Com'on, you got one...What is your heart wrenching moment?

[CrunchBerries]

Mine was....

I was a very young, too young DON at a care home. I was working late one night doing paperwork. I heard odd noises coming from outside my office. I went out to investigate and I saw Marjean, one of my fav's sitting under a tree rocking back and forth.

I asked what was wrong, she kept rocking telling me she was just gang raped on the pool table of the game room.

Marjean was a hard core, paranoid schizophrenic. It never happened, while we had a game room we had no pool table and, we had cameras in that room. Naw, it didn't happen but SHE totally believed it did, it was one of her hallucinations.

While it did not *really* happen, it did happen in her reality and she was going through the same emotions as a true rape victim would experience.

I finally got it, I finally understood. Hallucination or not, it was still real for her. I just sat with her under the tree rocking back and forth.

We ALL have one or more of those moments, what is yours?

[NurslingNicole]

You all are angels. Thank you for all you do.

[littlejo]

As a nursing student, working a dementia unit for our clinical studies left me in tears all the way back home. The lady I was assigned to was no longer very vocally lucid, needed to be fed, and had no bladder/bowel control. I'd come in to her room, greeting her cheerfully which was usually met with a groan. She remained limp as I washed her and dressed her for breakfast. After feeding her and finding a quiet spot for her to sit, I'd go back and tidy her room. Pictures displayed on a cork board showed a very handsome woman in her younger days. Articles of her accomplishments in local government told me she was very bright, enthusiastic, generous.

Her husband came every day joining her for lunch to feed her himself. He told me she always watched her weight as he whispered loudly into her ear, "you're getting fat my dear", knowing she could no longer respond to his ribbing. What dementia does to the family, watching a loved one lose control of their mind, spirit, and body was the heart-wrenching part of nursing for me. I mentioned to her husband that we would maintain the care of "our patients" every day for the next two weeks and if he needed some time off, we would be lovingly caring for them during that time. He accepted that offer as he worked on their old cottage by a lake (another picture I'd seen in her room}so he could sell it to finance her care.

One morning, as I gently brushed her hair for the day, I told her, "It's going to be a good day!", she responded with, "Yes, it is!". Another morning I asked her, while pushing her in her wheelchair towards the dining area, "How fast you want to go to get there?" and she tossed her head back with, "Fast as you want!" And we did, smiling all the way. My last day feeding her lunch slowly, she turned to me and said, "You know sometimes..." ....the thought was just totally gone and a tear trickled down her cheek. I asked my instructor to take over so I could step away.

Years later, I cared for a lady with early stages of dementia by visiting her at home once or twice a week and going out to eat where we acted like completely goofy teenagers. Later, yet, I stayed with a lady who was nearing a time where she would require round-the-clock care and we loved putting puzzles together or just watch TV. In both cases, I'd be told the same stories over and over again prefaced with, "Have I told you this?" but I'd always let them tell me again. Stories were usually from childhood, but some were more recent and traumatic to them. I'd often be asked the same question repeatedly in an hour's time but I knew in their mind it was the first time they were asking me. Answering patiently was never difficult because I would want to be treated that same way should I someday be walking in their shoes.

I will still always agonize with/for the family members watching this cruel, devastating decline. God bless those who choose to really care for these once bright, enthusiastic, generous persons needing your patient, loving, time consuming tasks.

[ReadyToListen, CNA, EMT-B]

I don't have any contributions yet, I'm just starting school. But I do want to say one thing to OP: THANK YOU! Your post can really benefit people (like me) who have a really, really hard time admitting we need help. A safe place like this gives an out for things to be released that are just eating someone inside. For example, nobody knows that my last shift in the ER I worked about 9/12 hours with stress induced chest pain. I tried to hide it just because I didn't want sympathy or extra attention or anything. I still don't know if that's good or not.

[No Stars In My Eyes]

ReadyToListen said:

I don't have any contributions yet, I'm just starting school. But I do want to say one thing to OP: THANK YOU! Your post can really benefit people (like me) who have a really, really hard time admitting we need help. A safe place like this gives an out for things to be released that are just eating someone inside. For example, nobody knows that my last shift in the ER I worked about 9/12 hours with stress induced chest pain. I tried to hide it just because I didn't want sympathy or extra attention or anything. I still don't know if that's good or not.

YIKES!

The thing is, ReadytToListen, you need not just be ReadyToListen, but also WillingToHear. Your own body is trying to tell you something, insisting you pay attention and really take in the meaning of its message.

Just because you 'know' it is stress induced doesn't mean you can ignore it and not do something about it. Like see a doc? Yah? There are many and multiple ways to help your body to stop yelling at you.

It doesn't mean your a wuss for caving to pain, it means you're smart enough to see what can be done about it before it gets worse and goes in any one of the several directions it might take.

As they say in the old cowboy movies,

"Head'em off at the pass, boys!"

