Claiming my Inner Bitch

My Patient Died Tonight

My patient died tonight. He came in a little after 10 PM, which pissed me off until I realized who he was.

He was a man I'd taken care of last year when he was in for a different aiment. He had serious cardiac disease and this evening had fallen and struck his head. It was the bum heart that killed him though, in all likelihood.

I had taken care of him within the past year. Then he was spry and wickedly funny and we had a ball that afternoon, bantering and teasing his son-in-law, who is a physician I work with. It was so refreshing to find that a family member of this doctor, with whom I've had more than one scrape in the past and who does not appreciate my biting sense of humor, had such a sparkling and quick wit. We had a blast throwing out one liners at each other and mercilessly but playfully teasing my doctor colleague. His looks and quick repartee belied his 71 years at that time. I thought he was ten years younger.

He was a different man tonight, the heart disease and other problems having ravaged his body in the intervening months. But his mind was still sharp and he was lucid. He did not want to be intubated. His family had brought his living will to the hospital. When asked if he wanted the tube to breathe, he adamantly and clearly stated he did not.

We gave a few drugs to try and correct the heart rhythm problems he was having. We gave Morphine to ease any pain and reduce his anxiety. Then we watched his heart rate and breathing slow. He remained present with us until about ten minute before he died. His daughter was with him the entire time. His wife was not with him when he died but arrived a few minutes later. I was glad she didn't witness the resuscitation. Sometimes it's easier for people to go when the one they love most is not there.

He was a year younger than my dad and had the same gaunt face my dad had before his mesothelioma really ravaged his already thin frame. He was ill-shaven, as was my dad when he died. He had the same hair color.

I wasn't at my father's bedside when he finally passed away. I was out working in Dad's shed with my son when Mom called to say she didn't think Dad was breathing. I was both glad and sorry I didn't witness Dad's last breaths, though I would have told him it was alright to go. That we would be okay. I had given him my permission earlier that day and the day before when he really started to go downhill. Dad knew I could let him go.

So tonight I caressed my patient's face and smoothed his hair with my ungloved fingers, I cleaned the blood off his forehead. I held his cold hand. I did all the things for this patient that I would have done for my dad at the moment of his death. It's important to make the transition easier. It's painful when it reminds you of someone you lost less than five months ago. I bawled a bit as I cared for my patient tonight, in a way I could not do for Dad at the moment of his death. I don't usually slobber over my patients.

It was terribly difficult but very important for me and for his family, taking this care with this man whose company I'd enjoyed for a brief time. This man passed away in peace and with as much comfort as we could offer him. He died with his wishes respected until the end. As it should be. He died as my dad died in March, even though I wasn't directly at his bedside at the moment of his death.

I wish all who must lose loved ones the kind of care and caring I was able to give to my patient tonight.

Damn, I miss Dad.

Technorati tags: death / life / nursing / work

posted by Cheryl @ 12:52 AM