I see many things in my career as a critical care nurse, some frightening, and some fantastical. I see moments of triumph, and conversely I sometimes see instances that make me want to scream in frustration. But occasionally I see true strength and courage exemplified in the face of difficult decisions, and it’s these moments that rock me to the core.
Sometimes the really painful calls made by a caring family member allow the patient to become pain-free. It clothes them in dignity as they pass beyond the walls of my hospital, and enter their forever home.
To the son of my dying patient I say, “thank you. You did good.”
Looking back the sound might have been deafening to anyone else, but the steady alarm had been going off long enough that those of us at the bedside had become comfortable with its high frequency call of urgency. Or as comfortable as you can be in a life or death situation.
The frantic yet fluid motion of life-sustaining interventions filled the room as fully as the sound of the monitor’s distressing cry. The normally large room felt very small then as commanding voices offered instruction for the team.
“Charge to 200 joules!!”
“Clear!!”
And her body jumped off the bed.
More medications were pushed, and more shocks were delivered, all in the concerted effort to get her heart back to a rhythm compatible with life.
The team conferred amongst one another searching for ideas for the next logical step to continue the course, to continue the fight.
“We should secure the airway!”
And that’s when I saw you. I looked over my shoulder, and I saw the anguish on your face immediately.
“Momma!” You cried. Then tears poured down your face.
She had a heartbeat, and it was regular for now. So we encouraged you to be at her side for the moment while we could.
“Hey Momma, I’m so proud of you.”
Your voice broke as you spoke, and I felt my throat try to close. I wanted to cry too, and I felt the tears well-up and threaten to spill.
No, not yet. I told myself though, and I willed myself to hold my emotions in as there was still serious work to do. I knew she wouldn’t stay in a regular heart rhythm long, and I could tell you knew it too.
I winced as she told you it hurt, and I recalled all the shocks and beating on her chest she had endured, and not just the one day either. This had been going on, repeated code blues and tubes down the throat for over a week.
“Don’t worry Momma. I won’t let them hurt you anymore.”
I watched you watch her while I hung more IV medication, and she smiled; then she closed her eyes. Exhausted from fighting. I watched your tears and your determination to do right by her.
Well, you did good.
When the doctor came back in after talking to you in the hall he told us the next step. “No intubation. No shocks.” I know it wasn’t easy for you to make those tough decisions, but I’m glad that you did. And I believe your Momma was too.
I knew the whole picture, the very stark physical obstacles we were fighting against, but we would continue to fight as long as you both wanted. Until it wasn’t time to fight anymore.
You did good, and you did the right thing. You know your Momma better than we ever could hope to know her, and when she was ready to let go and go home you allowed her that right.
I know that when you said goodbye it was hard. I’ve been there, and so many of those of us working at her bedside have made the same decision you made. Don’t doubt yourself, but simply celebrate the beautiful life your mother lived. Remember that she left this world with dignity. She was just tired, and she needed to finally rest.
She did good right up till the end, and so did you.
Patricia Stevens says
Brie, I truly love reading about your experiences. As I’ll be finishing nursing school in just a few weeks, I look forward to so many things but worry how I’ll react in those situations. Will I be able to keep my emotions in check until I’m alone to let the tears flow?
brieann.rn@gmail.com says
I can definitely tell you this. You will become capable of doing so much more than you ever thought possible. You’ll be amazed in fact. You will do whatever you need to do to care for your patient. Sometimes that means crying, but sometimes it means not letting a tear fall.
Tabitha Ward says
Wonderful post! We all can relate! There have been many of times I’ve had parents begging me, the doctors, and God to save their baby! One of the hardest thing is when they don’t make it. I have peace when I see the parents realizing their baby is not suffering anymore. Yes, I am one of those nurses that stand there and cry, but I keep myself together to take care of the family! Great post! I enjoy reading them! Thank you, and God bless you!
brieann.rn@gmail.com says
Thank you so much. God bless you for the special work you do as a nurse.
Kathy Nolan says
Had similar experience last night at work. It is the hardest and most satisfying part of our job…to help a family and patient get comfortable about end of life decisions. You express it so well and bring tears to my eyes. Thank you
brieann.rn@gmail.com says
Thank you. 🙂
Denise says
I can’t say it any better than those who have written before me. All I can add, and I am sure we all agree: I am proud to be a nurse!!
brieann.rn@gmail.com says
Thank you.
Karen S. says
Thank you for this very true and real post. Ditto this sentiment- for those elderly folks who are so frail and have lived an amazing life and are ready to go…
brieann.rn@gmail.com says
Thank you.
barbara napier says
I’m not in the nursing profession, but I stood beside my son’s bedside and let go of that special young man! I asked all to let me say a prayer and I prayed for him, his family, and everyone at the Med that had touched his and our lives over the last three months! Thank you for your caring words, the uplifting of needed spirits, and being a fellow professional to my son’s daughter!
brieann.rn@gmail.com says
Thank you so much for commenting and sharing. God bless you.
mona scarbrough says
Thank you for your words. I am a Hospice nurse and see these agonizing decisions every day. You described those feelings exactly. Thank you.
brieann.rn@gmail.com says
Thank you.