A new trauma nurse's journal about being a "Real Nurse", life and all the stuff in between
Tuesday, June 5, 2012
First Patient Death
I was an LPN working in a long term care center on a ventilator ward when I experienced my first patient death. It was a 80 or 90 something year old woman who had suffered a stroke and been deemed unable to be weaned from the vent, her husband was unable to care for her at home in this condition so she was sent to my facility.
I will never forget this patient as long as I live, she stayed with me for 3 months. She was a tiny fragile things with long blonde hair that had faded to silver and ice blue eyes that followed you around the room when you approached. Her body had turned on her and had contracted into a small hunched frame that could barely straighten out. She never spoke, but when you touched her she would contract further into a tiny ball, her blue eyes glaring fiercely at you. We couldn't even give her medications in the traditional way because her G-Tube had become infected and the surgeon had told the family that she was in such bad shape that she would not survive another surgery. She received her nutrition through TPN, and most medications had to be given as a shot, since most nursing homes cannot give medications IV push like in hospitals. We had pain medications sublingual or as a suppository, but you could rarely get her mouth open and turning her onto her side to insert a suppository was dangerous as her oxygen sats would drop dangerously, even on a vent. Even with all this going on the family refused Hospice care, it took several long talks with a physician before they agreed to sign papers making her status "Do Not Resuscitate".
One night I was helping our aid Janet bath her. I loved working with Janet, she had been an aide for over 20 years and her love for her patients always showed. She looked at me and said,
"She needs permission to go, she's only hanging on because she's worried about leaving her husband and he's not going to give it to her."
Janet was right, this little ladies husband would come in faithfully every morning at 7am on the dot and stay holding her hand until 7pm every night, we would often hear him begging her not to leave him.
Janet leaned over and gave the woman a soft kiss on the forehead and looked into those angry eyes and said,
"If you need to go darling, go. He will be OK, we will take care of him until it's his time. But you need to go, so go." She stroked her hair and looked at me, "isn't that right, we'll take care of him?"
"That's right" I said, "we'll take care of him, you just do what you need to."
Later that night the aid assigned to vitals rushed over to me, she got a blood pressure of 60/30 and was distressed. I got up and headed into the room and knew instantly. I had never seen a deceased person before, but somehow looking at this woman I just knew she was gone. There was no code, no rush of people to save her, the charge nurse and a respiratory therapist came in to confirm what I already knew.
I feel like that was the night I "grew up" as a nurse. The charge nurse knew that the husband knew me best and asked me to call him with the news. When I called I learned that night that I could keep my voice from shaking as I told him that she went peacefully in her sleep and assured him that I would meet him by the doors to let him in. I learned that night that death isn't always a terrible thing that we must fight blindly, that it can be a merciful thing that allows suffering to end. That night I ceased to fear death and see it as an enemy but as a natural part of life, only made unnatural by the way we approach it.
To this day I still carry those beliefs with me and they help me deal with the deaths that I have since in my new position. I will never forget that patient and what she taught me that night.