I only suction the dying patient when the family insists. I try, try, try, to convince them it's pointless and uncomfortable, but sometimes it's all about how the family feels. Not the patient.
I've always considered suctioning a form of torture. Secretions build up, suction them out, secretions build up, suction them out. A cycle that simply prolongs the dying process. Not everybody thinks the way I do, so I keep my belief about torture under my hat.
I feel the need to explain the torture thing. That's a personal observation. I'm not saying the nurse who suctions is evil and sadistic. Not saying that at all. I'm sure the nurse who thinks suctioning makes the patient more comfortable thinks I'm evil and sadistic. I've even had one or two tell me they thought I was wrong headed about this issue. Maybe when I'm dying, and I'm rattling enough to raise the roof, I'll know which one of is right.