I work on a very busy neurosurgical floor. I haven’t dealt with death a lot - only a girl with cerebral palsy but this was expected, she had comfort care, and she was surrounded by her whole family. This is what I considered a “good death”.
Another patient I had was an off-service medical patient who came in for hyponatremia, CHF, and failure to thrive. She was an elderly woman in her late 80s with no close family and was living by herself up until now. She was found by her landlord covered in feces on the floor after a fall, she was there for a couple of days and covered in pressure sores. On the the floor she would constantly ring every 15-20 minutes in the 12 hour shift for non-emergent things and she became quite well known as the call bell happy person. After 2 weeks, people were getting short with her (including myself) trying to get her to do things as best she could herself, but this didn’t really work out.
Fast forward to my night shift last night, one of my colleagues had her as a patient. She was audibly wet and had terrible SOB and her sats went down to the 80s. The doc came and started her on nebs, antibiotics and lasix. Respiratory came and got her 02 back up at 94 on 2LNP.
I went to help and insert and IV and she was shaking. I asked why and she said that she was scared and nervous. I reassured her that she is going to be okay and just for a moment to try and keep her hand still. After a couple of minutes her arms were still shaking and I said in the really direct tone please stay still and she did. At that point I felt rushed to get onto the next task and I could actively feel the compassion in my voice slowly go away. I needed to be better.
I got the IV in and she held into a rosary the entire time and and I said you have nothing to be afraid of we are going to take really great care of you, don’t be scared. God is with you. I was leaving the room and a CTA was with me. Her nurse was coming back for meds in a little bit. I said I was leaving but we would check in her.
The look in her eyes was pure fright. She said she did not want to be alone, she begged us to stay. We explained we have a whole floor to attend to also but we will check in routinely. We didn’t have the resources to stay 1:1 and her vitals were back to normal. Well her nurse went in for her meds not 10 minutes later and she was found dead. Nobody expected this at all.
She died alone, scared, and frightened. She had her rosary in her sweet hands and she held onto it until her final minutes. Wouldn’t even let go to wash her hands.
I feel an unbelievable amount of guilt. I let her die alone, I had no idea she was so scared because she probably knew she was going to die. She probably had an impending sense of doom and we left her. She had a PE. And if I was more compassionate and stayed with her and wasn’t short with her, her final moments would have been better.
I can’t do nursing anymore. I honestly don’t deserve to be one.