Best Death

judy ann · May 9, 2002

Some of the strangest looks I have gotten from my cohorts have been when I made the statement "I find it a priviledge to attend a death" Even those who are in LTC think that is "spooky". I'm glad to hear that others feel the same way. The only way I can discribe the feeling that I get is to compare it to the feeling I have at the birth of a baby. My friend says that birth and death are two ends of the same spectrum. To me, both are a miracle, and a priviledge to attend.

micro, RN · May 9, 2002

Originally posted by mattsmom81
.........
After 25 years in nursing I can truly say there are many things much worse than death. I look at death as the final stage of life in this dimension.........

mattsmom81......

thought your statement was very much worth the requote to me at least, so i quote you.....as your posts are always wise and well thought out.......

micro

postin out to #999:zzzzz

nursejws · May 9, 2002

I'm just a student, but I have witnessed the death of my Dad and my Grandmother just six months apart. I didn't know my Dad was ill until he'd been in the hospital for almost 2 months. I'm very close with my parents, so if we're not talking to one another or exchanging emails, something is wrong!

For weeks I had been telling my husband something wasn't right. Finally, one day at work, I called the nursing home where my Grandmother usually stayed when my parents would go out of town for the weekend. She had alzheimers, so they would let her stay at the nursing home, which she thought was the "O" club. Anyway, I called the kitchen manager to see what was going on. My Dad and I have the same name, so it startles people some times when I introduce myself. She told me my Grandmother did not get admitted this time and hesitated on telling me the truth. I persisted that she did, then she told me my Dad had cancer and had been in the hospital in Denver. I jumped up out of my chair and ran out the door trying NOT to let the dry heaves get the best of me. Obviously I could not work the rest of the day and after I told my office mate what happened she told me to go home and get the rest of the story.

I called each and every one of my siblings DEMANDING to know wth was going on! Finally my Mother calls me and tells me "I didn't want you to worry...blah, blah, blah". I later found out that those who knew what was going on were forbidden to tell me anything, which only pissed me off more. Even though he's my biological Father and Dad, he's their Dad too.

I did make a surprised visit to see my Dad while he was going through his treatments. I had 24hrs to decide about this trip...thanks to priceline.com, I was able to afford the ticket. My sister and I were going a week later, but I was returning to school so I had to act fast. She ended up spoiling the surprise as she felt like she was being left out WITHOUT hearing the WHOLE story.

One of my brothers lives in Denver so I stayed with them and they would drop me off at the hospital early in the morning and pick me up later in the evening. With the radiation and this other experimental test that turned him GREEN he slept alot! I did get one whole day with him by myself. We went to Mass and then he went to confession(I didn't think he'd ever return. =) ) It was during this time he asked me to stop smoking.

He was responding to treatment very well and I was feeling confident that he was going to beat this. Then one Sunday night I get an urgent phone call from my brother in Denver. It didn't look good and I was advised to get to Denver STAT! Couldn't get a flight out that night, got the first one in the morning. My poor Mother was so worn out, she had bronchitis, wasn't eating, nothing. When I saw my Dad I couldn't believe it...he had all these wires and hoses everywhere. His heart was beating so fast I thought it was going to explode. They had him tied down to the bed and he was sedated. He always had one of us at his side. I'm sure the nurses in the ICU weren't too happy about it at times but they were as accomodating as they could be.

To make the longer story short...he passed away after being in the hospital for about a week. Everyday he made baby steps to improve but did not wake up and had diffilculty breathing on his own. My Mother made the decision to take him off the support as his wishes were, "give me a try and if I don't respond, let me go". About 4 hours off the support, me holding his right hand, Mom holding his left hand, he took his last breath. He didn't die of cancer, he died from pneumonia. His oncology Dr. had a CT scan done before he was removed from support and the tumors in his head were not visible. They had once equaled a quarter of his brain.

I miss him like hell and it still hurts. My parents were soul mates, who had reunited just 6 yrs prior after having been divorced for 15yrs. 7 of the 8 children had been there at one time during that week. It was during this time I met one of his other daughters from a previous marriage. My Dad had 3 girls (including me) and it is said the 3 of us look alike.

Six months after my Dad passed away, and right after my Mom moved from NE to OK, my Grandma passed away. The eery thing is the that my Grandma lost her husband and Mother in the same year too. I hope history does not repeat itself, I will not be able to handle it. My Grandma died the week before my vacation where I was to be visiting with her. Once again, we were always in her room so she was never alone. The first night we got there, I stayed in her room with her, holding her hand and my Mom slept in my truck downstairs with her cat and dog. Luckily the next day we got a hotel room and the cat and the dog were boarded at the local vet. The day my vacation started, right as we were heading to my Moms, my husband was admitted to the hospital. I cried when he was discharged and I parked in our parking space because he came home unlike my Dad and Grandma. I miss my Grandma...she was one tough cookie!

