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About Me

I am an ER nurse, new to nursing, and new to the ER. I am terrified, exhilarated, and I LOVE my job. I have created this space to share and archive the lessons that I am learning, to blog about my day to day experiences, and to provoke discussions and dialogue with other ER nurses and healthcare professionals, and the general public on all things related to nursing, health and healthcare.

The Vigil

Submitted by ernurse on Fri, 06/20/2008 - 17:28.
  • Death
  • Hospice
  • Memorable

Two nights ago we had a patient pass away in our ER. There's nothing unusual about this. What made this case worth mentioning is the manner in which the events transpired and the lessons about human frailty that are embedded in it.

The patient was 56 year old female in the terminal stages of pancreatic cancer. She had been diagnosed 3 months prior and her family had made the decision in the last month to place her on hospice. She had home hospice nurses who would come to see her, and the family knew the end was near.

Earlier in the day, according to the family she began to exhibit a change in mental status. She would not eat, and was not responding to questions. The family panicked and called 911, which brought her to our ED. As soon as she got there, we begun the usual measures, trying to get an IV, checking her blood sugar, EKG, etc. Then one of the family members said to another "We should probably call Sandy". Since we could tell the prognosis was not good, and we weren't getting much of a history from the family, we grabbed onto this and immediately asked "Who's Sandy? Another daughter?" The response "Oh no, she doesn't have any children, Sandy's her hospice nurse." At the word 'hospice' we all came to a halt.

By definition, a hospice patient is placed on comfort care. They are in the terminal stages of a disease process and are usually DNR (Do Not Resuscitate), DNI (Do Not Intubate), and in some cases DNH (Do Not Hospitalize). We immediately set about calling 'Sandy' who then gave us the whole history, and wanted to know why the patient had even been brought to the ER. This question would not be answered until after the patient had passed. The family expressed a very obvious reluctance to take her back home. We could see they cared, and they were scared, and overwhelmed. The doc agreed to admit her for comfort care and the family left. They expressed that they did not wish to be called unless she passed.

She did. About 4 hours after they left, her heart stopped beating, and she ended her journey on earth, with five strangers, all nurses, at her bedside, two of us holding her hands. We had covered her with a special comfort blanket that our hospital provides and then we stood there and kept vigil, only moving away to tend to our other patients when they called, but otherwise staying close to her, sometimes talking to her, but mostly just silently holding her hand. We kept an eye on the cardiac monitor which we had silenced so it wouldn't alarm when her heart rate became erratic, and watcher as heart fluttered this way and that, until it finally stopped.

We all sighed when it was done, knowing we had been part of something very powerful and intimate. We had stood in, if only momentarily, for her family, and held her hand as she crossed from this side to whatever follows.

We then set about the business of calling the family, the sharing network, and anyone else that needed to know. It was somber and still in the ER, even the other patients were very quiet, like they all knew something was happening, even though no one but the staff knew of the events transpiring in that room.

When her family got there they stood around quietly, tears in their eyes. They thanked us and finally talked to us. "We were afraid, it happened too fast. We thought if we allowed her to die at home it would mean we had done something wrong. It just happened too fast."

Not everyone thought they did the right thing. There was the opinion that she should have been left to die at home at peace, instead of being carted to the ER. Maybe this is true.

But she did die at peace, with us. Her family reached out for a helping hand and we gave it. Had we insisted on sending her home who knows what would have happened. Instead we honored the wishes of those who had been caring for her, and we kept her comfortable until her heart gave out.

Such is life. Who are we to judge?

  • ernurse's blog

Wow

Submitted by Kim (not verified) on Wed, 07/02/2008 - 00:26.

This is a stunningly written post. Sometimes it is hard to understand how families respond - it sounds like this family was actually afraid of death.

Still, she was surrounded by people who cared - it's why we are nurses.

  • reply

It's why we are nurses

Submitted by ernurse on Wed, 07/09/2008 - 21:29.

Thank you Kim, that statement sums it all so well for me.

  • reply

Nice Work

Submitted by RandyBrown (not verified) on Sat, 08/16/2008 - 22:17.

Nice Site. I am new here but will be visiting more often as you have done a good job.

Thanks

  • reply

great work angels

Submitted by syria (not verified) on Mon, 08/25/2008 - 11:16.

thats what nurses call in here angels cuz we all know how hard there work and how hard to look after ppl lives so u did a great job in there

  • reply

Lovely! Really unusual and

Submitted by sskumar (not verified) on Fri, 09/05/2008 - 09:26.

Lovely! Really unusual and beautiful presentation.

  • reply

Thanks for your info

Submitted by Guest (not verified) on Wed, 09/17/2008 - 02:51.

Hey friends, I love your blog - i will try and keep up with it!! please keep more coming :) I share to my friend by added your post into my social bookmarking Hope people love your blog like me :D

  • reply

Nurses are best humanatarians

Submitted by tomschavo (not verified) on Wed, 09/17/2008 - 06:02.

Hats off to the medial proffessionals

  • reply

Thanks

Submitted by Petriks (not verified) on Thu, 09/25/2008 - 06:36.

Great Post....This is inspiring and motivational.Really Great. :( Thanks,

  • reply

A very touching post. Yes,

Submitted by Professional Web Design Company USA (not verified) on Thu, 10/02/2008 - 06:27.

