WORKING THE NIGHT shift on a busy med-surg unit, I went in to assess my first patient. Mr. P had been transferred from the ICU after being admitted with respiratory failure. He opened his eyes only in response to painful stimuli and required frequent suctioning.
I'd been a nurse for only about a year, and caring for a patient like Mr. P was overwhelming, especially since I knew he could take a turn for the worse at any moment.
Close watch
When Mr. P's BP started to drop, I immediately contacted the healthcare provider on call. Her assessment was simple: His body was beginning to shut down. Mr. P had a do-not-resuscitate order; knowing that I wouldn't be able to do anything if he coded was difficult to accept.
I kept a close watch on Mr. P as I tended to my other patients. I turned and repositioned him throughout the night and provided frequent mouth and skin care. I did everything I could to keep him as comfortable as possible.
I also continually talked to him, occasionally stroking his face with my hand.
Letting go
Toward the end of my shift, Mr. P became unresponsive, apneic, and pulseless. I experienced a flood of emotions: shock, sadness, relief, even guilt, wondering if I'd done enough. Mr. P was my first experience with death. It's something that nursing school and even the best of preceptors can't prepare you for.
My coworkers did their best to make me feel better, but it was the words of the charge nurse that comforted me most. She said I'd done exactly what I was supposed to. I'd made him feel comfortable and safe enough to let go.
Despite the advice of my seasoned colleagues, I went home and cried some more. I knew I couldn't move on until I'd cried for him, for his family, and for myself. What helped me the most was writing in my journal, which helped me deal with all of my emotions surrounding Mr. P's death.
Consolation and comfort
Mr. P's death taught me the importance of respecting my patients' wishes and taking the time to do even the smallest, seemingly insignificant things for them. I encourage new nurses to keep a journal and talk things out with supportive colleagues. By working through my own feelings on death and dying, I'm now able to be a better nurse for my patients and their families.