I left work today and had a patient who knew it was the last day of my stretch, shake my hand and thank me for all the care. He was a very healthy and active man whose world was shattered a few short weeks earlier with a diagnosis of a terminal cancer and he was given a grim life expectancy of less than three months. Before leaving my shift today, he thanked me and told me that he would be going home this week to live out the remainder of his time with his family.
In our job we don’t get to say to our patients, “All the best”, or “Get better”, when they leave our unit. I had to wish him quality time with his wife and family and tell him that we would be here in the end for him and his family, knowing that we would likely have them back on our unit in the next couple months to help him die peacefully & with dignity of a horrible disease that robbed him and his family of their future plans.
We will do our best to keep his pain under control, manage his nausea, try to encourage him to eat when he can, hold his hand in the middle of the night when his family is sleeping and he finally feels vulnerable enough to share his own fears without having to be strong for his wife and kids. We will encourage his wife and family to rest when they can and to look after themselves too, even though they will refuse. We will encourage them to say what they need to say to him, no matter how hard. And when the end is near, we will encourage them to whisper to him permission for him to let go.
We will then hold his wife and children after they have just witnessed him take his last breath and his heart is no longer beating, even though his body will still lay there in the room with us.
We will later give them information on what to do next, like how to call the funeral home and how the body will be picked up and what they need to do next, although they won’t remember. It’ll all be just too much.
And then we will hug them one last time before they leave the unit without their husband and father as he still lay in his quiet hospital room without life.
We will then respectfully, as a team in quiet reflection and respect, prepare his body for transport to the morgue. We will close all the other patient room doors, cover his body in a memorial blanket and the staff will quietly stand by as his body is wheeled off our unit on a stretcher. Some will touch the stretcher gently with their hand as it passes them as a respectful final goodbye to a good man who was taken too soon.
We will go home after our shift quietly reflecting and thinking of the family and come back the next day to do it all again for another.
This is what we do as palliative nurses. We provide quality, not quantity. We provide compassionate nursing, not just task-focused care. Psychosocial nursing is just as large a part of our jobs as providing the medications and treatments. We try to be strong, but we also cry with our patients and their families.
This is palliative nursing. Overwhelming and emotional at times, but also so rewarding to provide comfort and quality of life to people going through the darkest moments in their lives. We are palliative nurses.
Written by Larissa Pegg, RN, and AHPCA Member