I take a deep breath. Exhale slowly.
Comfort care.
New milestone in my nursing career.
Knock softly. Push the door open. Introduce myself to the family.
Patient unresponsive. Introduce myself to him anyway. They say hearing is one of the last senses to go, don't they? Might as well include him as much as possible in his own care.
I have other patients to tend to, but I try to check in on that patient and his family more frequently than I might normally.
What can he sense? Does he know where he is? Does he know his children are by his side? Is he comfortable? Does he feel loved?
I've known the family for six hours, and I already know more about this patient and his relationship with his children than I do about some others I've had all week. He is fiercely independent. He looks out for his children. He is well-prepared. He has a great sense of humor. He will be missed.
I enter the room with small doses of medications to keep him comfortable. I check the identification and clean off the IV site. Before I give it, I notice his breathing has changed. I put aside the syringes and pick up my stethoscope. His peripheral pulses, which had been decent when I first came on shift, are now difficult to detect. His breathing is labored. I don't have to use the stethoscope to realize that his heart is going into ventricular fibrillation.
I make eye contact with his daughter. "He's close," is all I need to say. I quietly step out. As I close the door behind me, I can hear his children sob.
A hug and condolences. Is that all I have to offer this grieving family? I can only hope that my attempts at gentle care of their dying father will help them eventually look back on this time peacefully.
May I not walk away from this experience unchanged. May God grant me the foresight to value my relationships with my own family. May I remember to work a little less, and hug my girls a little more. May my family always know how much I love them, not only in what I say, but in how I treat them. May I treat all my patients with the dignity, compassion, and gentleness they deserve. And someday, when I am on the other side of the equation, may the nurse taking care of me or my family member do the same.
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well written... Your patients, family and friends are so lucky to have you!!
ReplyDeleteEmily, I was so proud to read this post on one of the most difficult times for nurses. Particularly for critical care nurses, as our instinct is to ACT. That is how we are wired and often how we cope, it is immensely difficult to do what is contrary to your nature and your training. But that is what is required for comfort care. It is hard and you do feel inadequate. But you are not. I was caring for a patient the other night and simply took some extra time on her bath, washed and brushed her hair around the EEG probes as best I could. The husband came in and as I was running to get everything done at 6am as we do, he simply said thank you. I had no idea for what the pt was unresponsive, I hadn't had a chance to do more than introduce myself to him and say there had been no change over night. But her appearance and my attitude in my care towards her had made a lasting impact on him. So remember it is not always our ability to save a life that makes the difference it is our ability to respect a life. And that is what CC is all about. Erin Sibben
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