I could use a word of encouragement...

Published

Specializes in Policy, Emergency OR, Peds OR, CVOR.

Let me start off by saying that I am utterly exhausted right now so please forgive any typographical or grammatical errors.

Yesterday was a day unlike any other. I was 10 minutes late for work for the first time and that must have caused the earth to shift on its axis because the day went downhill from there.

I work at an assisted living facility as a CNA and usually work the 7-3 shift every other weekend. Well, we were short staffed and busting our humps non-stop. We had 3 very very ill residents. One had to be sent out to the hospital. One was drifting downhill and the last one had CF and was struggling to breath w/ o2 cranked as high as we could go. These residents were doing so poorly that I volunteered to work next Sunday because I didn't think any of them would make it the 2 weeks until I came back to work and I wanted to be sure that I was able to help make their last days as comfortable as possible.

Anyway, at 2:55 my nurse asked me to stay over for a while because they were short-staffed for the 3-11 shift. I am known as the go-to girl because I hardly ever refuse them when they ask. So of course I stayed.

My assignment included the CF resident that had been closely monitored all day and I checked on her. Her color was poor and she seemed only moderately coherent. She had always been very clear with the staff that she wanted to perform as many of her regular activities for as long as she could. This included eating meals with everone else in the dining room. At 3:30 I checked on her and she thought it was time to get up. I told her that it was not time to go yet and that she should get some rest. My med tech, nurse, and I would alternate checking in on her every 15-20 minutes just to make sure her breathing was okay(though very loud gasping) and that everything was fine. Each time we did, I would tell her that it was not yet time to go but that I would come get her soon.

Well, at 5:00 I went to her room to get her dressed to go down to dinner. She still seemed a little out of it and I was wondering if she would be able to sit at the table and feed herself. When I came into her room I told her that it was time to get up and get ready to go. I repeated this in various ways probably 3 times while I was trying to dress her. At one point when she was sitting on the side of the bed she nearly slid into the floor and that's when I decided that this just wasn't going to work. I was trying to ease her back into the bed and was struggling when I called for assistance. When another CNA came in to help I was holding her and needed her to help me get her back up on the bed. The head of her bed is up to keep her more upright to aid with her breathing. I was trying to put her on the bed and get her into the upright position when I realized she was non-responsive and her breathing did not involving any gasping sounds. I was a little panicked as I was trying to get her to respond to me. We called the nurse in and we all gathered around to comfort and soothe her as she took her last breaths.

This was a strong, beautiful, intelligent woman that touched many of our lives.

I took this especially hard because of several reasons. I have only worked as a CNA since February. I have never witnessed death before. I felt like she wasn't with it enough to eat dinner in the dining room yet I still tried to get her up and dressed. I am afraid that my lack of experience in assessing my resident's wellness kept me from making the right decision.

The nurse said that the time that she was first unresponsive, she was having a CVA. She was then unable to follow commands to breath only through her nose and she was breathing more and more slowly and shallow. We couldn't get her to focus her eyes on us or anything. There were four of us in the room and we did offer words of comfort and comfort touches.

I did get to spend time alone with her to say goodbye before they took her away. She had a very sharp mind and a quick wit. It came to me while I was sitting with her that I had told her time and time again today that it was not time to go yet. When I finally came in and told her it was time to get up and get ready to go, she took it as a direction to go on a different journey. When I told her goodbye, I told her that she definitely got me good and that I think it was an honor that she chose me to be with her as she left.

I really don't even know where I going with this but I feel a little lost right now and my dh doesn't understand. I thought if anyone could understand, it would be you guys.

Like I said, I'm exhausted so please forgive me if these is incoherent babbling. While we were in with her the building seemed to implode. There was a kitchen crisis, a fire alarm, firemen and residents wandering about. CHAOS. To top it off we were short staffed in CNAs and med techs. We didn't finish passing meds and settling everyone down until after 10:00. By the time we did med count, it was 11:45.

My heart is heavy and my mind is numb. Is it going to hit me this hard every single time? I don't know if I could take it mentally.

Up Vote Up Vote ×
Specializes in Telemetry/Med Surg.

