Nursing is a gift. it is a gift you give your patients, your patient’s families, your coworkers and yourself. No other profession allows for the level of compassion and human contact that nursing does. We see people at their most vulnerable. We help people when they are most desperate. We often are the link that keeps them hanging on, or the one that gives them the permission to let go. We are the soul of medicine. I believe that with all my heart.
I recently had two radically different experiences with a patient’s death. In the first, we had a patient who was all alone. His family wouldn’t stay with him. They would come, visit, and leave. This poor man had been through countless surgeries. He had wounds and machines and had suffered. His family had elected to make him no code status- to allow nature to take its course. We knew his time was limited, and we tried to encourage his family to stay with him. They decided not to. The night he died, he was all alone. Except for nurses. I looked up at the monitor, and saw that his heart and breathing was slowing. I went into his room, pulled up a chair and sat down. I held his hand and told him it was ok. I wasn’t his nurse, just a nurse working that night. His nurse was frantically busy trying to reach the family, but they wouldn’t answer the phone. I held his hand as he died, and saw his soul leave his body. I cried for him. It tore at my heart, but he did not die alone. I do not care what your religious beliefs are, but I maintain that you can tell when that “spark” is gone. Even when someone is not responsive anymore, when they are no longer conscious, you can still tell when they have passed away, machines or not. As a nurse, and as a human being, I cannot bear the thought of someone passing their last moments on this earth alone. Not if it is remotely in my power to prevent that. Eventually we were able to reach the family, they came and signed papers and left. It was hard on all of us to see that.
The next day that I worked, I had a vastly different experience. A patient that I had taken care of for many weeks was gravely ill. Multi system organ failure, no hope for recovery. No evident brain activity. I had become close to the family over the preceding weeks. His daughters came back to town in order to assist their mom and to say goodbye. I was not his nurse that day. but the family asked for me. My time was spent hugging the family, being a shoulder to cry on, and giving them permission to grieve. They were in limbo- not able to move forward because he had not yet passed away, but he was for all intents and purposes gone. They elected to withdraw care and let him pass. It was difficult and hard, and I cried with them. The funny thing was, my “nursing” was for the family. We had already done everything we could for the patient. We were there to ease any residual suffering- but he had family to be with him as he passed from this world. What the family needed was our support to tell them it was ok. That was the gift that I could give them that day. To acknowledge their pain, to validate their feelings, to support their decision and to tell them it was ok to feel exactly how they were feeling.
As I see the flurry over advanced education for nurses, I am struck by how little people seem to know. I realize that what people are struggling for is a way to quantify what nurses do. I don’t think that can be done by a piece of paper. There is no degree in compassion. There is no certificate for empathy. You can have the technical skills of a god, but if you lack the ability to connect with another human, you cannot be an effective nurse. You can memorize charts and drugs and machines and abnormal values. But if you cannot put yourself in the shoes of your patients and their families, you are doing everyone a disservice. Whether it is holding the hand of a nervous patient and telling her its ok, or bringing a sandwich to a worried husband, all of it is part of nursing. It is a gift, the gift of loving someone, even if only for that moment. And I am always enriched by that experience, no matter what form it takes.