End-of-life issues are usually a very difficult conversation for patients, family members, and physicians. Once it is realized that there is nothing more that can be done to save that life, our focus on heroic efforts must change.
When the patient says, “no more dialysis, no more feeding tubes, no more needle sticks, I’m tired,” it is then that we must listen intently and help them transition toward another goal, that of mercy.
Alleviating pain and decreasing anxiety become paramount. Most often, the medications that must be used will lower blood pressure and decrease respirations, eventually becoming the catalyst that will gently ease the patient toward death.
Tonight I watched a young nurse struggle with the fact that her actions were decreasing her patient’s blood pressure and that her patient might possibly die on her shift. I could clearly see that emotionally she felt a very heavy burden. I asked her if she was alright and she had trouble answering me at first, but then she slowly looked up at me and said, “not really. I feel like I’m out of my element.”
This nurse is a good, hard-working, and very caring nurse whose efforts thus far have been in keeping her patients alive, but tonight, she must help her patient let go.
I remember being her age and being inexperienced with death. I felt the same. It was painful and a bit frightening. But it takes years of nursing experience before we can realize the privilege given to us when caring for the dying patient, for it is this time that is most intimate of all. When we can show mercy toward the dying patient and at the same time, show empathy toward the grieving family, I believe it is then that we have reached our highest calling.
NOTE FROM THE AUTHOR:
40 years of nursing have helped me to ease many young nurses through emotionally difficult times. I am grateful for all those years.
I am a recently retired nurse who enjoys writing short observational essays that evoke strong emotion. I have always enjoyed the outdoors including kayaking, hiking, biking downhill skiing and now, cross country road trips in our new motorhome.