{{{{Supermo}}}}

I'm so very sorry. What you're feeling is normal; you've been working as a CNA since February so it is difficult not to form some kind of caring feelings for the patients you come in contact with. Sometimes the clients can go very quickly so there was nothing you nor the other staff could have done to reverse that. She sounded like a very special lady and you are as well -- staying with her during her final moments; she was lucky to have you with her. You have what it takes to make a wonderful health care provider in whatever route you take--you're very caring and concerned for your clients which is a blessing to them as they are often forgotten.

It's very sad, I know...the first patient I 'lost' hit me quite hard as well but we do have feelings. Try not to be too hard on yourself and think of how she touched your life and you hers.

Best wishes.

Up Vote Up Vote ×
Specializes in Med-Surg.

You're a very good CNA and you have human feelings.

Death is a part of life. It hits us hard sometimes.

Up Vote Up Vote ×
Specializes in Almost everywhere.

The "first death" can be very hard and you had a close relationship and attachment to this resident...a very human thing. Some deaths will be hard, some maybe not so hard. You did what the resident wanted, she wanted to be up and eating with the others...I would want someone to do that for me. Get some rest, try to eat, it will be difficult for a short time, but then you can move on. There are others who need you and how fortunate they will be that you are tending to them. A learning experience...:icon_hug: Take care.

Up Vote Up Vote ×

I think that is a beautiful story. I like the way you interpreted her last moments here with us.

She sounds like quite a lady. You have every right to feel both honored by and saddened at her passing.

Up Vote Up Vote ×
Let me start off by saying that I am utterly exhausted right now so please forgive any typographical or grammatical errors.

Yesterday was a day unlike any other. I was 10 minutes late for work for the first time and that must have caused the earth to shift on its axis because the day went downhill from there.

I work at an assisted living facility as a CNA and usually work the 7-3 shift every other weekend. Well, we were short staffed and busting our humps non-stop. We had 3 very very ill residents. One had to be sent out to the hospital. One was drifting downhill and the last one had CF and was struggling to breath w/ o2 cranked as high as we could go. These residents were doing so poorly that I volunteered to work next Sunday because I didn't think any of them would make it the 2 weeks until I came back to work and I wanted to be sure that I was able to help make their last days as comfortable as possible.

Anyway, at 2:55 my nurse asked me to stay over for a while because they were short-staffed for the 3-11 shift. I am known as the go-to girl because I hardly ever refuse them when they ask. So of course I stayed.

My assignment included the CF resident that had been closely monitored all day and I checked on her. Her color was poor and she seemed only moderately coherent. She had always been very clear with the staff that she wanted to perform as many of her regular activities for as long as she could. This included eating meals with everone else in the dining room. At 3:30 I checked on her and she thought it was time to get up. I told her that it was not time to go yet and that she should get some rest. My med tech, nurse, and I would alternate checking in on her every 15-20 minutes just to make sure her breathing was okay(though very loud gasping) and that everything was fine. Each time we did, I would tell her that it was not yet time to go but that I would come get her soon.

Well, at 5:00 I went to her room to get her dressed to go down to dinner. She still seemed a little out of it and I was wondering if she would be able to sit at the table and feed herself. When I came into her room I told her that it was time to get up and get ready to go. I repeated this in various ways probably 3 times while I was trying to dress her. At one point when she was sitting on the side of the bed she nearly slid into the floor and that's when I decided that this just wasn't going to work. I was trying to ease her back into the bed and was struggling when I called for assistance. When another CNA came in to help I was holding her and needed her to help me get her back up on the bed. The head of her bed is up to keep her more upright to aid with her breathing. I was trying to put her on the bed and get her into the upright position when I realized she was non-responsive and her breathing did not involving any gasping sounds. I was a little panicked as I was trying to get her to respond to me. We called the nurse in and we all gathered around to comfort and soothe her as she took her last breaths.

This was a strong, beautiful, intelligent woman that touched many of our lives.

I took this especially hard because of several reasons. I have only worked as a CNA since February. I have never witnessed death before. I felt like she wasn't with it enough to eat dinner in the dining room yet I still tried to get her up and dressed. I am afraid that my lack of experience in assessing my resident's wellness kept me from making the right decision.

The nurse said that the time that she was first unresponsive, she was having a CVA. She was then unable to follow commands to breath only through her nose and she was breathing more and more slowly and shallow. We couldn't get her to focus her eyes on us or anything. There were four of us in the room and we did offer words of comfort and comfort touches.

