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Wednesday, July 6, 2011

One Thing I Never Expected to do as an RN

A Nursing Story:

Everyone knows that many people go to a nursing home to spend their last days.  Its no secret.  One with a life ending diagnosis or slowly deteriorating status is kept as comfortable as safe as possible by the young and agile who can't comprehend that these people they are caring for were once like them.  Its a weird and unimaginable thing to face mortality so head on.

Mortality becomes even more fragile and real when you are watching someone take their last few breaths. 

After a long shift at work I had known one particular woman was soon to leave this world.  Her alertness decreased and breathing shallowed.  Every time I walked passed her room and her grieving family, who had gathered around her in this last hours, I gulped hard and thought of how just my last shift she was joking with me in her sarcastic way.  How quickly things had changed. 

While everyone knew she was going to pass no one knew when.  You can never know when.  Its such a deeply mysterious thing that is so unpredictable.  Sometimes a person may hold out for one family member to say goodbye to and other times the person will wait until all the grieving family has stepped out of the room and die alone, in peace.  So, I continued my shift, vigilantly watching this woman say goodbye to the world at her own pace.

As my shift ended and I handed over my patients to the incoming night nurse the slowly dying woman was still clinging to life.  She looked strong and I figured that she'd at least hang on through the night if not the next day.  When I arrived home I made my self a giant plate of spaghetti (of course) and sat down to enjoy it in front of the television.  It was my meager attempt at unwinding so late at night.  

Then my cell phone so rudely interrupted my efforts...   it was work calling me.

Dear lord, what did I forget to do before I left?  I wondered as I answered.  The other nurse didn't waste any time and informed me rather matter-of-fact like that the woman had just died.  Okay... I thought and was wondering why she was telling me this.  I appreciated her letting me know, but I didn't understand why she had to call me at midnight.  Such news could have waited for my next shift.  Then she explained to me why she called.

There were no RNs working that evening, only LPNs (licensed practicing nurses) and by law only an RN or an MD can pronounce a person once they are deceased.  I was the closest RN to the facility and the obvious person to call for the job at such an hour.  While I tried to digest the bizarre request to come in and declare the woman as legally dead in the middle of the night I changed from my PJs and set my spaghetti on the counter before heading out the door.  Shawn was asleep in his bed and oblivious. 

Five minutes later I was back at work and walking down the darkened hallway where the residents slept soundly.  Without so much as a word I nodded my head at the night nurse who thanked me for coming in, grabbed a stethoscope, and walked into the woman's room.

A dim light was on.  She was laying in bed, motionless, with her hands gently folded across her midsection.  I put the stethoscope in my ears and pressed the other end to her chest listening for any indication that life still ticked away inside her.  Silence.  Her pale, motionless face was turning blue around the lips, but her body was still warm.  She had drawn her last breath.  I glanced back at my watch and checked the time, being sure to make a mental note of it, and left the room bidding a mental goodbye to the woman. 

After filling out a couple of pieces of paperwork required for the funeral home, who was already called and on its way, I headed back home with heavy thoughts of the unknown of death.  Its hard to not think of such weighted topics at a time like that.  My little peanut kicking away in my belly only compounded the irony of the evening.  New life growing, old life ending, and myself balanced somewhere in between the continuum.  

I never would have guessed that such a steep emotional and physical responsibility would be placed on my shoulders simply because I now have the acronym of RN after my name, but its a responsibility I accept and actually appreciate the sincerity of.  The ability to definitively pronounce one's death is, in my mind, just as remarkable as being able to herald the moment of one's death. 


R. Roushey said...

Very moving Jen. It is a real honor to be able to do something like that. And a very special time to be around someone as they approach death.

SharleneT said...

I was raised in a rest home and learned of the sorrow and dignity of death on a regular basis. It's a painful, natural, part of life and kudos are to be given to those whose lives are dedicated to making the last days comfortable for their fellow man. You have begun a difficult, rewarding, journey and I'm in awe of all you can do. Being five minutes from work, something tells me this isn't your last midnight call. Come visit when you can.

Regan said...

Whether you hear it on a daily basis or not (most probably not), your compassion and caring heart are truly appreciated by those that you care for! Keep that spirit!

Anonymous said...

I am an RN in an ICU in Indiana. RN's here are not allowed to pronounce, only MD's. It would save lots of time if we could do our own pronouncing.

That said, I totally agree with you about the ending of life. I think the end of life is like the beginning in many ways: uncertain time schedule, strange breathing patterns, closeness to a feeling of 'heaven is near'. We have seen people pass with all their family present, and others go just as soon as they take a little time to get some food. One person's body actually sat up even though they had no heartbeat, and it surprised and spooked us all. I always try to help people know that even though the patient's body is passing, their hearing may not be yet gone, so it's good to talk to them, tell them they love them, or anything else that would make a comfortable loving atmosphere in which to pass to a different place.

Thanks for posting your stories, I find them very interesting.

Smile Steady said...

Oh wow. That's why I could never be nurse. I have so much respect for what you guys do!

kittyhere said...

I grew up in the household an uncle who was an old time funeral director (back when they were the ambulance service too)in the Upper Valley. The funeral home was just across the road from our house but the phone for home & business was in our kitchen. I remember the phone ringing at any time any day or night. I remember by age 6 or 7 being trained on how to take a call from a hospital, nursing home, policeman, or family member. We sat in the back row of church in case my uncle was called out. Many a restaurant meal was interrupted by a message called in to the owner. The one time I was taken for a vacation to Maine we stayed just one night before my uncle was called back for a case.

I was amazed that my uncle, relieved of the ambulance work by new laws, was able to continue this 24/7 might need to go to work routine into his late 80s.

So I applaud your professional attitude that yes, even though you are pregnant, if this is your profession & you are actively in the work field such responsibilities are to be expected & performed. And if you still are in this type of RN position when your little peanut gets to be elementary age she will learn a lot of life lessons from it.

Jen at Cabin Fever said...

Wow Kittyhere. That is an awesome story. I can't imagine at such a young age being put in such a position to take those calls! But you're right... the life lessons you'd learn must be so important and irreplaceable. Thanks for sharing! :)

Anonymous said...

What an example of the Circle of Life. You gave me goose bumps!

One Girl Trucking said...

Thank you for sharing such a personal part of life most of us don't know or understand until that day... I have tears!

Balisha said...

I'm a first time visitor...So glad I happened upon your blog. Your story held my interest...I hope someone like you is there for me at the end of my life. We should all be so lucky. You're a blessing..

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