that he may choose a way to die (we are not always that fortunate) he may choose many diffrent rituals including solitude. But the essence of that person does not change and this is demonstrated in how he enters his chosen ritual.
Not all of us are fortuante enough to enter our chosen ritual. Sometimes death comes swiftly. Sometime we are physically unable to effect a ritual or make known to others what we want done at this time. So it is important to make it known now. People make post mortum arrangements (funeral, etc.) while they are alive and healthy. But sometimes forget to make arrangements for those desired rituals as they enter into the dying process..
This death that I told you about was with a family that was always there for each other. That never left one anotherin life or dying. This was a woman who woke with concern on her face, distressed that her husband was not there. because her husband had take a few minutes to go home and shower (after 48 hours straight at her bedside) When he returned and she saw him she smiled and relaxed. Clearly I think this is the death that she would have chosen. She was not in pain. She denied suffering and did not appear to be. She asked for anxiety and pain med when she needed it, to relax. Not all deaths are like this. Not all pain free. Not all relaxed. She was comforted and indicated it by the presence of others. She knew what was happening and she entered it with dignity and grace.
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