My first death (yesterday)

[SaraO'Hara]

I'm training to be a CNA in a long-term care centre. Our residents are fairly garden-variety, mostly geriatric, a few Huntington's or MS patients. A couple are on hospice, like Mrs Hopkins (names have been changed). I and a classmate took care of her for about a week before her death yesterday.

Mrs Hopkins came back to the facility recently, after nearly dying of a gastrointestinal illness. She was at one time able to walk, using a walker, but I'd never seen her out of bed; she had severe contractures in her arms and legs, and never really left a contorted "mummy" position. Due to the fragility of her skin, it took two people to turn her, although she couldn't have weighed 100 pounds. My classmate and I could feel Mrs Hopkins's bones clicking together every time we repositioned her.

In her lucid moments, she remembered my name, and that of Anne, my classmate; at other times, she would call for her mother, and mention over and over that she had to get home, as her parents would be worried sick. She was never completely comfortable in bed, owing to her contractures; I'm sorry that I couldn't do anything about it.

I work day shift, and so I'm present for breakfast, lunch, and a snack after each meal. Mrs Hopkins had been lucid all day, but refused all food except liquids, complaining of nausea. She was vomitting continually, throwing up copious amounts of a dark brown, gritty fluid. Anne and I held her on her side, and kept laying fresh towels down. At about 1.15, the volume of vomitus coming up became so copious that Anne left to get more towels (understand that we had to hold Mrs Hopkins on her side, so while she was actively vomitting, a bed change was not an option), leaving me with Mrs Hopkins. I asked her to also find George, the CNA supervising us, as the situation was becoming a bit mad, in terms of housekeeping.

He came back with Anne, and immediately said "Her skin does not look good at all."

"What do you mean," I asked, "The scabs on her arms? Those have been there for a while."

"No, no, the overall colour. It's kind of.. non-circulatory. S**t." He ran across the hall to tell the charge nurse. She concurred, pointing out pale-purple mottling. "Were you able to get her vital signs today?"

"No," Anne told her. "but she's been breathing very rapidly all day."

The charge nurse kept her stethoscope over Mrs Hopkins's ribs for about five minutes, as George, Anne, and I tried to clean up the bed without disturbing Mrs Hopkins. We all talked to her, and told her that everything would be okay, that we were there.

"Is she gone?" Anne asked.

"Yeah, she's pretty much gone."

So we washed Mrs Hopkin's body, and changed the bed. I said the Catholic prayers for the dead under my breath; I don't know if she was Catholic, but it was better than nothing. None of us could get her knees to quite straighten out, or her mouth to close all the way, but I combed her hair, and we dressed her in a clean gown. Eventually, George told us to pull the sheet up to Mrs Hopkins's chin; there was nothing more to be done.

I don't quite know how to describe the experience of watching a human being die, especially when it happens as one is holding on to them. I remember that the room smelled like sour Dr Pepper; it's an unfortunate comparison, but I was drinking one yesterday. Death, to me, smelled like Dr Pepper.

I'm not sure how it felt. It wasn't perfectly clear when Mrs Hopkins's soul left her body, but sometime after George made his "non-circulatory" pronouncement, it was obvious that she had left the building. To me at least, it seemed that she was somewhere else - Heaven, Hell, or Purgatory, or on her way to one of those places. Anne and I held our own, to the surprise and commendation of George and our instructor.

I'm not sure what else can be said here, except that death does not seem quite as frightening. Mrs Hopkins quite obviously passed over quietly. I suppose that when the time comes, one simply goes... :gandalf:

[goats'r'us, ASN, RN]

you done good.

i'm sure she thanks you for your kind care.

[TheCommuter, BSN, RN]

I work at a nursing home. Even if the resident was difficult or mean-spirited, each death still impacts me in some way.

[sandys]

I know nursing is for me, but I never picture myself working heavily in geriatrics or a long term care facility. I'm not terribly fond of vomit, let alone copious vomit from a frail woman that you were almost afraid to touch their skin was so thin, but reading your post, I know I could do what you did, and I hope I'd do it as well. What a service you performed helping her pass in a peaceful, dignified, comfortable manner. It never occurred to me that it would be an honor to do so. You should be proud. Thanks.

[TazziRN, RN]

The last memory Mrs. Hopkins had was of the two of you with her till the end. Good for you. In all the years I've been nursing, all the deaths I've been involved with, I consider having done some good if I could be there when someone passed, so they weren't alone at the end.

[HM2VikingRN, RN]

Ya done good!

[Jack39]

Sarah, you told this story quiete wonderfully. Your compassion will serve you well in any nursing profession.

[Tweety, BSN, RN]

Thanks for sharing. Best wishes.

[nambour51]

'I said catholic prayers for the dead'. Your prayers were also important for you. They assist you in adjusting to the reality of death, and enable you to continue caring for others. Your thoughtfully worded post sharing your experience is a reminder to us all that helping someone through 'the dying time' is an honour regardless of what the person is like or the circumstances of their death.

[elcue]

Sara: To quote one of our colleagues above, "You done good". You cared for her with kindness and dignity, and I hope that throughout your career you will embrace the idea that helping a patient die as peacefully and comfortably as possible is most noble work. (regardless where in nursing you practice)

I have been in nursing for almost 30 years and still remember the first patient I was with at the time of death - her name, her face, the sounds. You will always remember Mrs. Hopkins and what you learned from your experience with her. You seem to be a beautifully compassionate person. Welcome to the sisterhood.

[SmilingBluEyes]

Bless you; you are one caring soul. You were there for that dying person and it will never be forgotten by you. (((gentle hugs))). Never change.

[911fltrn]

Dealing with a patients death is never an easy thing. If necessary seek support from, co-workers, family, friends or clergy to discuss your feelings.

Although i dont enjoy this part of nursing, Im honored to be a part of this cycle of life.

Please remove the patients name from your posting. The patients name is not necessary to your story and is potentially illegal.