The Sad Nurse Speaks
As it is with life in general, love and loss are part of nursing. We open ourselves every day to the possibility that we'll have to say good-bye to a patient we've come to know well, and when it happens, the pain can be intensely personal. This story was written on the same day the author suffered the double loss of a patient and a family pet.The phone call I've been dreading comes at 0217. It's my night shift med aide, who informs me through tears that our much-loved resident, Evie*, has passed away after lingering for days in an unresponsive, but obviously uncomfortable state. She has required morphine every hour and Ativan every 2 hours around the clock, as well as sublingual atropine to combat the secretions that made her respirations sound like the rumbling of faraway thunder.
At this same time, I can hear the death throes of my 14-year-old cat, Katie, who lies on a soft blanket at the foot of my bed. She's been in delicate health for the past year or so, but until Thursday night she was still eating, drinking, and using the litterbox. Now she is on her way over the Rainbow Bridge, and all my husband and I can do is wait for the end and wish they had hospice for pets....
Sometime around dawn, I hear him get up and shuffle around the bedroom. I ask him to check on Katie, who---like Evie--- clings to life with a tenacity we never knew she had. She's always been our little fraidy-cat, our shy girl who runs behind the sofa when guests come to visit.....what is preventing her from joining our other cats who have passed on?
I think about Evie, who also fought health problems and depression for most of her later years. What, I wonder, had she been holding on for? Her family was all there at her bedside, she had lived a long and productive life......and yet she had held on until the very end with a grip that surprised even those who knew her best.
I fall back into a fitful doze filled with vaguely disturbing dreams that vanish the instant I hear my husband open the bedroom door. This time, I don't even have to ask, because I know. She stopped moaning an hour ago. But of course, I am a nurse and I must see for myself, even when the departed is a beloved house pet. Perhaps because the departed is a beloved house pet.
Yes, Katie is dead. Definitely. I weep for one of the best cats I've ever had. But it doesn't take more than a minute or two to realize that I'm grieving for Evie too......and for all the patients and family members and pets I've ever had to say good-bye to. For a brief moment, I almost envy them, for they suffer no more and at moments like these, the pain is almost more than I can bear; however, this thought is quickly banished lest it lead down a path best left unexplored.
I watch as my husband prepares a grave for Katie in the back yard garden, under our bedroom window. Poor man, he always gets the worst job of all. He lays her shrouded body gently in the earth, and at this point I have to walk away because I cannot bear to see him cover her, to hear the dirt clods falling into the grave. Again, I think of Evie, who often quoted from the Bible, and recall the verse "from dust you came, and to dust you shall return". Strange, how we mortals think that we're so important.......and yet, when it comes right down to basics, we are but a speck of dust in the infinite expanse of eternity.
From the warmth of our living room, I stand at the window and watch as the brisk November wind strips the last of the autumn leaves from our trees. They swirl madly as if trying to show off their glory before dying.....then they finally surrender to the inevitable and fall like snow, carpeting the floor of our woods in brilliant yellow.
Being somewhat imaginative, I cannot help making a metaphorical connection between this scene and the sad circumstances of this day. I am a nurse, a student of science, but I have seen and experienced a great deal of death and loss in my lifetime, and I have to be able to explain these things to my heart so that I can open myself to care for another person---or creature---whom I will inevitably lose.
Eventually, of course, it will be my turn to leave. And as unscientific as it sounds, it comforts me to believe that everyone I've ever loved and lost will greet me at the gates of Heaven. I look forward to hearing more stories of long-ago times from Evie and all the other elderly patients I've cared for, and to having my lost fur-babies purr on my lap once again. But for today, the skies are grey and weeping for the dead, and for those of us left behind to mourn them.Last edit by Joe V on Jan 10, '15
About VivaLasViejas, ASN, RN Guide
Joined: Sep '02; Posts: 26,920; Likes: 44,517
RN and blogger extraordinaire; from OR , US
Specialty: 20 year(s) of experience in LTC, assisted living, med-surg, psychNov 17, '12So sorry to hear of your double loss today. I remember you mentioning your patient when you responded to my When Nurses Cry article. Is this the same one, or another one? I know in where you work, you have to deal with many patient losses.
Remember ...... Nurses can cry.......and so can cat lovers.
Double hugs to you my friend.Last edit by Joe V on Nov 18, '12Nov 17, '12As a former LTC nurse and a lifelong cat lover and owner you have my deepest sympathies.Nov 17, '12Oh my dear, sweet Viva--
How I wish my words could soothe your heart. What I would give to take the pain from you so, for just a moment, your spirit could quiet.
As always in these situations, I find words to be desperately inadequate, falling pathetically short of the mark. How blessed your darling Katie is to have had you as her guardian, her keeper, her mom. How fortunate Evie is to have had you as someone who saw her as a person, not a number and not "just another resident"--to have had you as her advocate and a gentle listening ear.
No, these words cannot heal you or dry your tears, or make you feel like the dawn will once again come clear the clouds.
So for now I can only offer condolences, heartfelt understanding, and a listening ear should you ever need to avail yourself of it.
"When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for that which has been your delight."
~~Kahill Gibran~~Nov 17, '12I am soooooo sorry, our animals provide us such a service, an abundance of the purest form of love, and hours of humor filled entertainment. We learn so much about their individual personalities, would know their bark or meow out of 500 others, and sleep so much more soundly under their intermittent watch(between snoring like crazy in my Boston's case). Team that with the death of a patient you have taken care, and it's definitely a heavy, gut-wrenching, and sad time. I am so sorry as I know there really are no words that can give comfort, but just wanted you to know I will send up a prayer! And, I don't care what anyone else believes- I believe their both free of pain, free of worry, and free to soar now- nothing to hold them back any more, in a place where all things are new- no more sickness, suffering, or fears. A place where lions lay with lambs- yeah, that's what I choose to believe. Sending Love your way!!!!Nov 17, '12Quote from tnbutterflyThank you.So sorry to hear of your double loss today. I remember you mentioning your patient when you responded to my When Nurses Cry article. Is this the same one, or another one? I know in where you work, you have to deal with many patient losses.
Remember ...... Nurses can cry.......and so can cat lovers.
Double hugs to you my friend.
Yes, she was the same one I spoke of in your article. No one expected her to survive for almost five days in the condition she was in when she came back from the hospital. I didn't expect Katie to survive the extra day that she did, either....guess she just needed to make sure all the good-byes were said. Maybe that was Evie's reason, too.Nov 17, '12I'm no good with this kind of thing, and especially when not in person and over a computer. I usually don't send across the message I mean to send. So I will simply tell you that I'm sorry for your loss-Both of them. I'm sure that Katie appreciated and in her own way treasured the times shared between you and her. I'm sure of this. As for your Patient, I have no doubts that she knew that she was more than just an obstacle between you and your clock out time before going home. People know when others care about them. They always do.
Again, my deepest sympathies.Nov 18, '12I love your writing..it is so vivid and your loss palpable. So sorry for your loss. I mourned for weeks after the loss of my cat. They become your little buddies and companions and are part of your family. It comforted me when my sister told me "You gave her a good life and a good home and you did the same and your patient was lucky to have such a wonderful group of nurses caring for her. We should all be so lucky.Nov 19, '12I am sorry for both of your loses. It is really hard when there are deaths that you face even if you know that it is coming it is still sad when it happens. Your words made me feel what you are going through and it is both beautiful and poignant.
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