I did get to spend time alone with her to say goodbye before they took her away. She had a very sharp mind and a quick wit. It came to me while I was sitting with her that I had told her time and time again today that it was not time to go yet. When I finally came in and told her it was time to get up and get ready to go, she took it as a direction to go on a different journey. When I told her goodbye, I told her that she definitely got me good and that I think it was an honor that she chose me to be with her as she left.

I really don't even know where I going with this but I feel a little lost right now and my dh doesn't understand. I thought if anyone could understand, it would be you guys.

Like I said, I'm exhausted so please forgive me if these is incoherent babbling. While we were in with her the building seemed to implode. There was a kitchen crisis, a fire alarm, firemen and residents wandering about. CHAOS. To top it off we were short staffed in CNAs and med techs. We didn't finish passing meds and settling everyone down until after 10:00. By the time we did med count, it was 11:45.

My heart is heavy and my mind is numb. Is it going to hit me this hard every single time? I don't know if I could take it mentally.

We all touch another life in so many ways. As she touched yours, you also touched hers and each of your lives were both bettered by it. Your feelings are quite normal - you have experienced a loss.... and you will grow from it as well. I have learned something from each of the patients I have lost over the years - about courage, love, fear, hope... we teach each other about life, and death. You will cherish what you learned and her memory for many years to come. The pain will lessen.

Just keep being the caring person you are and don't be afraid to continue to care. Sometimes we pull away for fear of being hurt again by another loss but if you realize that dying is just another part of living, you will find it easier to bear. After 27 years of nursing, I still cry.

Up Vote Up Vote ×
Specializes in Med/Surg.

You're human. everyone deals with death differently. as a 4 year veteran...it will get easier with time. I'll share with you my first experience with death:

I was 19 and i worked in a LTC facility with a lady died of what i know now is a pulmonary embolisim. after she had died, i had to go in there and help them move the body. Up to that point i had never seen a dead body outside of a funeral home which had been made up to look like they were just sleeping. I couldn't stop crying once we had put her on the gurney. it was so creepy, and at 19 it was teh first time i had been in touch with my own mortality. It was a real eye opener that people acually die like this (i was a young kid. i still had the whole i'm invincable thing going on).

You're a beautiful woman who tends to her patients as best as she can. When you get close to someone like that you can't just "turn off" your feelings. It will get easier. Death is a part of life.

Up Vote Up Vote ×

{{{supermo}}}

you did great. you tried to help her follow her wishes and when you realized it wasn;t going to work, you laid her back down. youave her permission to go, and she wasn't alone when she did. you did just fine.

Up Vote Up Vote ×

You are a kind and compassionate person. What you are feeling is normal. It is somewhat of a catch 22 in our profession... if we didn't care, it wouldn't hurt so much but if we didn't care we wouldn't be doing what we do. You are an asset to the nursing community. I only wish everyone were so compassionate. You did everything just right for your resident and I'm glad you decided to stay for the evening shift to be her comfort.

Up Vote Up Vote ×
Specializes in M/S/Tele, Home Health, Gen ICU.

Some patients touch our lives more than others, in my 20 + years as a nurse there are some that still make me smile when I think of them. These patients are hard to loose. You are a compassionate, caring patient advocate. Your patients are lucky to have you as is the nursing profession. Take time to grieve, look after yourself and celebrate your patient's life by doing what you did for her for others. She was lucky to have you at her side. Celia

Up Vote Up Vote ×
Specializes in LTC, home health, critical care, pulmonary nursing.

Beautiful. There is something so beautiful and life affirming about being present with and comforting and loving the elderly as they slip into eternity. It can be hard. It does get easier. Grieve if you need to. You're residents are lucky to have you.

Up Vote Up Vote ×
Specializes in Peds leukemia, APON, GI in a clinic.

Way to go, Supermo!! You have seen the best AND the hardest part of nursing care. I feel that when you get to a point where situations such as this DON"T affect you, it is time to move on to another type of nursing. Some practical advice? Try journaling your feelings. Develope a written plan of how you will handle the next time, and there will be next times, differently. That way, you are prepared with a script to mentally follow. Check in with your employers employ assistance program, even if you don't feel you need professional level help, they are great at grief counseling, because that is what you are going through. Exercise, celebrate her life, paint, draw, sculpt, sing or do any other activity you like. You will feel a little better tomorrow, then the day after, and the day after...

Hang in there since we all need great aids and nurses. Good luck, Gary

Up Vote Up Vote ×
+ Join the Discussion