Best Death

[zumalong]

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.

[micro, RN]

Death

We will all

We come into this world

Very private

Very emotional

Very

For all involved

and we see it

happen to others

and care for them

because of our vocation

it brings out our humanity

our own mortality

our memories of

author---a nurse and human

[nursedawn67, LPN]

Originally posted by angele

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.

Angele

I lost my brother to a drunk driver doing over 100 mph, and almost lost his 16 year old daughter....So I totally understand what you mean about not getting a chance to say goodbye. It doesn't give you closure. Not a day doesn't go by that we don't think of him and try to make sense of the lose.

[zumalong]

Angele and greer128 I am so sorry for your losses. I started this thread because I have lost both my brothers to suicide and I did not have any closure with either death--probably never will. But when my FIL died we did have closure. It was hard to lose him, but at least everyone was able to say goodbye.

mario you are so deep. I like what you said to your Dad before he died- that as long as you are living a part of him will be also. I feel this way about those close to me who died. As long as I can remember the special things about them--they are not totally gone.

I don't think death is ever easy, or that we ever get used to it as nurses. But I do think that we can make a difference in how a person dies. We are the caregivers that learn all the deep secrets sometimes. We are the teachers who help family through the dying process. We are the shoulder that is offered to cry on when the person has died. We are also human and many times cry along with the loved ones if it was someone who touched our hearts. This is a large part of nursing. No other profession would take on this job.

[blitz]

Hi all,

Great thread, and interesting postings! It's really fascinating at how differently people look at death. I personally feel very privileged to be present at a patient's death. I try my best to make them as comfortable as possible, and if family is there, to accomodate them as much as I can.

At a hospital I worked at in Tucson, the staff had very definite superstitions about the subject This was on the ICU, and if a patient was suspected of being near the end, the room window was opened. Honest to gosh. I even heard someone during a code say, "Is the window open, for Pete's sake?" They all felt that the window being open allowed the soul or spirit to escape after death and that it wouldn't be stuck on the unit. There have been some-not-so calm deaths I've witnessed after which there did seem to be negative vibes. I'm not normally a superstitious person, feeling that I'm usually quite rational:) but having worked on this particular unit and now on another without windows, I prefer the window method.

Anybody else have similar experiences? Other superstitions, beliefs?

[Agnus]

Is it a superstition or a cultural belief that is common in this geographic area?

Sometimes we forget that there are subgroups that are not necessairly ethenic or racial that have different customs and beliefs from main stream america. Yet the sub group it self in all other ways is main stream.

my daughter and I grew up in a family and school that said looking a superior in the eye was defyant.

My daughter had a Japonaise boss. Who felt disrespected because she did not look her in the eye. My daughter explained it was cultural. The Japonise boss misunderstood and said she was not traditional Japonese and so it was not cultural.

My daughter explaind that it was my daughter's culture. Because my daughter appears and is main stream american the Japonise boss did not accept this saying that she (the boss) understood american culture and that my daughter was lying.

The fact is we come from a very closed french canadian getto with french canadian nuns for teachers. We come from a tiny town in northern NY. This was sacramento CA and the woman has no clue as to what my daughter spoke of.

My daughter quit and told me she could not make eye contact. I understand as that is my culture. And mainstream is also my culture. You would never guess.

[Catie]

I have worked in a LCF for 5 years and have seen a lot of death. In this setting I think death is a wonderful thing, I'm not saying it's wonderful to die but it's a blessing. I give my residents dignity, they deserve it. Most of them have lived wonderful lives, and some,not so good . I'm glad I have been there to hold their hand and tell them it's ok. I lost my mother of an MI when I was 20 I wasn't at home when it happened and I thank my lucky stars. I was at my brothers that night because I had clinicals. But I have no regrets because we were very close. I think now I've hardened myself to death because it can happen to anyone at any age at anytime.

[blitz]

Agnus,

In answer to your question, I honestly do not know. That was the only place I've ever worked that had that "ritual" going on. I don't think it was cultural, but a specific bit of belief for that unit.

[Agnus]

I think now I've hardened myself to death because it can happen to anyone at any age at anytime. [/b]

Please, allow yourself to experience your feelings. I know people have at time thought I was hardened but I always privately cry, chant, feel, meditate after a death. It will destroy you if you deny your feeling. It may not be appropriate to do this with other's around or at work but it is appropriate.

Remember it WILL happen to everyone of us.

[micro, RN]

Originally posted by zumalong

...................

I don't think death is ever easy, or that we ever get used to it as nurses. But I do think that we can make a difference in how a person dies. We are the caregivers that learn all the deep secrets sometimes. We are the teachers who help family through the dying process. We are the shoulder that is offered to cry on when the person has died. We are also human and many times cry along with the loved ones if it was someone who touched our hearts. This is a large part of nursing. No other profession would take on this job. [/b]

zumalong.......great thread and thoughts......

we have all experienced loss and yes this loss is so personal and so ........................

please zumalong and all...forgive me for removing part of the quote.....as all the words above are very very meritted.....but space is taken into account per micro more lately.....appreciate is a better word.....