[nursejoy1, ASN, RN]

I have had several as a nurse, but none so terrible as a personal happening. My neice died of SIDS at 15 weeks of age. On the day of her funeral, after she had been interred, my son, who was six at the time, grabbed my arm as we were driving away and begged me to go get her because "you're a nurse, you can fix her." It has been 11 years and that still breaks my heart.

[WKShadowNP, DNP, APRN]

I have several that are coming to the surface from reading this but for some reason this one wants to be told first.

At this point I had been a nurse for I think 10 years, had done home health, hospice, oncology briefly, and now was back in the hospital setting. As the charge nurse on the busy med/surg unit, I did one of the direct admits that had come in. She was a fantastic lady. Funny, easy to talk to and teach. Her presenting complain was unresolved abdominal pain and weight loss. "He just wants me to be here over night for pain management and some tests in the morning."

As was the regulation, for every little thing we had to ask for her name and date of birth. We'd developed a rapport and she'd even tell me the time of birth (except it was her son's time of birth just to be extra silly.). I got her settled in and kept her comfortable relatively easy. Her husband was a lovey gentleman, too. I seem to recall he was a chaplain or deacon, something like that.

Well the next day when I came in she was still there (I worked 2nd shift) and I was surprised because after her tests, she should have been discharged. "Oh, well, the CT came back with a suspicious finding, they want to do more tests." But she was still upbeat and hopeful. Pain seemed better controlled.

The third day she was sent home after further tests were done with a follow up appt. for a biopsy as an outpatient. She had several abdominal masses. Notably on her pancreas, liver, and colon.

I saw her a few weeks later as a patient. She wasn't as vivacious. She still joked with me about her name and date of birth, and her son's time of birth as her own, but the spark was a bit duller. Her pain was worse. She tolerated the surgery well, but chemo or whatever treatment she was getting just did not suit her.

About two months later her husband was visiting patients in his role and caught up to me. She's hanging in there, he said, it's hard. Probably time to call hospice.

Then the last time I heard from him is when I got a card thanking me for my care of her and my kindness, and would I come to the funeral? It had her date of birth and death. I had a bittersweet smile that her time of birth was included. It probably was not meant just for me, but it felt like a little pat on the back from her.

It was the first time I had not gone to a funeral of a patient I'd cared for. That was a rough year for me and I was funeral'ed out.

[WKShadowNP, DNP, APRN]

Having been a hospice nurse, death, of course, comes with the territory. But some lives (and deaths) seem to resonate with you more than others for a variety of reasons.

Such as my first hospice death. This bright eyed, feisty yankee from Brooklyn had dementia. She could feed herself, walk, and talk. But for the vast majority, her words were repetitive phrases and not part of any meaningful conversation. I'm going to call her Red because she loved her hair dyed brightly red. Her most common phrases were, "You're beautiful. No, you are." It was amusing to take care of her because she could be so sweet and being a Carolina girl, that Brooklyn accent was somewhat of a novelty.

One thing Red did not care for was oral care. She'd forget to brush her teeth, so an aide and I would tag team and try to help with personal hygiene overall. I'd distract her with a baby doll that she was fond of and we'd coo over the baby. Then she held my hands, or rather I held hers, because it was time to swab her mouth. We were having our "normal" conversation and the aide gently took an opportune moment to slip the swab in. Red looked me straight in the eye and said, "You tricked me!"

I chuckled because that was the most appropriate piece of conversation we'd had, but her teeth were clean. She got over it rather quickly and we resumed our normal routine. Another gesture this lovely lady employed was to caress your cheek when she'd tell you of your beauty in her eyes.

A few months into her care she began to decline. She wasn't as ambulatory. She lost her appetite. Already thin, she became cachectic. Then came the abnormal lady partsl bleeding. Her previous diagnosis of some gyn cancer in remission was void. So we kept her in bed. Kept her comfortable. Daughter came down and we shared a few more days, no more than two weeks, together.

At three am on a Saturday morning I got my first on-call page. She had peacefully transitioned in her sleep. I attended the assisted living and met the funeral home after assisting with post-mortem care. Her children couldn't bear to be there. Arrangements were made in Brooklyn.

The following week I was lying on my side in bed facing my closet. I know I was not asleep and that what happened next was not a dream. I saw a shock of red hair and the shoulders of Red, but from there down was a mist, almost imperceptible. Then I felt her last caress on my cheek. It was her way of thanking me, her beautiful Carolina girl, one last time.

[VivaLasViejas, ASN, RN]

My first patient death came when I was a brand-new nurse working in a SNF. The patient was a 53-year-old lady who was dying of pulmonary fibrosis, and as night fell she became weaker and more uncomfortable. I called hospice and her family and did what I could to help her, including frequent administration of morphine and Ativan. The family and hospice nurse arrived at about the same time, and this large group surrounded her in the small single room we reserved for hospice patients. I turned to leave, and they asked me to stay and pray over her with them.

