You Might Be The Last Person Whom The Patient Sees Before He Dies

TheCommuter, BSN, RN

One of my sweet patients, a gentleman in his late 80s, died not too long ago. To keep things short and sweet, I will leave out the major details surrounding his demise. I wish to guard the man's final moments on this earth while upholding his honor and privacy. After all, his last few living, wakeful hours are filled with experiences that are not mine to reveal.

I will divulge the fact that his decline and eventual death were sudden. 24 hours prior to his final departure, he was in stable condition, ambulating with a rolling walker, and was expected to discharge home soon. I clearly recall assisting him with toileting at one point during a recent midnight shift. He was smiling during the ten minute affair, conducted himself in a gracious manner, and thanked me for my help.

This might sound trite, but I take the utmost comfort in the fact that his last few memories as a living man included an attentive family who loved him and competent healthcare workers who treated him with dignity.

A number of patients in his age range die alone in this country after having either outlived or alienated family and friends. Moreover, a handful of healthcare staff members are not always pleasant with every interaction, so some patients' final moments consist of encounters with people from 'the system' who might have been less than polite.

The abrupt doctor who quickly breezes through rounds while not paying close attention to his or her patients' concerns is guilty of this behavior. The unfriendly nurse who does less than the bare minimum is guilty of this behavior. The rough nursing assistant who views his patients as objects is guilty of this behavior. The clueless unit manager who walks past a blinking call light without finding out what the patient wants or needs is guilty of this behavior. In fact, anyone who works directly with patients in the healthcare system can be guilty of this behavior.

To be frank, some patients are verbally abusive and others are outright despicable. Who wants to be nice to someone like this?

However, it is feasible to avoid stooping to the level of our more spiteful patients, and it is possible to provide competent care to them while maintaining one's professional composure.

In summary, make it a point to treat all patients with professionalism, courtesy, and respect during each encounter. After all, your face might be the very last one the patient sees before she makes her final departure. You might be the last person who ever touches the patient before he dies.

Rest in peace, sweet patient. I didn't know you very well but I will never forget you.

BrandonLPN, LPN

Thank you for sharing this, Commuter. Nurses wo say they could never work in LTC because it seems like a "pointless" job would do well to read this.

TheCommuter, BSN, RN

Thank you for sharing this, Commuter. Nurses wo say they could never work in LTC because it seems like a "pointless" job would do well to read this.

Thanks. However, I no longer work in LTC. I actually work at an acute rehab hospital where the average length of stay is anywhere from one to three weeks. Since the average age of our patient population is 60+, we do see our fair share of elderly patients here.

But, yes, I worked in LTC on and off for six years and I know exactly what you mean. In most cases, these are the final years of the patients' lives and you might be the last caregiver they see before they pass away.

So it always pays off to treat patients with kindness, because without them, nurses and other healthcare workers would not have jobs. We cannot provide nursing care if we do not have patients.

LindaBright, MSN

I have the utmost respect for LTC nurses, and have heard similar stories from many colleagues. The care provided to a person prior to death is one of the most selfless gifts a nurse can give, even while heading off insults and some of the abhorrent behaviors a lot of LTC patients can have (that are usually no fault of their own).

**Hygiene Queen**

When I worked in LTC as an aide, I was often caring for those residents as they drew their last breath.

I spoke to them, gently turned them, kept them clean and comfortable and stayed with them until they passed.

Several times, I had walked into a room and realized the end was near, held their hand and let them know they were not alone and it was okay to let go.

Some of these residents were not very nice people... didn't matter.

It's about respect and making those last moments comfortable.

So many of these folks have no one. Just us nursing staff.

You always have the best articles, Commuter!

TheCommuter, BSN, RN

I have the utmost respect for LTC nurses, and have heard similar stories from many colleagues.

The patient in my aforementioned article was not a LTC resident. However, LTC nurses deal with end-of-life issues all the time due to the geriatric patient populations with whom they come into contact, so this definitely applies to them.

I once stumbled upon a statistic indicating that less than ten percent of elderly people in the US live in LTC institutions such as nursing homes. The vast majority live in the community either alone, with spouses, or with adult children.

Patstagner

In all encounters we have regardless of this being a patient, neighbor, family, friend or a stranger we happen to meet, give respect. It may be us in our last moments of life too.