I think all that we can do is be human in our nursing and give to all what is needed to given at that time.........of death or approaching death.....to the patient and even more sometimes to the others remaining.......

beyond that death and the feelings left behind way too personal for even this bb...

lol to all,

micro:zzzzz :zzzzz :zzzzz

[mario_ragucci]

My mom died in her sleep, and I was away when it happened, although I was living with her after my dad passed away. She encouraged me to take this job that required off shore work ($).

My mom and I shared a great deal of time together after dad died. Being the youngest in the family, and single, I considered it a privilage to live with her, and my duty, in a way, to return the favor of making me.

My mom did not want anyone to see her dead, and made that known to us, especially me, since I was living with her. Very proud woman.

I had absolutely no desire to see my mom dead, because of her wish. My last memory of her alive was of her kissing me goodbye before I left to go off-shore for a week.

My brother, sister in law, and sister left me in the room at the funeral home (they flew in from out of town) while they went to look at my mom. Knowing my mom would NOT have wanted that was tough on me. I told them, and they knew, but they viewed my mom anyway.

When they came back into the room, after viewing my mom, my sister in law, and sister were crying. My sister in law said "oh Mario, she looks beautiful." I never thought I could hate someone so much as I hated her for saying that. My sister said I should take a look, that she looks so peaceful. I never felt so opposite a person after she said that. They knew my mom didn't want any viewing or anything like that. I lashed out at my brother for disrespecting mom like that, but her wishes didn't matter to him, like they did to me.

I will never feel any love for them after that day they viewed my mom.

:zzzzz

[BarbraJean]

This has all been very interesting. I have worked in Nursing over 15yrs. some in Emerg/CCU, long term care & Most recently as a Palliative Nurse in the community as well as at Hill House Hospice in Richmond Hill, Ont( a3bed free standing hospice unit that takes people in the last month of life)I have witnessed many deaths The most peaceful of which are those in home or in our hospice. A palliative nurse educator one told us that people who are dying don't follow the textbook, forget Elizabeth Kubler Ross. People die how they feel comfortable. We have a patient in our hospice at present who quite plainly told his family to " go away and let me die in peace" Death is so individual for as many deaths I've been privileged to be at that's how many different ways there are. Also how we feel about death & dying also colour our outlook on those making the journey Barb

[rncountry]

Oh, Mario! I feel deeply distressed for you. While you respected your mother's wishes, and did what you felt was right perhaps you can try to understand the need of other family members for them to say goodbye? I likely have no right to ask that from you, but the obvious pain and anger radiates out of your post. To carry that much anger and bitterness will harm no one but yourself. I have watched that kind of bitterness and anger consume my own mother, making her, ultimately very difficult to be around for a great length of time. While I don't mean forgetting what happened, because you know that would be impossible, but forgiveness can be very freeing to the soul.

It has been a year and a half since my dad died. It was then that I started posting here regularly, it was his death and the circumstances around it that made me an outspoken proponet for change in not only my profession, but in healthcare. Mario, my dad was a Christian Scientist. He did not believe in the modern concept of healthcare at all. He ended up with melanoma, a little spot on the top of his head, a little area in which his hair had thinned quite a bit. If he had treated it initially it would likely have been no big thing, and he would have went on. But because of his religion he did not. I never pushed for him to do what I truly felt would be the right thing to do because I knew how important his religion was to him, though I do not share his beliefs. My stepmom convinced him to see a doc after he had seizures at work. The melanoma had metatasized as mult. droplets down the occipital region of his brain. He started going through radiation therapy. I knew nothing about this until about 2 weeks into the therapy. My dad called me (he lived in Tennessee, me in Michigan) and just the simple act of him calling I knew immediately something was wrong. We "talked" mostly through email. At first all he would say was that he and my stepmom were planning on downsizing their home and he wanted me and my sister to come to their house and let them know what big pieces of furniture we wanted. The whole thing took on a surreal feeling for me, I simply could not have imagined that conversation in a million years, so I kept asking what was wrong, what was going on. My dad then began weeping. That was so bizarre I knew before he told me that he was extremely ill. Actually it was my stepmom who ended up telling me because my dad simply couldn't. I found out everything that was happening 2 days before I, my family including my sister and her son, were going to Hawaii. You need to understand that my parents divorced when I was 8, and Hawaii was the last place I had lived with my dad. He was in the Navy, traveled extensively. I had also spent years angry refusing to speak to him. It had only been in the last couple years that relationship was repaired, and only in the last year before he died we actually had a good relationship. Going to Hawaii became so much more than the vacation I had been dreaming about for years. I did not tell my sister until after we came back. She had been born there but was only a year old when we moved so she had no recollection like I did. I am 7 years older. I did not want her time there to be clouded. The following weekend after I got back from Hawaii I drove myself and my sister to Memphis. He looked like his normal dashing, handsome self, except he had lost weight and he was always very trim to start with. He hid the nausea, the pain very well. And we talked about things we should have talked about years before. This was the last time my sister was to see him alive. She still had a great deal of anger towards him, she somehow never got past the my parents divorced and my dad didn't see me thing. She is 30 and still hasn't. She can't seem to grasp that he remained in the Navy and in the years following my parents divorce and his retirement from the Navy he had been in California, Florida, Spain, Germany and Iceland twice. He was in and out of Memphis.

