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Our peaceful Sunday afternoon was shattered by that one phone call. "I think your mother-in-law is dead" were the chilling words spoken by my wife's father. We rushed over to their house to find my mother-in-law on the bathroom floor surrounded by paramedics and firemen. The instincts instilled in me after 15 years as a registered nurse in the intensive care unit, acute care, home care, and hospice quickly kicked in, and I checked for a carotid pulse but felt none.


There I stood with my father-in-law, a retired Texas State Trooper, watching in disbelief as the emergency personnel attempted to revive my mother-in-law for some 30 minutes. The helplessness I felt as I watched the Emergency Medical Services personnel continue to administer cardiopulmonary resuscitation to no avail was profound. As nurses, we believe sometimes that we can do almost anything. We are trained to save lives, administer medications to maintain the equilibrium, or stabilize the delicate balance we so often take for granted. There I stood, tears flowing down my face, unable to do anything for a wonderful person whom I loved and admired so much.


I could not help but wonder if Mom were watching what was going on, what were her thoughts? Then I remembered the conversations we had had, about others she knew who were seriously ill and their families took extreme measures to revive them or prolong their life. She was very clear that she did not want those kinds of measures; she wanted to be allowed to go peacefully. Yet, here we were, sensors and monitors beeping, emergency medical technicians compressing her chest repeatedly. I knew this was not what she would have wanted. And yet I was immobilized to stop it!!


The days following her death were filled with too many decisions regarding funeral plans. Traditional burial or cremation? If burial, what style of casket? What kind of service do we want? Do we want to request memorials in lieu of flowers? What were her favorite songs? All of these decisions seem rather mundane and simple on the other side of the experience, but in the midst of grief, these decisions can seem daunting and insurmountable.


As I reflected on all the events that transpired around my mother-in-law's death, I continued to be unnerved by my sense of helplessness. There should have been something I could have done. As I mentally replayed all the events, I realized that clinically, there was nothing else that could have been done to save her life; the emergency technicians did everything they could.


Where I could have made a difference was before her death. In my work, we encourage patients to put their wishes regarding the end of life in writing through proper documentation, such as a living will. Making arrangements ahead of time through the funeral home can also relieve the family from making decisions based solely on emotions. I should have encouraged my in-laws to put their wishes in writing, thus ensuring that her death was as she chose.


Being a nurse did not prepare me for the death of my mother-in-law, but I hope experiencing death on a personal level has prepared me to be a better nurse as I care for patients and families. This experience not only makes me more compassionate at the time of death, but also encourages me to be proactive in assisting patients to voice their wishes in advance and through proper documentation. I know now that I was not prepared for the front row at a funeral. In the future, I will be much better prepared.