On Death and Dying

Events at work have been depressing lately. We've been having a lot of nursing home patients in our telemetry unit. It's been a lot busier than ever. Patients are a lot sicker. In a week, we've had 6 deaths: 2 code blue patients, and 4 DNR patients. Yesterday was my turn to have a patient to die.

Even though Mr. S was already a DNR, it still was kind of sad the way he died. I remember the night before he died, I went to his room to turn him and before leaving, I told him, "Mr. S, I am going home now. Have a good night sleep. I will see you tomorrow,ok?" And Mr. S weakly tapped my hand as if to say thank you. He rarely talked at that point. And the feeble attempts he made at communication were slurred and incomprehensible. The next morning, during report time, Dr. G came in to the report room and asked who was Mr. S's nurse. The night nurse was ignoring him, so I said, I would be his nurse for today but I had just gotten report and I hadn't seen him yet. He was asking how long Mr. S's breathing was like that. The night nurse continued to ignore him for reasons I don't know. So I asked the nurse myself. Then she said, it must be just now because she was just there about an hour ago. The three of us, including the on-call resident, went to the room. Mr. S was pale, he was in agonal breathing. Then finally as Dr. G was listening to his heart, he made his last breath. How I wish the night nurse had observed this earlier. She could have notified Mr. S's son and he could have been there with his dying father. But it was all too late, then. Perhaps this was how Mr. S wanted it. To die alone.