After graduating from nursing school, I decided that I
did not want to be employed in long term care. I felt that I would get
very attached to patients and then would have a rough time with letting them
go. I understand that death is a part of my job; however I would rather
have only a few day relationships with them then a couple months.
Occasionally we will have patients that turn into long
term patients. One in particular was very challenging. He was in
his mid-40s. He had been an alcoholic and began to have liver
problems. He went to the doctor and they discovered he was experiencing
necrotizing pancreas. In other words, his pancreas was eating
itself. The patient looked healthy when he arrived but slowly and over
time he began to decline. It was hard to see. Eventually his
pancreas began to eat away into his lungs. This was causing all sorts of
oxygen problems and making it difficult for the patient to breath. The
patient was on our floor for months, although he would decline and be moved to
a higher acuity floor, and then be returned once he had stabilized. We
learned all about our patient: his kids, family, job, dreams, desires and
fears. It was part of the normal routine to know the patient was going to
be there for us to care for. As he started to decline more and more, we
all started thinking about how hard it was going to be for us when he
went.
It was tough. The toughest part was seeing the
interaction between him and his family. His family had come around to
accepting the fact that this was the end. They were discussing end of
life care and living wills, and the patient would not talk about it. He
wasn’t set against the end. He just didn’t want to make that decision and
he didn’t want his daughter to have to make the decision for him in case
anything happened. It was difficult. The patient was depressed and
suicidal at the end. He was cranky to his family and medical staff.
We understood he was going through the stages of grief, but we felt bad for his
family.
At the end, we knew it was time and we were all
dreading it. We were all debating and trying to switch days so that no
one would have to work the nights surrounding the end. Thankfully he was
moved to a hospice floor a few days before the end so we didn’t have to face
that challenge. However, we all felt it when we heard the word of his
death. We reached out to his family, and cried along with
them.
It was a tough situation. I'm glad we were able
to grow close to his family and be there for them throughout one of the
toughest times in their life, but I'm so glad I do not have to do that every day.