A very touching post. Yes, all of you who stood beside her and were there at her last moment deserve kudos.

  • reply

Recognition for Nurses are well deserved.

Submitted by Joker Nurse Costumes (not verified) on Fri, 10/03/2008 - 00:08.

With the bad publicity the medical field gets these days, it's good to hear these humanitarian stories like this one. Nurses are taken for granted and need more recognition they deserve today.

  • reply

Touching article..

Submitted by guest (not verified) on Mon, 10/06/2008 - 16:48.

Its really touching and nice to know that there are still good people in this world.. Keep it up

  • reply

Guardian Angels

Submitted by Paracho Michoacan (not verified) on Wed, 10/22/2008 - 08:31.

I always wanted to be a nurse ever since I was a little kid. But unfortunately, my family actually can't afford it. I feel that nurses are guardian angels of people who needs to be taken care of. Thanks for an inspiring post.
-M from Mexico

  • reply

This is very well written

Submitted by Wicked Aliens (not verified) on Fri, 10/24/2008 - 09:31.

This is very well written post and in todays world is good to see there are still good people around.

  • reply

very very heart touching

Submitted by coolbudy (not verified) on Fri, 11/14/2008 - 11:10.

very very heart touching post

  • reply

hi

Submitted by busby seo test (not verified) on Thu, 11/20/2008 - 16:57.

very emotional and compassionate...

  • reply

Its really touching

Submitted by stevie teever (not verified) on Mon, 11/24/2008 - 11:36.

Its really touching and nice to know that there are still good people like you all in this world.May Gob bless all of you.

  • reply

It took me a lot of time to

Submitted by Pakistan News updates (not verified) on Wed, 11/26/2008 - 17:36.

It took me a lot of time to think and write a comment, that every thing is simple yet so beautifull. Awesome

  • reply

it’s a good article. Like

Submitted by seo6nik (not verified) on Thu, 11/27/2008 - 22:10.

it’s a good article. Like and others said - thanx to you!

  • reply

Very good.

Submitted by Watch Naruto Shippuuden Episodes Online (not verified) on Fri, 11/28/2008 - 14:39.

as a fellow nurse, i think you've done well with your blog. Nice post here.

  • reply

Great post.. Thanks for

Submitted by teakgarden (not verified) on Thu, 12/11/2008 - 03:44.

Great post..
Thanks for sharing..

  • reply

Cool Post

Submitted by jeenaweb (not verified) on Wed, 12/17/2008 - 15:46.

Hey I am also a nurse i am happy to see this blog. Thanks for posting this article.

  • reply

some information

Submitted by stevie (not verified) on Thu, 01/15/2009 - 06:20.

Great Blog with very good posts .Can you please tell me that how much time you take to create this wonderful blog,although i am new on internet but your work is very good and i appreciate your work.I also want to make an blog,hope you help me.

  • reply

I was touched..

Submitted by Ana-Kitchen Designs (not verified) on Mon, 01/26/2009 - 10:17.

That's the hardest part of being a nurse to become emotionally involve by your patients condition. You can't help but to feel for them. My brother is a nurse and there are times when he got home from work looking so sad because they lost a patient. Every minute someones die and someones born. This is life..It is sometimes sad but it's beautiful after all.

  • reply

Touching Information

Submitted by Shawn (not verified) on Fri, 01/30/2009 - 11:46.

Its really hard work to deal with the patients and nurses are doing really great job. i must say them angles of world as they treat and care the patients on bed when they know they are going to leave us soon.

  • reply

Nice

Submitted by chrislittle09 (not verified) on Mon, 02/09/2009 - 05:08.

This a very compassionate blog.

  • reply

Emotion

Submitted by rosemarschall09 (not verified) on Mon, 02/09/2009 - 05:10.

This is a emotional post and really inspires me.

  • reply

nice information

Submitted by Sam (not verified) on Sun, 02/15/2009 - 11:24.

great information, i am visiting your site for the first time, will visit now often

  • reply

Thanks for the post!

Submitted by Ana (not verified) on Thu, 02/26/2009 - 15:51.

Nice article. It is so heartwarming. Thanks for the nurse like you whose compassion is beyond words. May you continue to serve on, serve well.

  • reply

Very well written

Submitted by Kim (not verified) on Fri, 02/27/2009 - 00:47.

Your article is very well written.Although its sad how the family reacted towards the patient.Thanks for sharing your thoughts.

  • reply

Angel in Disguise

Submitted by Ana l Shower Design (not verified) on Tue, 03/10/2009 - 05:02.

Nurses are “angel in disguise”.
How could you be able to take care a stranger all because of money, their salary is not that big to handle all frustrations and hardships in the medical field. The only key is their dedication and commitment to the chosen career, they put their heart and soul to the vows and to their oath taking. I'm glad to know that these kinds of nurses still exist.

  • reply
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The cases and persons that are described in these pages are composites, none representing any one particular patient, person, or case. While the medical facts are all true and accurate, I have edited and doctored and composited enough that none of the personal descriptions, family settings, or any other distinguishing features are representative of any real actual person. In other words, I am not violating any HIPAA laws and regulations on this website, and the privacy of all my patients is completely protected. Any resemblance to any living person is completely accidental and unintentional.

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