One Last Goodbye

Working as a nurse in a very small rural hospital gives you a chance to get to know your patients. You meet them on the street, in the grocery store, and at school functions. They become more than a number or a disease process, they become neighbors and friends. Members of their family work beside you.

One night as I was the charge nurse and the ER nurse all rolled into one, I recieved a call from the front desk that I had a patient in the car downstairs and I needed to open the ambulance door so I could get him into the ER. As I ran down, I was wondering what what I would encounter. I opened the door and as the car pulled in I saw a man hanging out the passenger side of the car. I went over to the side and saw that he was blue and not breathing. I ran into the ER to call for some assistance in getting him out of the car and into the ER. I also called for the CRNA that was on-site to do an intubation. Normally our CRNA lived about 10 miles away, but he was on vacation and his cover stayed in house.

We got the man into the ER and intubated. The doctor came down and we stablized him for transport to our SCU. Because we were such a small hospital, we had a special care unit that had three beds and some of the best nurses that I have ever worked with. The rest of the evening went by without any more commotion. I left that night feeling good about having saved someone.

The next day, I came in and went into the unit to check on how the man had done overnight. I was told that he had pulled his tube out three times and was mad because we had replaced it. Apparently he had not wanted anything done to prolong his life, but we hadn't been aware of it. Once, he had recovered enough, his doctor sat down with he and his family and discussed their options. He was made a DNR and all the staff was made aware of this. When he saw me I got a royal chewing out for having him intubated in the first place. That was the start of a friendship that went on for a while. I worked with his daughter and grand-daughter, so I was soon his favorite nurse. Every time he came into the ER with trouble breathing and that blue look to him, he always made sure that no one else put a tube down his throat.

Of course, a person can go on like that only so long before the body decides that it has had enough. The time came when he came in and was not responding. We placed him in the room that was directly across from the nurses station and I made the family comfortable to wait for the inevitable. I checked on them periodically, but for the most part they were left alone. Soon, the daughter came out and said that he had passed away. It was my responsiblity to verify this information and get in touch with the proper people. I walked into the room and the harsh sound of his breathing was gone. I did the things I needed to make sure that he was really gone. As I looked at the family, there were tears in all our eyes. His wife hugged me and told me that I had always been his favorite and she thoughts he would be happy that I was there when he left.

After gathering all the information from them that I needed, I left to call the coroner to notify her and to call the place that would handle his interment. He had decided long ago that he wanted to be cremated. As there was only one crematorium in the area, they were already out when I called, but they would be there as soon as they could. I relayed this to the family and told then they were more than welcome to stay if they wished. Some of them did stay. I provided them with privacy, tissues and any comfort they might need. Everytime I went to check on them, although there were tears, there was also laughter at stories about his life. Once, they looked at me and asked me if I was uncomfortable with their laughter. I told them, no, I knew that they had been prepared for this and although it's never pleasant, it was nice to see that they could look back with love at the time they had spent with him.

Soon, the service came and picked him up. The wife and daughter thanked me for the kindness of letting them stay and spending a last couple of hours with their loved one. I have always felt that a family should have as much time as they need to say goodbye. After they left, I had housekeeping come and clean the room. When they were done the door was closed and we all went about the rest of our shift.

Near the end of the shift, the other nurse and I were at the desk charting on the night's event when a buzzer went off. We both looked to which patient was calling for assisstance. It was the call bell from the room across from the nurse's station. As we were both at the desk, we knew that there was no one in there. Neither one of us wanted to go in, so we tried to cancel the bell from the console, but we were unable to. I felt that it was my responsiblity to go in as it had been my patient that had been in there. As I walked into the room and turned on the light, I saw that the cord for the call bell was pulled out of the wall and was across the room. Now, with no one in the room that was eerie to say the least. I hurriedly put it back and left the room.

A few weeks later, I was talking with the daughter of the patient who had passed away in the room and she smiled at me and said that it was probably her father coming back to tell his favorite nurse goodbye one last time.