There is patient I will never forget.
She is my Roman Empire since the age of 22. I pray for her patience, understanding, and forgiveness from the side effects of a broken medical system
A lot of patient’s blur together and there is no recalling anyones names from my time in hospitals but I remember the face of everyone I had to perform post-mortem care on and the patients who died in my care. The privilege I held of taking care of them near their final moments on this planet.
Taking care of someone who is dying is a gift and privilege even if it doesn’t feel that way in the moment.
Death is special, just as special as a birth but often hidden away and not talked about in the Western world. Seen as the worst thing that could possible happen to someone but it’s not is it? There is peace in death. Especially in old age, after someone has lived a long life, or someone who suffers from a painful chronic illness that is incurable. Witnessing someone in so much pain that even the strongest dose of the most powerful pain medication on Earth doesn’t scratch the surface of the pain. Death hopefully providing the peace they deserve.
There are worse things than death.
The average person doesn’t know what the body looks like as it’s dying: the colors the skin turns, the way the breathing changes, and how death looks in that person’s eyes.
The patient I will never forget deserved more dignity in her death.
She was an elderly woman and collapsed at the facility she lived in and someone called 911. She was intubated at some point en route to the emergency room and was admitted to the intensive care unit where someone realized she had “Do Not Resuscitate” wishes. The doctor decided to pull the breathing tube and fast track her to the floor I worked on where she became my patient on a late, busy Friday evening because they “needed the ICU bed” for someone else, someone who wished to stay alive. She was wheeled down the hallway looking incredibly uncomfortable, skin already modeling, alert but gasping for breath, and death in her eyes.
She was actively dying.
“HOLY SHIT” was all I thought. I was not experienced enough for this and didn’t have the time to care for her with my four other sick patients that had a million tasks and medications needing to be completed before the end of the night. All the other nurses on the floor drowning in the same boat. Rushing and running around like there were never enough minutes in the day.
Sudden questions springing to my mind as we settled her into her new room, the ICU nurse spewing off report and darting out of the room as fast as possible.
Was there an order for palliative care?
Was hospice called?
Were there orders for end of life care or medications that make patients more comfortable as they die?
No, there was nothing but an actively dying patient now in the hands of an inexperienced nurse who had no idea what she was doing.
I called the admitting doctor on call and got berated at asking for end of life care orders, medications, and palliative care on a Friday night.
HOW dare his Friday evening be interrupted to do his actual job, asking for orders on a patient whose vitals were “stable” but she was very much suffering and needed more support. Saying “I think she is dying” but only getting screamed at because she was a DNR and he already put in basic bare bone telemetry floor orders. Bare minimum doctor he was. Basically saying because she was a DNR it didn’t matter.
Tears streaming down my face on the phone as I looked out of the big windows in her room while the sun was setting, her laying in the bed next to me with labored and gulping breaths, obviously in pain.
FUCK that doctor.
Finally getting an order for morphine and Palliative care consult but she wouldn’t be seen until the next day.
She wasn’t going to make it until then.
As I pushed morphine through her veins I saw the look in her eyes. She mouthed a “thank you” and looked a little more peaceful and at ease.
Scrambling through the rest of my shift caring for my other patients but only checking in on her periodically.
Every time scared to enter her space, scared to witness the end but relieved when she was still breathing and alive. Never wanting to stay too long in her room. Not wanting to face the looming energy of death. Not knowing how to sit in the discomfort and support her.
I gave report to the nightshift nurse and practically ran out of the hospital that night, sprinting away as fast as I could. I lay awake thinking about her, finding out the next morning she had died a few hours after I left. Alone in that cold, dark hospital room. None of her family or friends beside her. No one to help her pass from this life into whatever is beyond.
No one should die alone in a cold, dark hospital room.
In fact the death of a person should be treated like a birth. It’s strange how we so happily and gladly welcome life into this world in a cheery environment with family, friends, and a whole healthcare team in the hospital room. In death it’s quite the opposite, a lot of family members don’t want to see their loved ones actively die. We shove aging people who are dying away where we don’t have to see or hear them, hospital rooms or nursing homes covering it up for us, making people fend for themselves in their final moments.
There are incredible hospice agencies and palliative care but most people don’t utilize those services or even know what they can provide. Some people and families RUN at the word hospice and all it means. They want no part in their own death and dying process. They don’t want to look at the end of their humanity in the face.
Nursing has traumatized me but it has also given me a gift as most traumas do. The gift of the sacredness of death, a gift that will carry me throughout my lifetime.
Now when death is arriving I see the celebration and value in it, the dignity necessary for the dying, the grief and transformation it can bring, and not shoving it away to fend for itself.
I will walk into that room to dim the lights, turn on relaxing music, and sit down.
Because no one deserves to die alone.