My own nursing anecdotes:
You could give me a hug
"Mrs Neal's* blood pressure was 28/0 when I checked it with the doppler a few minutes ago. Her respirations are becoming more and more labored and they're developing a Cheyne-Stokes pattern. She can't last much longer. She's got a DNR order, so we're not to call a code blue or attempt recussitation. Her sister is with her now."
I let out a muffled groan. No one likes to be told that the patient they are getting report on from the nurse going off duty will probably die on their shift. I had been off a few days and had never met this patient or her family. What type of situation was I inheriting? Well, I will just have to make the best of it.
As I began my initial assessments, I went to Anna Neal's room first. "I'm going to be Mrs. Neal's nurse tonight. My name is Lois," I offered. The slender, gray-haired woman sitting close to Mrs. Neal's bedside replied, "My name is Maggie,* I'm her sister. I think she's getting worse. They said her blood pressure is down to 28."
I applied the gel to enhance doppler transmission, and began to maneuver the probe until I found the familiar "whoosh" sound over the brachial artery. I inflated the cuff then let the air out slowly until the "whoosh" returned. Mrs. Neal's blood pressure had dropped to 26/0 now. Even with the oxygen mask secured to her face, her respirations were labored between the periods of apnea common to Cheyne-Stokes. The only thing I could do for Mrs. Neal was to try to make her as comfortable as possible.
Her sister stood by my side and began to talk as I examined Mrs. Neal's limp form. "She wanted me to be the one to handle things for her when this time came. She knew I would do it the way she wanted. That is why she designated me to do it. "But our brother is angry with me because I chose to let her go on instead of putting her through the surgery. He wouldn't even come up here with us, said he couldn't stand to see Anna like this. I feel so alone now.
"Anna is 80 years old." Maggie continued. "Her body is worn out. The doctor said she probably wouldn't survive another operation, and even if she did there would be little chance that the surgery would do anything beyond buying her a few more weeks. I know that when God says it's time for her to go she will go. Why put her through another surgery?"
"I understand," I replied. "You did the best you could for Anna. Now you must continue to rest in the knowledge that you did what is best, regardless of what anyone else may say. I know that is really hard, especially when your family doesn't understand. It sounds like you are looking to the right source for your strength though. God is the only strength we have in times like this."
"I know," she whispered tearfully.
I tried to position Anna as comfortably as possible and then I turned to her sister. "Is there anything I can do for you?" I asked.
"Well..." Maggie hesitated. "Yes, you could give me a hug."
"I can do that," I reassured Maggie, as I embraced her tightly.
"Would you like me to pray for you?" I asked.
"Would you, please?" Maggie responded.
I continued to embrace her as I thanked God for being available to us in our needs. I thanked Him for giving Maggie the wisdom she had needed to make the decisions she had to make for Anna. I thanked Him that we could trust Him to do what is best and in the right time for Anna now. I asked Him to especially comfort this one who was being left behind, to meet her in her aloneness and help her feel His strength and love. Maggie held me tightly as we prayed. After I said "Amen," we squeezed each others hands at arms length. I offered a few more words of encouragement and assured her of my availability if I could help in any way.
I checked on Anna and Maggie frequently. Somehow Anna managed to hold on for another four hours. I was sitting at the nurses station documenting on another patient, when I looked up and saw Maggie. "She's gone Lois."
I rose immediately and slipped my arm around Maggie's shoulders as we walked down the hallway. One of the other nurses walked with us. There was no hurry. Anna was not in this world anymore. She was in God's care. My main concern now was to be there for Maggie in whatever way she needed me.
"She went quietly, without a struggle," Maggie said. "Her breathing just started getting slower and slower, until finally she just didn't breathe anymore. I was with her all the way."
Somehow it seemed appropriate that no one but Maggie had been in the room with Anna during those last moments when they went "all the way" together. I was glad that God had arranged things so I didn't interrupt that moment to check on Anna.
By the time we got to Anna's room, she was already cyanotic. I did the obligatory pulse check, and after confirming that there was none, I turned again to Maggie. The other nurse recognized that Maggie needed me, and she offered to go call the physician for me.
Maggie's eyes filled with tears. I reached out again and embraced her. She sobbed on my shoulder, and once again I audibly thanked God that we could trust Him to take care of Anna now that she had gone on. I asked God to be with this one who was left.
After more words of encouragement, and necessary arrangements, I checked on my other patients. Then I returned to the desk to continue my documentation while I waited for the physician to arrive and make the official pronouncement of death.
I and the other nurses were engrossed in our charting when I felt someone hug me from the back. As I turned around, I saw that Maggie had slipped behind the nurses' station to express her thanks. I stood and embraced her once more. She asked me to pray for her in the coming days, and I assured her I would. Maggie assured me she was ok for the drive home a few blocks away. I watched as she got on the elevator and the door closed behind her.
As we cleaned Anna's body gently, and prepared her for the morgue, I thought of what I had just experienced. I would have not chosen to be Anna's nurse tonight. But God in His wisdom knew that Maggie and I would find a bond in this hour that would minister to us both. After all, I chose this profession so I could help and comfort others. Maggie needed someone to comfort and stand with her in her aloneness. How fitting that God should put us together for this time.
Lord, let me never lose sight of why I am a nurse. Thank you for letting me minister to Maggie in her need. Help me always to be your hands and your heart and your love to those I care for. Amen.
*names and some circumstances have been changed to protect patient confidentiality
If you would like to read more material about meeting the spiritual needs of the patient, see Nursing the spirit.
