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I will never forget a difficult shift in 1992. I was working evenings on a busy medical unit at the Veterans Administration Medical Center.

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We didn't get many cancer patients on our floor because they were usually admitted to the oncology unit. So, I was quite surprised when I learned a young, female patient with advanced breast cancer was being admitted into my primary module. Her name was Carol.


I had one year of previous experience working in oncology and wonderful memories of taking care of these exceptional patients. It takes a special kind of person to deal with cancer patients. It is not only the illness of the patient, but the emotions of their loved ones and extended family members that compound and intensify everyone's needs. Once, in the middle of the night, I checked on a patient and found his wife in the hospital bed with her husband, her arms wrapped around his waist squeezing her dying husband because she knew it would be the last time that she would hold him in her arms. What do you say or do in times like these? I've cried right alongside my dying patients as well as with their grieving spouses, releasing the pain of watching the transition from this life to the next.


I've prayed with some patients when asked and have held their hands when others have prayed. I have often felt the presence of God during the last moments of life. When my father and mother-in-law were spending the winter near us, he threw multiple emboli to his kidneys and intestines; both organs simultaneously shut down. In less than forty-eight hours, he went from being a relatively healthy seventy-six-year-old to a dying man. After his physicians gave him the grim prognosis of dialysis and a colostomy, he said, "I have lived a good life and I do not want to go on any machines; I just want to die in peace." So the family, including six of his sons, his wife and many of his daughters-in-law came to be with him. He was given palliative care at a local hospital and lived six days. My husband and I took care of him the last two days of his life. It was a wonderful experience to see so much love around him, and we knew when he died he was at peace with God.


Despite my experiences with death and dying, I did not realize how the experience with Carol would change my life. Carol was thirty-two and had been sent home from the Gulf War after she found a lump in her breast. She was a wife and the mother of two children, quite afraid as she awaited a prognosis of her condition. I was standing in her room when a young physician came in and announced to her that she had terminal cancer and would likely die soon. Then he walked out, without saying another word. Carol began to sob.


I thought, What a cruel, stupid thing for anyone to say, especially a physician to his patient But I couldn't let Carol realize my anger or frustration. Somehow, I had to turn my energy around and focus it on her. I wanted her to understand that she was the most important person in the world at that moment and that I cared how she felt. I asked her if I could sit with her for a while and she said yes. I excused myself to ask my coworkers if they could watch my other patients, explaining Carol had just been given her prognosis, and no one else was with her right now. They understood and encouraged me, saying they would cover my work as long as was needed. I gave them a quick report on my patients and returned to Carol's room.


I sat, saying nothing, trying to console Carol while she cried, occasionally touching her arm or shoulder. At one point, she drifted off to sleep. When she awakened, she thanked me for staying with her, repeating she would never be able to thank me enough. I told her, "That's all right; I wanted to stay."


She then said, "How will I know when I'm going to die? I'm scared."


I thought for a while because I didn't know how to answer. I hadn't considered this before but knew there must be a helpful answer. I pondered to myself, "What would God say if she asked him that question?" Suddenly, an answer came to me. I told her what I believe God impressed on me: "You'll know when the time is near; I know that for sure." That seemed to ease her mind, and she said "Thank you," closed her eyes and went back to sleep.


Carol spent several weeks on our unit trying to get her pain under control. Often I would rub her back or just listen to her. Occasionally, she would ask me to pray with her and I would-always trying to find the right words to comfort a dying young woman. Carol was discharged home with hospice care and died not long afterwards.


Several months passed. As I was walking down the hall one day, I looked up and saw Carol's husband. He walked toward me with his hand reaching out to shake mine. I told him how sorry I was about Carol and asked how he and the children were doing. He said, "I just want you to know that you made a difference in Carol's life. She talked of you often and what a gift you were to her. She wanted me to be sure and come tell you that you were right when you said she would know when the time was near. She died within hours after telling me this."


How did this experience change my life? We do not know what kind of impression we make on our patients. I would like to think it is always a good one. But I know in our busy work life we can overlook the fact that our patients are real people with real emotions, real lives, real hopes and dreams. The evening these were dashed for Carol, my hope was that I was the person I was supposed to be, sent by God in that moment to meet a need for a hurting young woman. God knew Carol's deepest fears about death, and I wonder if he used me to tell her a secret thing he wanted her to know, that death would not creep up on her and overtake her without her knowledge.


I, too, have been distraught at various times, and God often sends someone to guide me in the right direction. God tells us in Scripture that he will guide us (Jn 16:13) and that he sends his angels-ministering spirits (Heb 1:14)-to help us. He makes the wind his messenger and uses flames of fire in his service (Ps 104:4). As nurses, we need to be willing and prepared to be used by God for his purposes, to do his will when he asks us. We never know when those times will come, but we can be sure they will.