Thanks for letting me vent. I have been needing to get this off of my chest for some time as it still hurts. I get upset just thinking about the plans my parents had...they had bought an RV and were going to start traveling. At 31, and the baby of the family, it's hard seeing and realizing that your parents are getting older. I NEVER saw my Mom age as much as she has in the last 2 years. Words cannot express how I will feel, or what will happen when I lose my Mother. I know death is a natural process, or should be, but she is my rock! I think I was 5 or 6 when my Great-Grandmother passed away, but she told my Mom that I would be the one to take care of her...and I intend to do just that. Social security does not provide very well for my Mother. After all she has done for me, and continues to do, she can have whatever she wants. She doesn't ask! So when I've got some cash to spare, I tell her to save it for HERSELF for one of those rainy days.

Again, thanks for letting me talk about this.

Agnus · May 9, 2002

nursjws,

Thank you for your story. It is seldom I read post with the rapted attention that I read yours. You have given us the the other side of the picture. It is hard to know how families see these things and to really know what they go through. Bless you.

zumalong · May 9, 2002

nursejws

So sorry for all your losses. When I started this thread, I just wanted to vent some of my feelings of loss in a positive way. I am glad that I have given you a forum for helping with your losses. (I lost my 2 brothers to suicide in 1997 and 2001--and my father-in-law in 1998--4 days after my Sean was born).

I truly believe that there is some kind of afterlife. I also believe that some people can contact the other level (or whatever you want to call it). What bothers me about John Edwards is that he has commercialized others suffering.

mattsmom81 · May 9, 2002

Zumalong, I feel the same way about John Edwards...didn't want to comment earlier because I thought I might offend someone who liked what he was doing.

The exploitation of strong emotion in people always troubles me...The shock TV shows like Maurie, etc. bother me too..with the anger, fighting, screaming...ecchhh..

I'm glad your thread is helping people cope with their losses too. It is so hard to lose a loved one...I miss both my parents very much...still hurts... I try to remember the good times and 'make a memory ' for their grandchildren to know them by. (((HUGS)))to all!

And thank you Micro for your kind words...I enjoy your posts too!

(You're getting close to the magic number aren't you?) LOL!

boobaby42 · May 12, 2002

It is so amazing how similar these posts have been about death. I too was at my father's side when he died. He had lived with me as he slowly withered away with his terminal CA. He did not go without a fight. But, he was staying alive until he knew his daughters would be ok. After fighting that good fight for months, my husband took his hand and said, "Don't worry, I'll make sure your girls will be alright." He looked upward as if looking at an angel, closed his eyes, and took his last breath.

It is true, the end of the life cycle is as much a miracle as a birth. I would not trade being there with my dad for all the money, miracles, in the world. You can't imagine how much I grew, both spiritually, mentally, and emotionally.

whipping girl in 07, RN · May 12, 2002

I had my first patient die on me my first day out of orientation in the ICU.

It wasn't as bad as I thought it would be because the family was expecting it. All he had going was a MSO4 gtt that I was titrating. I am just thankful he waited 30 min after I went up on the gtt to draw his last breath. Not sure I could have handled being the one to hasten his death.

I had my second patient die last Wednesday at 3:07 AM. Taking care of this patient was the single worst experience of my life. End stage renal, bilateral AKA, comatose, eyes fixed and dilated the last two nights I took care of her, multiple decubitis ulcers including a stage IV that stretched from the midthoracic area of her back to her tailbone...you could see her iliac and spinal cord. Even that is not the worst part.

She was a full code.

We almost coded her the second night I took care of her. She went from breathing 40 BPM on a 40% VM with sats in the 90s to 16 BPM with sats in the 70s. Weren't real sure about accurate sats since only place we could put the sensor was on one earlobe (other ear was almost gone from decubitis and all fingers had decubitis). So we drew stat ABGs and her pH was 6.9! Called the doctor then the family, who didn't want her intubated at that point. Put her on 100% NRB mask and hoped we wouldn't be able to revive her when she coded.

3rd night: we intubated her. She coded, we bagged for 20 min while MD was called. He said we'd have to intubate since she was a full code.

