Mario experiences PT death for first time - page 6

Today when I was in report, waiting for rm #'s and nursing assignments, about the 3rd thing the charge nurse said was that Mrs. U passed away over the night. My reaction was instant, and i flinched... Read More

  1. by   adrienurse
    Although I am agnostic, and don't follow any particular faith, I find caring for those on the brink of death to be a deeply religious ritual. Positioning them, studying their breaths, watching as consciousness slowly drains out of them, as muscle tone is lost is an extremely precious and personal thing to experience. It feels wonderful to provide the symptom control, to be there for the family -- just a presence for them. To teach them about the process, alleviate their fears, normalize the experience is very rewarding -- they never stop thanking you. I like to take my partner and cleanse the body before the person dies. This is so calming to them -- as if they continue to be aware that they are being cared for in arms of love, even though they have lost most of the awareness of the world around them. I know these people, I have cared for them for months, sometimes years. I talk the them. I tell them that there family is here. That they are loved. Give them permission to leave (amazing how it seems thay are waiting to hear this).

    I'm getting misty.

    I know this is different, but this ritual (I think of it as that) is my most rewarding part of working is personal care.
  2. by   SmilingBluEyes
    HUGS mario....I remember my first fetal demise like YESTERDAY...i carried that tiny, lifeless body, wrapped in a blanket to the nursery in tears, asking "Why God why this tiny one?" All my coworkers and the dr has seen countless demises and deaths...I was so green...Sad thing for me, She appeared physically perfect in every way it was just her time, I guess. She still holds a place in most tender heart of hearts, and I will never, ever forget her or her mother. Gosh infant/fetal deaths just make SO LITTLE sense sometimes, upsets the balance of things in my mind.

