Related Stories:
Nurse Anxiety 
My Ideal Shift

I am getting used to the habit of setting an intention of what I want my nursing shifts to be like before going to work and so far, it has been working out wonderfully.  My last attempt in setting my intention in the article Nurse Anxiety have resulted in My Ideal Shift, where almost everything I had asked for was given to me.

My Intention on Monday was: to have a shift that is physically easy and emotionally rewarding.

Manifesting my Intention

I was assigned 4 patients with 3 of them who are clear in the head AND being able to walk and talk.  In fact, two of my patients were sent home by the end of my shift and I didn’t even have to worry about admitting new patients who couldn’t walk and talk. I had one patient who could not walk, but I had two LPNs who were willing to help me at any time.  I felt SO lucky!  Thank You Universe!  It looked like I was going to have a very easy shift yesterday but I was unsure how I could have a emotionally rewarding.

At around 12 pm, one of my colleagues went on her lunch break and asked me to cover for her patients.  She was expecting an admission from the Emergency Room but she said she will take care of the patient when she comes back from lunch.

The new patient arrived while I was inserting a foley catheter on a very big female patient (for those of you who REALLY want to know about this procedure, click here), so I sent one of the LPNs working with me to look into settling the new patient.

As I was finishing up my foley catheter insertion, my colleague ran into the room and said, “May, you better come quick! He doesn’t look good!”  I hurried into the new patient’s room and found the 80 year old male patient to be unresponsive to verbal command, extremely pale and grey looking, and worse of all, covered in feces.  Immediately, I asked the LPNs to check his vital signs and found his blood pressure to be only 65/32 (normally this should be around 120/80), his oxygen saturation was only 84% (normally this should be 97~100%) while on as much oxygen as we could give him.  This was the vital statistics of a man who was seriously crashing.  I began calling for help, I called the doctors, and found out that this patient has been made “comfort care”.  This means that he was expected to pass away within the next 6 hours and he was basically sent here to die.

I approached the patient’s son sitting outside the room and explained to him that his dad had a little accident and we are working hard to make him more comfortable.  The truth is, he probably knew his dad had an “accident”, the feces on the bed was somewhat dried and it smelled really bad, I think the nurses in the emergency room was far too busy to change him.  The patient’s son was a man who looked like he was in his mid-fifties.  His eyes were slightly red and watery; and I could tell that he is trying hard to hold back his emotions.  My wonderful colleagues worked so hard to clean up the patient and make him comfortable.  We left the room and ask the patient’s son to come in to be with his father.  One of the LPNs said to the patient’s son before she left the room, “you might want to touch your dad’s hand and let him know that you are here…”

Twenty minutes later, my wonderful colleague came rushing at me looking white in her face.  She said, “May! I don’t think he’s breathing! I went to check on him and he looked like his is dead! I don’t know what to do!”

Did she think “I know what to do?!!” She is 48, I am 28, she’s got 20 years ahead of me and she wants ME to do something? At this time, the nurse I was covering for came back from her break so I said to her, “Oh yeah, your admission came in and I think he is now dead, you have to go see your pronounce the death and talk to his son”.
“NO~~~!!” She grabbed on to me for dear life and said, “I don’t want to go! I am not ready for this! YOU have to go!”

“Ok, ok, fine! I’ll go.” I said as I gathered myself and walked towards the patient’s room.  I recalled the doctor’s written orders stating “RN may pronounce patient’s death” and thinking about the fact that I had NEVER pronounce anyone dead before.  I got to the patient’s beside and he clearly was not alive anymore.  I asked my LPN colleague to get me a stethoscope and asked the patient’s son, “How’s your dad?”  The patient’s son said, “He hasn’t moved.”

Damn!” I thought to myself, “he has no idea his dad had passed away”.  The LPN came in to give me the stethoscope and I proceeded to listening to the patient’s heart and breath sounds.  Nothing.There was no longer any breath sounds or heart beat audible via the stethoscope.  I looked up at the patient’s son and very calmly said, “Your father has passed away.”  I saw the son let out a burst of emotion and I had the feeling the flood gate was going to open at any second.  With same calm voice, I said to him, “I will let you guys hang out for awhile…”

I walked straight to the supply room and got a box of tissue and very tactfully discretely placed it beside him, as I was just about to leave, the patient’s son said to me, “What am I supposed to do now?”  I said, “Be with your dad. He is still around, he hasn’t gone very far, just because he has left his physical body doesn’t mean that he is not here.  Our policy here is that we will not move him until you are done visiting together, so please, take your time.”

My colleague must have been standing beyond the curtain that was drawn around the patient because I could see that she too, was emotionally affected by the circumstances of this situation.  Her eyes was watery and she was having a difficult time dealing with how quickly the patient passed away.  I suppose even staff members need some time to emotionally prepare for an impending death of a patient.  She was so amazed at the way I handled the situation so calmly and peacefully that she asked me if I had ever considered working in palliative care (nursing for people who are actively dying).

I was quite impressed with the way I handled the situation too.  I felt calm and composed as well as being supportive and effective at communicating with people at the most difficult and critical moments.  Most importantly, I was able to come to terms with my own emotions.  The last time I found a patient dead was when I was a nursing student.  I was just starting my work day when I found the patient dead.  Of course that was an even more unexpected death than the one I have experienced this time, but I recall going home and crying for hours after I was done with my shift.

I feel like I now have a better spiritual understanding of death and how it works.  Death is a continuation of life, and life is a continuation of death.  When we die our soul is released from this dense physical reality into an energy form of higher vibration.  Since we are energy and energy cannot be created or destroyed, we cannot cease to exist, we can however, change from one form of energy to another.  Who we are consist of more than what we can see or feel.

This was no doubt an emotionally rewarding shift for me and I thank the universe for granting my request by allowing me to participate beautifully in the final process of a person’s life.  I also learned a few things about myself:

  1. I am an excellent communicator
  2. I can be calm, composed, and appropriately supportive when necessary
  3. I realized that I see life as a beautiful process and death as an integral part of life
  4. I was inspired by the insight life is a continuation of death and death is a continuation of life.