of charting. That's all it took to sum up the death of my 89-year-old patient yesterday, a man with dementia and Parkinson's disease who came in with a colon full of stool and a little, old, bent-over wife named Lenora.
He'd been in so much pain, and the morphine was helping only a little......and then I'd had to go in there and give him MOM, Miralax, and two enemas which relieved only part of the obstruction. Lenora, meanwhile, sat there and held his hand through it all, talking him through the procedures and even encouraging me: "It's OK, dear, I know you're doing what you have to so he can feel better".
Finally, she went home with her family a couple of hours later, after he'd lapsed into a fitful sleep.....I got a wheelchair for her as she was too tired to walk downstairs, and promised her that I'd take good care of her husband of almost 70 years.
I checked on him throughout the afternoon, medicating him a couple of times when he groaned, watching his respirations as he slept, but otherwise allowing him to rest after the rigors of the morning. It was right at six o'clock when I went in to tally his I & O for the shift that I found him, lifeless and cold.....I knew without even checking for a pulse that he was gone. He appeared to be at peace, as though death had come not as an enemy, but as a comforting friend; still, my first thought after the initial shock was, "But I promised his wife!"
God, obviously, had other plans for this man, and since He knows best, I said a prayer for the repose of his soul and began the post-mortem ritual of notifying the physician and the nursing supervisor, preparing the body, and then calling the family. As I did these tasks, I wondered who this elderly gentleman had been........had he been happy as a boy? Had he fought in the war? How many children had he had? Was he a good husband and father? What kind of work had he done? I wished I knew these things......
I sat down to document what must surely be the second most important passage of a person's life, and it struck me as sad that the event could be described so simply......almost ninety years of what must have been a productive life, reduced to seven lines of dry medical descriptions in black ink on a piece of yellow paper. Yet I knew, even as I wrote, that this was meant to remind me that, however insignificant an individual may be in God's infinite universe, it's not how one dies that matters......it's whether he or she loves, and is loved by others.
And I was reminded again of how we, as nurses, are privileged to be part of our patients' and their families' lives........even in death. We see it all.......people of every shape and color and creed, at their worst moments and their best.......and we are given the sacred trust of caring for the patient even after the soul takes flight, preparing his body for its final rest, and providing support for those he leaves behind.
Just a few thoughts on a hot summer's day, when the world is bright and Heaven has just welcomed its newest resident. :)
Specializes in LTC, assisted living, med-surg, psych.
Thank you everyone.........I share these thoughts with you because no one but a nurse (or student nurse :) ) knows what this is like. My family tries hard to understand, but they can't......they have no real concept of what it is that I do all day, or how deeply it affects me sometimes. It helps me immeasurably to be able to come here and wrap some words around my feelings; otherwise I'd probably keep it all bottled up inside and then blow a gasket.
At a funeral once, the preacher was talking about peoples tombstones. He said "there will be a birthdate and a deathdate...but the most important thing is the dash in between. Its our lives here on earth that is the most important...thats what the dash stands for" This has always stuck with me. Marla, now you can be a "part" of this pts "dash".
Specializes in LTC, assisted living, med-surg, psych.
At a funeral once, the preacher was talking about peoples tombstones. He said "there will be a birthdate and a deathdate...but the most important thing is the dash in between. Its our lives here on earth that is the most important...thats what the dash stands for" This has always stuck with me. Marla, now you can be a "part" of this pts "dash".
Thank you. I really didn't do that much for him.....but as always, I felt honored to be there for him at the end. Some of my most memorable moments as a nurse have taken place at the bedside of a dying patient. For some reason, it's then that I often feel the closest to God, and I still marvel at the mystery of death, even though I know the science all too well and have gotten pretty good at predicting when it will happen for a given patient.
For me, it's the ultimate adventure.......and while I'm nowhere near ready to undertake it myself--nor would I ever hasten it intentionally for anyone else--I find sharing those final moments with a fellow human being both a humbling and inspiring experience.
Thanks for helping us all to reflect on an event that can become routine to healthcare workers. I am typing this with tears in my eyes as I was moved so much, and I know your words will come back to me the next time I am present at the passing of a soul.
Brings back memories of my four years as an inpt hospice nurse. Here is my favorite poem on dying- it brings tears to my eyes every time I read it.
Gone From My Sight
by Henry Van Dyke
I am standing upon the seashore. A ship at my side spreads her white sails to the morning breeze and starts for the blue ocean. She is an object of beauty and strength. I stand and watch her until at length she hangs like a speck of white cloud just where the sea and sky come to mingle with each other.
Then someone at my side says: "There, she is gone!"
"Gone where?"
Gone from my sight. That is all. She is just as large in mast and hull and spar as she was when she left my side and she is just as able to bear her load of living freight to her destined port.
Her diminished size is in me, not in her. And just at the moment when someone at my side says: "There, she is gone!" there are other eyes watching her coming, and other voices ready to take up the glad shout: "Here she comes!"
Specializes in LTC, assisted living, med-surg, psych.
I love that poem, too......the very first time I read it was at a friend's funeral, and it's one of my favorites. Thank you for including it in your post.
I think you made him feel comfortable enough to "go home." I know I'm not looking forward to making those "phone calls", but I like to think I will be lucky enough to make that person feel safe enough to go. He knew he was with someone good last night and his wife knew that he was in good hands when she left and that is a tribute to you.
Marla, it certainly sounds like you kept your promise to his wife after all. You took care of him, such good care he was able to die peacefully. She had all the faith in you or she wouldn't have left. Good for you for not letting her down.
The prayer of St. Francis..........One of my favorites.
Thank you for including it in your post.
VivaLasViejas, ASN, RN
22 Articles; 9,996 Posts
Thank you everyone.........I share these thoughts with you because no one but a nurse (or student nurse :) ) knows what this is like. My family tries hard to understand, but they can't......they have no real concept of what it is that I do all day, or how deeply it affects me sometimes. It helps me immeasurably to be able to come here and wrap some words around my feelings; otherwise I'd probably keep it all bottled up inside and then blow a gasket.
I'm glad you all are here. Thanks again. :)