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Shaving Cream & Expiration

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I shaved a dead man today.

Shaving Cream & Expiration

I hadn't planned to. I'd planned to shave my patient. When I mentally scheduled his "bath appointment" for 1600, he was still alive. But later, when I arrived for our engagement, he was already pretty near dead.

In truth, I really wasn't expecting it. But then, at the same time, I really wasn't that surprised.

I was next door in my other patient's room, helping her on and off of the bedpan when I noticed, via the bedside monitor, that his heart rate had dropped. He had been ticking away at around 83 beats per minute for the majority of the day, so when I saw the big, white numbers dive down into the low 50's, my eyebrows raised.

"Oh, man...is this it? Is he really gonna go for it this time?" I said to myself. I gave him a silent cheer of encouragement.

This might seem like a callous reaction, possibly a heretic. But it was necessary if I freaked out at every dipping vital sign, or critical lab value I see, I'd be a burnt out, nervous, wreck of a nurse. Also, I knew this man's story, and based on countless medical opinions found throughout his chart, he deserved some sympathetic, go-for-it cheering. He'd come to us without a chance in hell of being anything but a mechanically ventilated body. He'd suffered a massive head bleed, and his family had decided against the idea of risky surgical interventions.

Just that morning, the attending on our unit had upped his "Code Status" (aka what we do if someone's heart stops) from "Allow Natural Death," which only excludes chest compressions, to "Allow Natural Death, and Limit Therapy," which means that, in the event of cardiac arrest, we don't do anything at all except make him comfortable, and pronounce him when his heart stops. Pretty much just about everyone had signed off of his case because of his extremely poor prognosis.

I finished up with my other patient and made my way to his room to investigate the monitor's fluky readings. He had done this before - yesterday - his heart had slowed down and then picked back up again, ticking away without a glitch. But this time was different. I didn't even have to look at the monitor or feel a pulse to know that he was dead. In the short time since I'd been gone in my other patient's room, his face had gone from pink and rosy to yellow-ish blue, and he had started cooling down. I ran a cycle of the blood pressure pump-no reading. Thready pulse. Called the resident, and we both agreed...even though this man's heart was still beating 70 times a minute, he was almost completely gone.

It only took a few more moments for it to become official. While the monitor beeped ASYSTOLE! ASYSTOLE! ASYSTOLE! the resident did his death assessment, pronouncing the patient just a few minutes after four o'clock. I did my best to keep our delayed appointment, lathering up his face to give him his last shave, only five minutes late.

Sick? No. Weird? A little. But let me explain. When a patient dies who is a family member to anyone - girlfriend, niece, daughter, wife, brother or cousin - the best thing that can be done is to make he or she look as normal as possible. After having looked at their loved one with tubes and drains sprouting from their mouths for the past week, all the family wants to see is that the patient's face has become familiar once again, even if in death.

So, I took out his breathing tube and feeding tube, and the tape that held them in place, and I shaved his slouching face. The cut came out clean; without any life behind it, his face had no reason to resist or turn away from the razor's blade. When I was finished, I took out his IV's, put on a new gown, made sure his hair was in place and laid his hands open on the bed for his family to hold.

It's peaceful to help someone leave this place when it's right for them to go. There's something strangely holy about watching a person's life change from breaths and words, to numbers falling to nothing on a computer screen.

Hospital policy: Patient's families have two hours to come and view the body after their time of death. Two hours passed, and no one came. The resident, who had spoken to the family, told me that they couldn't make it.

No one to see how well I'd shaved him.

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19 Comment(s)

OUTSTANDING.

I'M SURE HE APPRECIATED IT NO MATTER WHERE HIS SPIRIT TOOK HIM.

Blaze

Trust me....someone saw how well you shaved him.

Starr1966

Specializes in Acute,Subacute,Long-term Care. Has 14 years experience.

beautiful and very touching article.

Someone above saw and noted your kindness. It will be returned when one of your family is in need. The patient appreciated it too, in spirit. Have a blessed day.

gentlegiver, ASN, LPN, RN

Specializes in Geriatrics.

Sometimes the things we do go unnoticed to all those surrounding us. What you did was wonderful and you were seen, make no doubt of that. Your story brought tears to my eyes and a prayer to my heart.

Thank You

dbscandy

Specializes in Renal; NICU. Has 37 years experience.

This was a most moving and well-written article. I cried but am thankful for what you did for this lone soul.:heartbeat

streptococcus

Specializes in Emergency Department.

I would be grateful for such after life care. So would my family. Great nursing!

My father died the day after we moved him into a LTC. I live 6 states away. I hope someone as loving as you took care of him:heartbeat

walk6miles

Specializes in ICU of all kinds, CVICU, Cath Lab, ER..

I believe you understand the secret to being a nurse. God bless!

santhony44, MSN, RN, NP

Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

Your efforts and kindness weren't wasted. Thank you for taking such good care of him.

cyndiangel13

Specializes in Trauma/Surgery Floor.

your story is wonderfully inspiring, especially to a student nurse. thank you sooooo much for sharing. you embody the spirit of nursing!!! :)

martinb216

Specializes in LD, stroke rehab, orthopaedics, urology,. Has 22 years experience.

agree entirely with what you did

I don't think your thoughts were weird or unkind. I have felt the same way. I think the Nurse who says "Don't you die on my shift!" is the one who is unkind, and your aftercare was wonderful.

One night I too had a patient who was knocking on heaven's door. Her hair had been put in a ponytail and was very matted, almost like a dreadlock. My awesome nursing assistant spent over an hour carefully bathing this homeless, substance addicted lady who was sedated, ventilated and on multiple drips, while I washed and carefully brushed out her hair. It turned out to be a lovely shade of strawberry blonde. I carefully fanned it out prettily on her pillow. For some reason it is very important to me that nobody should cross over on a bad hair day! My very tough hardcore charge nurse boss actually told me how impressed he was that we took the time to focus on this. The thing I love best about ICU nursing is having the time to focus on my patients and give them real, personal caring. It may seem petty or irrelevant when someone is dying, but I love to give people the spa treatment, footie rubs and those little comforts, especially when they have no friends and family with them. Everyone deserves to feel loved as they depart this existence. If I have cared for them for a while and gotten attached, I will kiss them on the forehead and say a blessing after they are gone. It is also a local tradition that we must open the window in the room to let the spirit depart. It is an honor to help people pass with dignity. I can usually sense it on some level beyond concrete senses when someone's spirit departs. Sometimes they body is still being vented, supported with pressors, but they already are gone, one just knows it. Sometimes it's a blessing when we let them move on.

Mishka13

Specializes in OB/NICU/ER/Psych/Drug Safety. Has 31 years experience.

Hi-

Not "no one" as you gave this man some dignity and I am sure that he appreciated it.

LovingNurse, BSN, RN

Specializes in Oncology, Triage, Tele, Med-Surg.

No act of kindness, no matter how small - is ever wasted. Doing the right thing, even when no-one is around to appreciate it, is what really shows a person's character. Enjoy who you see when you look in the mirror. :redpinkhe