I've been a nurse on the skilled unit at an LTC since January and my last shift had two firsts. My shift started with my first admission that occurred entirely on my shift (I work night shift so this means this poor woman wasn't discharged from the hospital until after 6:30 at night). Fortunately the admission went well (other than the fact that I had to do a complete med pass for the other residents in addition to all the new admit paperwork). I also had to spend some time with the family of one of the residents who was on hospice and was in the process of actively dying. Early in the morning, I called the family back, because I was concerned the resident was not going to make it until morning when they returned. When she was still alive at my 6 am med pass (even shortly before 6:30 when I was giving pills to the resident next door), I thought that she would make it to the end of my shift. However, when I went to check on her right before the day shift nurse came, I walked in and immediately knew she had passed away. She wasn't breathing (although she had periods of apnea before, they hadn't lasted this long). I grabbed my stethoscope and could find no heartbeat. I caught the day shift nurse coming in and had her confirm. And so my shift ended with my first patient death. I know it won't be my last. However, working in the skilled units, we get to see people get better and return home more often then we have hospice patients. I had a lot of respect for hospice nurses before, but I have even more now. It takes a special person to deal with that patient population on a daily basis. I know it's not for me--I need some good outcomes mixed with the bad.