4th night: I couldn't believe she was still alive when I got to work. She was on 20 mcg of dopamine and 15 mcg of levophed with a pressure anywhere from the 40s to the 80s. I just knew she was going to die on me, so I decided to get her good and clean for God. I used almost an entire package of toothettes on her mouth (before we intubated she would always bite down when mouth care was attempted). The family came in to visit at 9 and were talking about "when" she'd start dialysis again once her blood pressure rebounded. The MDs, social workers, chaplains, and nurses have been harping to these people since admission to ICU (for hypotension!) that her pressure was NOT going to rebound, the kindest thing would be to make her DNR and let her go to God. She could not have dialysis, it would kill her, and she would not live without dialysis. But one son, the one who cared for her at home, would not budge. Around 2 AM I decided it was time for her bath (she was still pooping and it was getting into that honking wound) so I went in and got started. When we turned her on her side and started cleaning, she just pooped and pooped, bradyed down and then went asystole. We were unable to revive her.

I called the family and let them know, they came to the hospital and we were really surprised that they didn't make a scene. Can you believe they REALLY didn't think she was going to die? They hadn't even THOUGHT about a funeral home; they were going to have to make some phone calls in the morning and figure out what they were going to do. I could not believe it!!

My charge nurse told me, "Congratulations, you've just given your first death bath."

I went to breakfast that morning with two of my co-workers so we could decompress a little. I told the days charge nurse on my way out not to even bother calling me to ask me to work; the answer would be no.

I got home and I slept a deep, dreamless sleep until almost 5 PM. I usually get up at 2. I fell back asleep at 9 and woke up at 1:30 AM and then couldn't sleep after that. Everytime I'd close my eyes, I'd see that awful wound.

I'm glad I've been off work for several days and that I don't go back until Tuesday. Not sure I could have faced that place any sooner. But if I had been scheduled back that night, at least I wouldn't be starting my run of days off on a bad note. It took me two days to get over my funk.

Sorry so long...but I really haven't gotten to vent to anyone who knows where I'm coming from. My husband's an engineer for heaven's sake. :chuckle

Any comments would be appreciated.

mattsmom81 · May 12, 2002

Konni, it's hard to lose patients and it will be less traumatic as you gain experience. Some patients grab hold of your heart and even veteran nurses have lots of trouble resolving things on occasion. I'm glad you're taking care of yourself through this.:)

Something I've told myself which helps me gain perspective in codes, etc: The docs and I really are not in control here. God is, and when my patient's time comes it does not matter much what I do or don't do...God is in charge.

You will find many families who cannot deal with the finality of their loved one's death and have NOT made arrangements or thought about it at all...it's quite common. Often they ask the nurse for suggestions...I'll give them a list of area funeral homes, let them have some time to decide, then I will call for them. I get the signature to release, then send them home to rest and they can call the funeral home later about the details.

I understand how you feel about the MS04 drip and knowing that by turning it up, you may hasten death. But remember you are doing it to ease suffering associated with the inevitable. My mother was struggling to breathe and I was thankful the drip was turned up for her and she had a peaceful death...families remember that and appreciate it. :)

((HUGS))) as you deal with these difficult situations...they will get easier, promise! :)

mario_ragucci · May 13, 2002

Whoa KOnni; I really enjoy reading and learning so much from your post. Your vocabulary is very interesting, as a nursing student, I really love that you took the time to introduce me to new words and scenarios.

Some folks would be opposed to "worst death" cases like you describe so well and fun to read. Iy'd be heartbroken if someone kept me going on and on. :-(

BTW - God said "I like the klean ones better."

I'm sorry :-) ;-0

whipping girl in 07, RN · May 13, 2002

No reason to be sorry about the joke, Mario. If we don't joke around (sometimes in terrible taste, I might add) about some of the awful things we see, we'd just have to sit down and cry.

I have always thought that the worst thing would be to die in your own excrement (even though I'm sure it happens a lot). But at least my patients are going to be clean as they pass through the pearly gates. :-)

I guess she was listening to me as I told her to go toward the light that night (although I forgot to open the window for her).

I'm just glad it didn't happen at shift change like it normally does for me!! (Prior to this patient, all my patients who've coded did it during report!!)

Keep truckin'. I am. Back to work tomorrow night.

Agnus · May 13, 2002

Originally posted by mario_ragucci
Whoa KOnni...., as a nursing student, I really love that you took the time to introduce me to new words and scenarios.
.....

Mario,

Clarify something for me. I thought in another post, on another fourm you said that you graduated and are working in ICU. Is this correct?