The Sad Nurse Speaks

As it is with life in general, love and loss are part of nursing. We open ourselves every day to the possibility that we'll have to say good-bye to a patient we've come to know well, and when it happens, the pain can be intensely personal. This story was written on the same day the author suffered the double loss of a patient and a family pet. Nurses Announcements Archive Article

The phone call I've been dreading comes at 0217. It's my night shift med aide, who informs me through tears that our much-loved resident, Evie*, has passed away after lingering for days in an unresponsive, but obviously uncomfortable state. She has required morphine every hour and Ativan every 2 hours around the clock, as well as sublingual atropine to combat the secretions that made her respirations sound like the rumbling of faraway thunder.

At this same time, I can hear the death throes of my 14-year-old cat, Katie, who lies on a soft blanket at the foot of my bed. She's been in delicate health for the past year or so, but until Thursday night she was still eating, drinking, and using the litterbox. Now she is on her way over the Rainbow Bridge, and all my husband and I can do is wait for the end and wish they had hospice for pets....

Sometime around dawn, I hear him get up and shuffle around the bedroom. I ask him to check on Katie, who---like Evie--- clings to life with a tenacity we never knew she had. She's always been our little fraidy-cat, our shy girl who runs behind the sofa when guests come to visit.....what is preventing her from joining our other cats who have passed on?

I think about Evie, who also fought health problems and depression for most of her later years. What, I wonder, had she been holding on for? Her family was all there at her bedside, she had lived a long and productive life......and yet she had held on until the very end with a grip that surprised even those who knew her best.

I fall back into a fitful doze filled with vaguely disturbing dreams that vanish the instant I hear my husband open the bedroom door. This time, I don't even have to ask, because I know. She stopped moaning an hour ago. But of course, I am a nurse and I must see for myself, even when the departed is a beloved house pet. Perhaps because the departed is a beloved house pet.

Yes, Katie is dead. Definitely. I weep for one of the best cats I've ever had. But it doesn't take more than a minute or two to realize that I'm grieving for Evie too......and for all the patients and family members and pets I've ever had to say good-bye to. For a brief moment, I almost envy them, for they suffer no more and at moments like these, the pain is almost more than I can bear; however, this thought is quickly banished lest it lead down a path best left unexplored.

I watch as my husband prepares a grave for Katie in the back yard garden, under our bedroom window. Poor man, he always gets the worst job of all. He lays her shrouded body gently in the earth, and at this point I have to walk away because I cannot bear to see him cover her, to hear the dirt clods falling into the grave. Again, I think of Evie, who often quoted from the Bible, and recall the verse "from dust you came, and to dust you shall return". Strange, how we mortals think that we're so important.......and yet, when it comes right down to basics, we are but a speck of dust in the infinite expanse of eternity.

From the warmth of our living room, I stand at the window and watch as the brisk November wind strips the last of the autumn leaves from our trees. They swirl madly as if trying to show off their glory before dying.....then they finally surrender to the inevitable and fall like snow, carpeting the floor of our woods in brilliant yellow.

Being somewhat imaginative, I cannot help making a metaphorical connection between this scene and the sad circumstances of this day. I am a nurse, a student of science, but I have seen and experienced a great deal of death and loss in my lifetime, and I have to be able to explain these things to my heart so that I can open myself to care for another person---or creature---whom I will inevitably lose.

Eventually, of course, it will be my turn to leave. And as unscientific as it sounds, it comforts me to believe that everyone I've ever loved and lost will greet me at the gates of Heaven. I look forward to hearing more stories of long-ago times from Evie and all the other elderly patients I've cared for, and to having my lost fur-babies purr on my lap once again. But for today, the skies are grey and weeping for the dead, and for those of us left behind to mourn them.

I am sorry for both of your loses. It is really hard when there are deaths that you face even if you know that it is coming it is still sad when it happens. Your words made me feel what you are going through and it is both beautiful and poignant.