This morning I was informed one of my patients, and their family, was ready for a terminal wean. Basically, they were ready to withdraw interventions that may prolong an otherwise natural passing while providing patient comfort through medication.
After report, the reality of the situation hit me… Today I was going to help this patient die.
Now, I don’t know about you, but that’s an awful heavy task for a Friday morning To Do list. I thought of the patient’s wishes and comfort. I ached for the family and their greiving. I worried about my role and the impact it would leave.
They don’t teach you this in nursing school.
Thankfully, I had the resource of my preceptor and an incredible palliative care team. They emphasized the importance of the process and following the patient/family’s lead. Also in this instance, the patient’s family could not have been more supportive. They had prior discussions with the patient regarding end of life and were collectively in a place of acceptance. Unfortunately, I know this is not always the case.
When the time came, medications were on board and family was at bedside. Patient had made some final remarks. Not a dry eye in the room. Oxygen was being decreased. Respirations slowing. It was a unique situation. I had only met this patient yesterday and here I was, present on their final moments with their children. I didn’t want to interrupt. I didn’t want to add pressure. I didn’t want to take away any attention that should be on the patient. And yet I was “just doing my job”.
At 1006, the patient had passed. Fellow staff considered it a success judging by appropriately dosed medications and the patient’s uneventful passing. I found this to be relatively reassuring. However, it was only after speaking with family that I was sure I had done my job.
To say the family was grateful would be an understatement. They appreciated being an active part of medical decisions. They thanked us for individualized care and support. They say they found comfort in the process, knowing their parent wouldn’t suffer.
But what struck me was when one of the daughters said “Thank you for today. I know this can’t be easy on you either.”
She just lost one of her parents and she’s acknowledging my feelings? Am I even allowed to have feelings in this situation?? And of course, the answer is yes. Feelings and compassion, empathy and kindess, are all what drive us as nurses. Drives us to “just do our job”.