I wasn't doing anything that couldn't wait, so I agreed and joined the circle. As we prayed, I could hear the faint strains of "Can You Feel the Love Tonight" from The Lion King playing on someone's radio down the hall. Yes, I could definitely feel the love, and I hope she felt it too...and as her soul left her poor, wracked body, the group quieted and marveled at how tranquil she appeared, for the first time in what seemed like forever. We said a final prayer and I left them to go do what must be done after a death in a nursing facility.

It wasn't until I'd finished my duties, given report to the night shift nurse, and got in my car that I lost it. I bawled all the way home, as much from the beauty of what I'd witnessed as from sadness. I'll never forget it.

[Cricket183, BSN, RN]

I have several. I worked my entire career in oncology. You often get to know the patients and their families pretty well as they are with you for extended periods of time (especially leukemia patients) or are admitted frequently over an extended period of time (or both).

One of my first patients to pronounce had been with us frequently. Mr. B was an older gentleman and he and his wife were the sweetest people I have ever met in my life. He always had a smile on his face, even when he was in obvious pain. He had prostrate cancer that had metastasized to the bone. The mass was so large it blocked the lymph nodes in his groin and his scrotum was swollen beyond what seemed possible. It caused the skin to split and required frequent wound care and we had to splint his scrotum on a towel. Even with premedicating him liberally beforehand, I know it had to be excruciating, but he never complained. He just smiled and told us stories about his life--travels, adventures he and his wife experienced, about his children & grandchildren. I suppose it was his way of keeping distracted and he was an amazing storyteller!

His wife seldom left his side but occasionally she would go home. We encouraged her to rest but she always came back with some sort of goody tray for the nurses--banana nut bread, cookies, pie, cake. She said that was her outlet, her stress relief. When it got to be too much for her if she could just go home and bake for a little while she felt better.

He fought long and hard but when it became clear that his end was near he gave each of us nurses a magnetic hematite & beaded necklace (they were all the rage at the time). He had picked out a different color for each of us. It's the only gift I've ever accepted from a patient. (Maybe it was wrong but he would have been highly offended had we not.) He didn't want to go to hospice, he wanted to pass at the hospital "with us". He had pretty much been incoherent for several days before he passed. The day he died, his family was there and I had been in and out checking on him and them. His son came and got me, said he thought it was "close". Mr. B took two, maybe three very agonal breaths, very far apart and then something I had never seen before or since--the biggest most beautiful smile came across his face for a split second--and that was it.

It it was a heartbreaking, yet beautiful moment.

[Cricket183, BSN, RN]

Another one. We had a long-time leukemia patient. She was just one of those people with whom I had an instant connection. I'm not sure why that happens. It's really an unexplained phenomenon. Maybe because we were about the same age, both dealing with teenagers at the time and shared the same type of humor. Or maybe because we were complete opposites in some ways--I'm kind of quiet and reserved and she was spunky and outspoken. Or maybe it was just that intangible something that makes two people hit it off from the moment they meet. Anyway, we hit it off right away.

J.C. was one of the patients that was with us both frequently and for extended periods of time. She responded well to chemo and went into remission. At some point she had seen a doctor in a metropolitan area and there was talk of a bone marrow transplant (we did not have a BMT unit). They wanted her to do a few more rounds of chemo and then at some point in the future they were going to do the bone marrow transplant. One of her children was a match. Because we don't have a BMT, I'm not familiar with exactly how all that works. But for insurance reasons we were going to do a few more rounds of chemo, but not the chemo immediately before transplant.

Anyway, she was in for Round 1 of chemo. She had completed it fine and was in the nadir period (think low platelets). I was working as Charge that day not her primary nurse. JC was another one of those patients who seldom complained. Her mom reported to the primary nurse that JC had developed a sudden intense headache, which her primary nurse reported to me. The second I saw JC I knew it was bad. Called a RR, transferred to ICU, stat CT showed a spontaneous massive brain bleed. A few days later they turned off life support. Heartbreaking.

[WKShadowNP, DNP, APRN]

Most recent:

Ambulance calls with a gunshot wound to the head, CPR in progress. They arrive and the thumper is in use. I recall being confused at seeing his hands strapped to it to where it looked like he was holding it. His head was covered.

Despite the obvious gray matter coming out of his nose and ears, the code continued for 20 more minutes while two docs tried to intubate better. Compressions continued, we suspected at the time to maybe make some organs salvageable. He was only in his 40s or 50s.

Finally the code was called. We still didn't have a name. Eventually family showed up (the spouse was tied up at the home with the investigator, understandably.)

With a name his full patient history was available. Leukemia. He'd been in and out repeatedly. In fact he had stayed at a medical university for a month related to bone marrow or stem cell work. He'd received recent positive news and outlook.

We were so mystified as to why he elected to inflict this on himself and family.

You can never tell what someone is going through, be kind always.

[offlabel]

Spilling my beer after work.......I try not to dwell too much on the crappy side of things.