1. Cunha, Samantha BS, RN, CMSRN, PCCN

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WORKING THREE NIGHTS in a row is something that usually doesn't bring a smile to my face. On one particular weekend, however, I had the privilege to meet an amazing man who not only brought a smile to my face but also a tear to my eye.

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I work in a progressive care unit, where we take care of patients who have complicated medical problems as well as emotional and spiritual needs. Mr. W, 88, was admitted with a diagnosis of bacterial pneumonia and neutropenia. He had a history of atrial fibrillation, chronic obstructive pulmonary disease, and transient ischemic attacks. He'd recently been diagnosed with chronic myeloproliferative disorder and transfusion-dependent anemia. Mr. W was aware of his diagnosis and prognosis and requested do-not-resuscitate status.


Before he was admitted, Mr. W had been living with his son and daughter-in-law, whom he spoke of very highly. His wife had passed away 5 years earlier; they'd been married for 67 years.


Deciding to go home

The first night I took care of Mr. W, he was receiving I.V. antibiotics. By the time I came to work on Saturday night, he'd decided he no longer wanted to continue treatments that would prolong his life.


During the night, we had several conversations about his life and things he'd done with his family over the years. He told me he didn't want to spend the last moments of his life in a hospital and wanted to go home.


When I left work that Sunday morning, case management was getting hospice set up so Mr. W could leave the hospital on Monday morning. During his last night in the hospital, Mr. W and I spent almost 2 hours talking about his family and his decision to die at home. I usually don't have that kind of extra time to spend with my patients, but my coworkers helped care for my other patients because they realized that Mr. W needed to talk with someone who'd be willing to listen. I was lucky enough to be that someone.


Mr. W told me that he wasn't afraid to die. He said he'd been ready for a long time and couldn't wait to see his wife again. He'd already planned his funeral and was hoping that his son would carry out his wishes. We talked about his family and his collection of vintage cars.


One simple request

Mr. W hadn't been eating much, but he asked me if I could get him some deli turkey with pickles on the side. No bread, no mayo-just turkey and pickles. I called the nursing supervisor and asked if she could go to the kitchen and get this for him. She did, and Mr. W couldn't have been happier. He told me I made his night.


In the morning, as I was getting ready to end my shift, I asked Mr. W if he wanted some breakfast. He said all he wanted was a banana. When I called the kitchen, I learned that no bananas were available. I felt bad that I couldn't fulfill this simple request. I gave report to the day nurse and told her about Mr. W's desire for a banana. Somehow she was able to find him one later that morning.


When I went to say good-bye to Mr. W, I held his hand and told him how it had been a pleasure and a privilege to take care of him the past 3 nights. At that point I saw a tear on his face. I had to work hard at holding back my own tears as he told me that the pleasure was all his.


Savoring the moment

Later, the day nurse told me how happy Mr. W had been when she handed him the banana. He smiled at her and graciously thanked her. She'd offered to peel it for him but he said he could do it by himself.


After she left the room she watched him from the nurse's station. Mr. W was taking small bites of the banana, savoring each one. He couldn't eat the whole thing, but what he was able to eat brought him joy. And at the end of the day, that's what it's all about.