The Day You Died

NurseAlwaysNForever

I knew you had been declining. I had even talked to your daughter about your "transition". She had been in denial and didn't really want to hear about the dying process at all. Were you already gone, was I too late, had I failed you and her both? All of these thoughts raced through my mind. As we entered the room I could hear you breathing, deep ragged breaths. I wasn't too late, I could still help you die comfortably as you had so often made me promise. I squeezed your daughter's hand and told her I would see what I could do, she nodded and said thank you.

Upon entering your room I found you lying flat on your back, you were pale gray and clammy, I could see you grimacing and you were very restless. Immediately I rolled the head of your bed up to 30 degrees and applied O2 at 2 liters per minute. In your nightstand, you had a bottle of Atropine Ophthalmic solution 1%. I gave you 2 gtts sublingual, as well as 10mg Roxanol SL for the pain. I also gave you a breathing treatment with Duoneb and 10 mg of Roxanol with a mask. Halfway through this treatment your respirations eased and you finally became comfortable. I took your vital signs. Your heart rate was fast, your blood pressure low.

Respirations at 12, shallow. Oxygen level was 82%. Heart irregular, thready. Lungs coorifice bilaterally. Foley, scant amount of tea-colored urine. I looked at your feet then. I don't know why I always save that for last, but I do. I saw it there, the hard evidence. The dark purple coloring I saw creeping it's way up your legs, almost to mid shin, was my confirmation. Your pinned earlobes and fixed pupils further told of what lay in your future. The breathing treatment was through and I removed it, however, left the oxygen in place. I whispered in your ear and promised you that I would not let you suffer and would keep you comfortable. You were resting so I took your daughter into the kitchen to talk with her.

Before I could say anything, she asked me if you were dying. I looked up and nodded my head. She fell into my arms, sobbing. She didn't want to let you go, you were the only parent she had left, the only family since her son had been killed in an accident. I held her for quite some time as she sobbed, soothing and consoling her. I guided her to a chair at the kitchen table and we sat and talked she cried, my eyes teared up and I snuck when she wasn't looking to wipe away my tears. We talked mostly about you and about the things you had taught her.

I told her how close we had become and how much I had learned from you as well. I thanked her for this wonderful opportunity. I fixed her a cup of tea, peeked in on you. You were still resting. I offered to call a chaplain, she refused. Gently I approached the topic of your passing and I explained that your body had become so frail and weak that it took every ounce of energy you had to even breathe these days. I explained to her that you had told me you were ready to see all of your family "on the other side." I explained the benefits of dehydration at this time as a natural painkiller, explained that your heart rate was beating rapidly trying to overcompensate for everything else going wrong. Explained that your kidneys had started to shut down. I told her that more than likely your heart would continue like this until it gave out and then the heart rate would start dropping and eventually stop. We talked about the mottling on your feet as well. She said, "It's really it, isn't it?" I slowly nodded my head yes.

She decided then that it was your time and that she didn't want you to suffer anymore, said she didn't want to be selfish and keep you here. She looked up and said, "Now what?" I said, "Is there anyone you want me to call, anyone you want here with you?" She shook her head and said, "No, all we need is you." I smiled and hugged her, "Okay, now you need to tell your father these things you have told me, he can still hear you and he needs to know how much he means to you." That's all it took. She came to your side and climbed up in the bed next to you and told you all of the things you had taught her and how much she appreciated them. She told you how much she loved you and respected you. Then she told you she needed you to go check on her mom and her son. You squeezed her hand then and a tear slid down her face as she kissed you on the forehead. You didn't have any more pain or breathing problems and as night approached she kept falling asleep next to you and then startling herself and waking up.

I finally got her to lay down on the couch. She hadn't slept at all the night before. She made me promise to awaken her if I thought you were going to pass. She lay there sleeping fitfully, you remained peaceful. At 2130 your respirations had slowed to 6 per minute and you were having longer and longer periods of apnea. Gently I awoke your daughter and told her that it was almost time. She sat by your side, your hand in hers and began singing. "Amazing grace, how sweet the sound that saved a wretch like me." I joined in, holding your other hand. After amazing grace, she started singing, "I'll fly away to that home on God's celestial shore." Her voice sounded like an angel. I can only imagine that as Heaven's Gates opened to let you in that the angel's joined her in welcoming you home. As you took your last breath she held your hand and ran her fingers through your hair over and over again. After your last breath, you were still,10 secs.......20 secs..... no breath.... 30 secs.... 40 secs...... I listened with a stethoscope, nothing. I felt for a pulse, nothing. I looked at your daughter and told her you had gone home. She cried, but not violently. I removed the O2 from your nose and turned off the concentrator. Together we changed your bed linens and gave you a lavender-scented bath. She said you loved lavender. We brushed your hair and put your dentures in. We folded the sheets down and placed your hands folded on top of them, she kissed your forehead again.

Smiled and said she should have put on red lipstick when she did it to make her mom mad. I called the police department and they sent out a deputy, called the funeral home as well. They arrived and took you to the funeral home. Your daughter is doing alright. She had a tough time at first. If I could tell you what happened in the last wondrous moments of your life, this is what I would have said, but I can't, it doesn't work that way. I do know that you would have been proud of her and the way she handled things. And as far as promises go, I kept my end of the bargain. When it comes my time to go, just stand on the sidelines and root for me at the pearly gates and make sure I get in.

The Day You Died

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