Last hours (musings of a hospice nurse)
I arrive to see everyone gathered around her bed against the far wall in the living room of the small suburban family home. The house is warm and well lit, a welcome reprieve from the February chill outside. Family, friends, even the neighbors from across the street, all there to say goodbyes and commiserate through their love and grief.
She looks so small in the single bed. Her cheeks are sunken, jaw slack, skin waxy and greying. I take her cool hand in both of mine and tell her I'm here and that everything is alright. If she can hear me there is no noticeable response. We are told hearing is the last sense to leave us so I talk to her regardless.
She is dying. Her heart has finally reached the end of its ability to sustain life after a long time fighting and has begun the process of shutting down her organs and higher brain functions until it ceases beating altogether. Her breathing, that I can barely detect through the rise and fall of her chest beneath the blankets, has already started to falter, the pauses called apnea are long and frequent and when I take out my stethoscope and listen to her chest her heart beat is too faint for me to hardly hear. I know through experience she does not have much time left.
When I pull her daughter aside and share my findings she does not cry yet, stoic and strong until she can grieve in private later. She takes in each bit of information quickly, handing me a small tablet to write out new directions for the few comfort medications her mother is receiving and watching carefully as I demonstrate how to administer each. The familiar blue of the liquid morphine transfixes me momentarily as I fill the syringe carefully. She will get it every few hours now to keep her out of pain as she continues to pass.
Her brother is calling from out of state. He is on his way but still has many hours to go and I know instinctively he will not make it in time. I hold the phone to her ear, pushing back my own emotions as he cries and begs her to hold on, tells her that he loves her and he'll be there soon. This is the last time he will speak to his sister while she is alive.
I stay for awhile answering questions from many loved ones and passing around tissues and hugs, keeping a close eye on the small figure huddled in the bed. I am hesitant to leave as I know in my gut this will be the last time I will ever be here. I have cared for her for many years and no matter how many times I go through this it is still difficult to let them go.
Soaking in my last images of this home and these people, I approach the bed one last time. Laying my hand over her heart I kiss her head and whisper "safe journey". I offer my regards briefly to everyone else before heading back out into the cold winter air, the sky dark and foreboding above me.
An hour later she is gone.
I arrive to see everyone gathered around her bed against the far wall in the living room of the small suburban family home. The house is warm and well lit, a welcome reprieve from the February chill outside. Family, friends, even the neighbors from across the street, all there to say goodbyes and commiserate through their love and grief.
She looks so small in the single bed. Her cheeks are sunken, jaw slack, skin waxy and greying. I take her cool hand in both of mine and tell her I'm here and that everything is alright. If she can hear me there is no noticeable response. We are told hearing is the last sense to leave us so I talk to her regardless.
She is dying. Her heart has finally reached the end of its ability to sustain life after a long time fighting and has begun the process of shutting down her organs and higher brain functions until it ceases beating altogether. Her breathing, that I can barely detect through the rise and fall of her chest beneath the blankets, has already started to falter, the pauses called apnea are long and frequent and when I take out my stethoscope and listen to her chest her heart beat is too faint for me to hardly hear. I know through experience she does not have much time left.
When I pull her daughter aside and share my findings she does not cry yet, stoic and strong until she can grieve in private later. She takes in each bit of information quickly, handing me a small tablet to write out new directions for the few comfort medications her mother is receiving and watching carefully as I demonstrate how to administer each. The familiar blue of the liquid morphine transfixes me momentarily as I fill the syringe carefully. She will get it every few hours now to keep her out of pain as she continues to pass.
Her brother is calling from out of state. He is on his way but still has many hours to go and I know instinctively he will not make it in time. I hold the phone to her ear, pushing back my own emotions as he cries and begs her to hold on, tells her that he loves her and he'll be there soon. This is the last time he will speak to his sister while she is alive.
I stay for awhile answering questions from many loved ones and passing around tissues and hugs, keeping a close eye on the small figure huddled in the bed. I am hesitant to leave as I know in my gut this will be the last time I will ever be here. I have cared for her for many years and no matter how many times I go through this it is still difficult to let them go.
Soaking in my last images of this home and these people, I approach the bed one last time. Laying my hand over her heart I kiss her head and whisper "safe journey". I offer my regards briefly to everyone else before heading back out into the cold winter air, the sky dark and foreboding above me.
An hour later she is gone.
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