    I am sorry for your "loss" Mario, and it IS a loss to you. You have a tender heart and will make a great nurse. Carry on, friend.
  3. by   Enabled
    Mario, my thoughts are with you as you go through this event in your nursing career as well as your life. I still remember my first patient and I think we all do. There are others that will also be special. I also have said that I learned more about living from my terminal patients than I learned anywhere else. I had a patient her name was Betty and she had progressive CA. She had lost her hair so we all chipped in and bought various turbans, etc. Each admission we would all go in no matter what are day was like. Similar to you she only had her husband. They were never blessed with children. You could see that old fashion love in their eyes and words didn't have to be spoken. The floor I worked at the time was med/surg and mostly chronic respiratory that were more or less on borrowed time. Betty had let it be known to the staff that she did not want hubby there when the moment came as she did not want him to remember her that way. She felt it was a final gift she could give him. He would stay unless he had a tee time as they had been avid golfers. We would go in and give her a hard time about the particular turban she would wear on a particular day. We tried to get colors that matched his golf pants like the late Payne Stewart wore. Betty was granted her last wish and the staff were well aware it was not far away. In time, unfortunately that becomes a part of nursing as you see how quickly or how slow a patient lives and you learn to be able to tell in the future. Unfortunately, this is an aid in particular when family are not sure if they should come in or stay. I would use if it were my mom and yes I to had to hear those words from a colleague on the floor I worked. Betty was weakening quickly and her hubby had a 2:30p tee time so that he would be back for dinner. Well, he had left and just about the time he would tee of is when Betty left us. I felt honored that I had her that day and was with her because even all that she had been through she did not want to be alone. That is something else you will learn there are things that are never spoken but you gain a sense. I was priviledged to hold Betty as she took her lasts breaths and saw the peace before it was taken. She knew she had kept her promise for hubby not to be there. Some nurses deal with death in different ways. No matter how many you have they are never the same. Sometimes and I know it sounds crude we would shroud a patient and someone would crack a one liner so that the emotions were dealt with. If I had the time I would help the aids shroud a patient as that was also my patient. I didn't mind changing a bed or giving a bath if the family was on the way in. The hardest ones like you say are the ones you get to know. They are not just patients they are friends and sometimes feel like family. Unfortunately, twice I had to shroud colleagues that were so young. It really makes you think about what is important. Sometimes for closure I would go to the funeral home and or service. When that was not done a sympathy card. You will find the best way for you. Don't let anyone say " so or so what" because they are just as afraid as they have to face their own mortality which you may find you do from time to time. The hardest ones are also the patients that family and friends either don't exist or have walked away. So many of those such as HIV just want a human touch.
    Colleague and friend my thoughts and prayers are with you as you go through this true nursing experience. Give yourself time to feel and don't let anyone tell you otherwise. If you are having any difficulties check with your facility chaplain or someone you can talk to
  4. by   Enabled
    Originally posted by schrandt
    Wow, what a thread you started Mario.
    Go to funerals?? Absolutely. Years ago when my son died at age 4 months, I was so wrapped up in my own grief, I paid little attention to those around me. I was so shocked to see former teachers and hospital personell come out of the church in tears. Some of those nurses related years later to me what an impact that awful morning had on them. And altho some of the events of those days are still a bit foggy, I still remember those I came into contact with. So I am never distant with those in the dying process, it may be just a touch or a word they remember but that may bring a little peace. One story--a friend recently went through her mother's death. She was the one who carried my son up the elevator the morning we took him in. She was at her mom's bedside all day and had not left. I called my husband & had him bring up stuff from my kitchen so we made sure her family ate. Darcy was very grateful, & I told her-no need, just payback, She looked at me quizically & I related the story about her carrying Robby up the elevator. She was dumbfounded and had no reply. So it really is the little things.
    My husband also lost a daughter at age 1 1/2. She had been in & out of hospitals since birth and became close to all her caregivers, & 6 of her doctors acted as pallbearers. Imagine that! One of those docs, Dr Deering in Wisconsin, he still talks about, had a profound impact upon him. When I did a genetic course, I contacted Dr. Deering and believe it or not, he still remembered Mindy's case and was able to answer my questions without hesitiation. Must have made an impact on him too.
    I found that when we had a break over the holidays and summer I would check the newspaper almost daily as I knew that some of the patients I had cared for in clinical were not going to be there the next time. There were times when I questioned why we did things to patients who if they had been alert would have declined. For example, A woman who had either ovarian or uterine ca and it was actually sitting on the bed and the doc ordered a catheter. She hadn't had anything po or IV to speak of then why. She was in her 90s and had to be kept in high fowlers in order to stimulate respirations. We have one doc in particular that if you want to put even a posey on for safety will order a neuro, psych, nephro, and any other kind of consult he can. Why? do they get a kick back on the referrals. We had a nonresponsive older man whose IV blu and with the protocol of attempts as we did not have a team the doc was notified. The patient was not long for this world and did not have any type of nutrition or visitors He ordered a consult with an anesthesiologist to start a line. The anesth. did and it was a $350. consult as I have from time to time had anesthesia start myself. His was gone in no time as he did not have the vasculature to support one. He wanted another consult. The nursing supervisor got involved and unfortunately the order was called but the patient beat him to the punch.
  5. by   Enabled
    Stevierae, it is never too late to speak to a family if you know where they are. I had a male patient that had the same first name I have. Marian We would kid a lot who had the better form and he argued for John Wayne otherwise known as Marion Morrison. He was worsening and in a semi private and we were able to work it out to get him into a private. Well, it wasn't long after that. Well, sometime later I was in a store that had the same last name but I did not know there was any kind of connection. As soon as one of the family spotted me the whole family was there. They had also asked me to come back when everyone was there so that they could talk to me about the little things that had made the difference for dad and for them. I felt that I should respect their wishes. I did. And I didn't do it to get a discount either. As it turns out the family had just found out that one of the sons had the same disease and was in the earliest stages. He was there and said he hoped that he would get anywhere near the care his dad got whenever he should get to that point.
  6. by   Enabled
    Two short stories. We had a gal in her early 20s with CF. She had her infusaport put under her arm so she could still wear a bikini. Well, one thing she wanted was to marry and have a child which she did. The child was a little boy named Patrick after his dad. Today he is close to being a teenager. His mom passed away when he was about 6. She had left Florida and went to PA for a double lung transplant. Unfortunately, she ended up in ICU and never had the surgery. She fought with everything she had. When she was in for antibiotic treatments she would get passes and go to the park and have all kinds of activiities that she was able to tolerate with him. He became like a son to all of us. She was kinda crazy in the good sense. She would sit on the bed and order pizza and toss the ball back and forth with Patrick. Melissa was truly a wonderful person. We also need to stop sending monies overseas and take care of our homeless, those in need of medical attention and finding the funds to tackle some of these terminal illnesses so that people no numbers can have a life expectancy like anyone else. We need to support orphan drugs to help these wonderful people because you may have noticed it is usually the nicest people you can meet that have these problems.
    Also, there is a population that we as nurses forget. When it is not possible to move a dying patient we need to consider not only his relatives but the other patient and his/her visitors or family. Some of these patients are with the dying while they are still with it so to speak and have established even if cursory a relationship. We need to have something set up for these individuals such as offering the chaplain or someone with counseling.
  7. by   mario_ragucci
    Thank you so much for keeping this PT alive for me. With new PT, and other PTs who could be on their way out, life goes on, and is effected. It's easy for me to think about it as a positive, after a good week and having completed more dancing and thinking of her/realizing the finate nature of our swirling electrons.