Musings of a hospice nurse...

I attended a death of a patient last week...a younger woman with a quick progression from diagnosis to death.  I say "attended" because that's the fancy hospice term for going to the house, pronouncing the person and calling everyone who needs called.  I always feel like that word is too sterile...too formal.

Anyway, this patient was a fighter and she wasn't going to die.  We did not discuss death, dying or anything to suggest that she was not going to live.  From my perspective, there was no question that she  was going to die and it was coming pretty fast.  But, her plan was to be in the 5% that beat the odds and that was the way I cared for her.  

Then last Monday, as I was caring for her, she sat on the side of the bed and said, "Terry, I think it's time to go."   I shook my head and looked up at her (because of course it seems like when those moments come, I am already on my knees) and she asked me if I understood what she was saying.  I told her I did.  "You are tired of fighting so hard, tired of feeling bad and tired of being in pain.  You're ready to die."   As I was talking, her husband came around the side of the bed and began to tell her it was okay..."I don't want you to go, but I also don't want you to be in so much pain as you have been in the last few days" and then he went on " You are my hero...I've never seen anyone fight as hard as you and if you are ready...it's okay to go."  

We settled her into bed, gave her the medication for comfort and walked down the stairs.  We talked about the patient, her strong will, her faith in God and how she had finally come to the place of acceptance.  He wondered if he needed to take her to a hospice facility...or could she stay home?  

I spent the next half hour talking about how he did the hardest care for his wife already.  How she was in pain and he medicated her and how when she needed to be cleaned up, he did that too.  "Now your job" I told him "is to get in bed and hold her and love her until she is gone."

Tuesday came and I called him to check on her.  He said she was awake and talking and that the kids were there and everyone was in the bedroom with her loving her up.  I encouraged him, offered to visit and he declined.  He felt like the family was with him and she was very comfortable...

The Wednesday visit was hard as she had declined more and was less responsive but very comfortable.  It was all it could be in the worst situation possible...losing a wife and mother so quickly and so young.

The call came Thursday that she was "gone".  I arrived at the house to find the family in bed with her, comforting each other and talking about how peaceful she was and how the end was "good."  They were in tears for the loss and tears for the feeling of relief that she was not in pain anymore.  

Oh good Lord, it was so sad.   When I began my job...I put my stethescope to her chest, put my head down and began to choke up...I was so happy that she was out of pain and she was at home with her family, but so sad that she was gone.  I looked up at the family watching me, embarrased that I was so emotional from the beginning and nodded yes.  She indeed had crossed over...was gone...had passed away.  I looked at her face and it was if she had a little smile and asked the family what they thought.  They agreed and took solice in her expression.

I learned a lot from this family and how they handled adversity.  The patient's husband talked about how he was told by so many people that she had to go to a facility and how she had to admit she was dying.  I, at times, felt like it would have been better to talk about it.  He always said no and politely declined.  It wasn't that he didn't know or didn't want to face it...he was honoring her wishes to fight until she decided she didn't want to fight anymore.  He decided that he was not going to have any regrets and so he went about his last days with her that way.  He cared for her with grace and dignity and kindness and love...and when she said she was done, he helped her through that time in the same manner.

The next day, Friday, I walked around in a fog but wanted to celebrate life, so I invited some friends over.  As I sat on my patio sipping wine, I thought about my patient's husband and the heaviness of his heart...and uttered a silent prayer.  Me, I poured myself another glass of wine and listened to the laughing and banter around my table.

Once again, the lesson is...Life is short, hard and wonderful at the same time.  I only hope and pray that I have less regrets and more fond memories and I continue to live.  I wish that for all of you as well!

We'll tawk tomorrow,
I love you all,
Terry