Shortly before my dad died, my stepmom called me because he was having difficulty with his left leg. He couldn't put any weight on it without severe pain. An xray had been done a couple days before but they did not see any extension of the cancer like had been expected and they sent him home. He was 6'4" and my stepmom 5' flat. So they sent him home and she was trying to help him into the bathroom etc... just imagine the difficulty. She tells me that he is thirsty constantly, that he is urinating much more than normal. At that point I asked to talk to him myself. Alarm bells are going off in my head. I know he has been taking decadron at heavy doses to help reduce the swelling in his brain, I know that blood sugars must be watched carefully with this medication. I talked with my dad, and for the first time since I found out he was sick I got an entire list of what all was happening with him. My dad was a very private man, and he was embarrased to be talking about physical problems with his daughter. The short of this is that he was in full blown diabetes from the decadron, no one had been taking blood sugars despite them taking blood every day M-F when he was going to radiation therapy, and no one had followed up on a leg I was positive had a blood clot in it. It was later in the evening when I got this phone call, but first thing in the morning I called his physicians office and asked about blood sugars, and doppler studies. I was not nice. At one in the afternoon I got a phone call at work from one of my stepsisters, telling me that she thought my dad was going to be put in the hospital, the doctor had called and wanted to see my dad right away. She felt I needed to come down asap. I called my dad as soon as I got off the phone with her and talked to him a minute before he left to go to the hospital. Told him I was coming down and was bringing my family with me. He asked me to bring my sister and her son too. Now Mario, here is the biggest point to the whole story. She wouldn't go. She didn't feel she could "deal" with it right now. I offered to take my nephew at least, she refused that as well. So me, my husband and kids went alone. By the time we got there emergency surgery had been done on his leg to attempt a bypass as there was a clot in the leg, and the lower leg had been without blood flow for 6 days at this point. The bypass was unsuccessful. The care he got in the hospital was horrid. His nurse had 12-14 patients alone each day he was there. Those conditions were enough to upset me greatly, but it was even worse to know that he had wanted to see my sister, to see my nephew that he had never met, but that my sister had denied that. You have to understand he was not some bad person, he had done nothing except decide that he couldn't live with our mom, and continued his Navy career. To avoid any ackwardness we didn't discuss her decision.

I stayed in Tennessee for 9 days, came home because the kids had to start the school year. My dad had to have the lower leg amputated, which was done after I came back home. He took that better than I did. I was furious at my sister, furious at the healthcare system who had taken this man who had not seen a doc except for the yearly checkups demanded by the Navy, and in my opinion his piss poor doctor had butchered him by pure negligence by ignoring and not doing the simpliest tests. My dad was at the doctor's office for followup on the stump that was not healing, when he grabbed his chest saying it hurt and crumpled. He died almost immediately. This was just two weeks after I had come back to Michigan. I was so angry with my sister for not having been able to get over what I considered very childish feeling, and for not being able to consider his feeling. When we all drove down for his funeral, the whole 12 hour drive, I simply could not bring myself to talk to her, or even acknowledge she was in the same vehicle as I was. At the time I felt that she shouldn't even go to the funeral. If she couldn't be decent while he was alive, why try now?

Eventually though I realized that she felt worse about having not gone to see him than I did. And of course my attitude did not help. And I think everything I was angry about, she got the brunt of it all. Mario, I will never forget what happened, but I have forgiven. Not easily, mind you, but I did do it. Whether that met anything to my sister I can't say, but it took a whole load off of me. I have yet to forgive the healthcare system though. I don't know that I can ever do that. My dad's biggest fear was that he would lose his mental capabilities because of where the cancer had mets to, before he would die. He talked to me about that frequently. I felt that while many other things happened that should not have, he at least died with his full mental abilities like he wanted.

I know this is a long post, and maybe it doesn't mean a thing to you. I just wanted you to know that I do understand your anger with your family, I have been there. But carrying that around with you will only harm you, it doesn't affect the person you are angry with. Your post just really touched me because I have felt that same way. I hope time will heal things for you.