My Homework

1. Think about your first professional experience with the death of a patient. What was this experience like? How has this influenced your understanding and approach to caring for a dying patient and family?

When I was 18 years old, I was a transporter in a large hospital. One of my jobs was to pick up patients that had died and take them to the morgue. My first body was in the ICU. The nurse had told me, “I am just so busy; can you bag the patient for me?” I had no clue what I was doing, and I remember struggling as I was trying to put this body into the bag. It look like he was alive, but the patient was (obviously) unable to help move for me. I also remember that every time I touched him, he bled which left me thinking that death must be dirty and gross.

There was no family at the bedside; I always hoped that they were there for his death, but it bothered me he was alone. Did the people/staff realize the magnitude of what just happened? I remember thinking in my teenager mind that I couldn’t believe people weren’t “freaking out” that a dead guy was right there.

2. Think about your first personal experience with death (friend, family member, relative, pet, etc.). What was this experience like for you? How has this experience influenced your understanding and approach to caring for a dying patient and family?

Family relatives have died around me, but I haven’t felt the true loss of a loved one. I remember when my Dad’s mother died. I wasn’t sad that she died; I didn’t see her that often, but I was incredibly sad watching my Dad cry. I couldn’t help putting myself in my Dad’s shoes, and I began to cry over the thought of losing my own mother.

3. In addition to these two experiences, have you had any professional or personal experiences with death which stand out as critical events that have influenced your understanding, empathy, and capacity to care for a dying patient and family?

I began my nursing career in OB where death is not common, and in my biased opinion, the most tragic. I remember taking care of a mom who was 38 weeks, and she decided to go to Triage because the baby wasn’t as active as usual. The week prior she had an ultrasound that showed she had a perfect baby with a great heartbeat, but now the baby’s heart beat was gone. She had to deliver a beautiful 8 pound baby girl stillborn, all of the pains of being a new mom, without the reward. I had the mom as a patient for a couple days. She kept the baby in her room during the day, and I would undress the baby and take the baby in the morgue every night. I remember the baby had purple lips, but no other signs of death. It was if the baby was just wearing lipstick. I took such good care of the baby, not wanting to hurt her arm as I tried to put on and off her little pink dress. I would swaddle the baby with my signature wrapping as if it was going to help her sleep better that night.

I stayed with the family and did minimal medical nursing care, but I was there and listen. I wanted to be strong for the family, but I cried right alongside with them. The grandma even hugged me. I learned death is not scary or dirty. The real hard part of dying is the one’s left behind.

4. In what ways do these past experiences represent a resource that you can draw upon in working with dying patients? In what ways do these experiences present challenges or barriers for you in working with dying patients?

Recently I was in the room with the doctor and the family as the patient was dying. The doctor was hugging and praying with the family, and I remember thinking that the doctor was the most amazing person ever. I realized that when I had cried with the grieving families before that it was ok. I was feeling the love for the patient and giving more power to the patient’s memories.

5. Consider your own personal cultural and spiritual/religious values and beliefs. How do you think these influence your care of seriously ill patients?

I believe in an afterlife where people can decide, even after death, to follow Jesus Christ, so they can experience the joy of heaven. When I am with my grieving families, I am very generic in my terms of Heaven and God, but I have them start the dialogue. Last night, I had a tragic patient and when his mom finally made it to his room and asked what she could do, I told her to just pray for him.

I love to call the chaplains for grieving families, and I truly believe this is one of the most underutilized practices in the hospital. I am amazed how well they talk to families and how accepting patients are to chaplains.

My fellow staff nurses sometimes tease me, but I am known to sing primary church songs to my patients. My patients are often confused, restless, agitated, or combative, but they recognize the old familiar hymns. The patients calm down, and we can just hold hands.

6. What does a "good death" mean to you?

I do not want to be “trached” or “PEG-ed”. I do not want to fight in vain. I want a romantic death.

I don’t want to die in a hospital. I wanted to die at home, but since death is harder for the one’s left behind, I won’t out of respect to my husband who has a difficult time with that concept.

Take me to the beach. Let me sit in a lawn chair while the waves take my last breath. I want people to be enjoying life around me.