Finishing the Race

My patient died on my watch. I knew it was possible…I just didn’t think he would. He was on comfort care – basically hospice in the hospital. I have 5 patients each night and he was the only one on comfort care. He was breathing like he was running a marathon all night. His breathing was so loud I could hear him down the hall. 

Fortunately it wasn’t a crazy night – no alcohol withdrawals, active seizures or patients jumping out of bed - so I was able to spend a good amount of time with him. I have only had one other patient die and she had family and many visitors around when she died. With this patient, his family left around 10 that night to get some rest with assurances from me that I would call if there were any changes. But there weren’t any changes…until he was gone.

His life story isn’t mine to tell. I didn’t know him. When I took him as a patient he was no longer responsive. I don’t know what his personality was like, what he did for a living or if he had a good sense of humor. I just know his medical history. His heart was in really bad shape – kidney’s weren’t so great either. He then had a pretty significant stroke and his body and his mind just couldn’t recover.

I tried to make him as comfortable as possible – after all, it is called “comfort” care but I just couldn’t seem to change his breathing no matter what I tried. It was almost like he was racing to the end. I asked the more experienced nurses that night for advice. I didn’t feel like I was providing him much relief. When all the medications didn’t seem to be changing anything…I just spent time with him….did my extra charting in his room, put chapstick on his lips and swabbed his very dry mouth. He was working so hard. From my experience with running, there isn’t anything better (other than finishing) than having a cheering section along your route. If I couldn’t give him a more comfortable pair of shoes, at least I could provide encouragement along the way.

My shift was just about done. The day nurse was there and I was giving her a report on the night. I had just finished telling her how hard this patient was working all night when we walked in his room. It was silent. His race was over. We listened for a heartbeat and it was still there…barely. We stood in his room in silence as he died.

Being with someone when they die is mostly beautiful with just a smidge of terrifying thrown in. He seemed peaceful…the most peaceful he had been all night. But, in the back of my mind I am wondering, is he scared? Is he comfortable? Did I do all I could do for him? I will be left to wonder. His heart came to a stop and his soul was gone. 

I knew my patient would die soon. I just didn’t expect it to be on my shift. Maybe he took pity on this poor new nurse who was trying desperately to provide some measure of comfort and wanted to show me how comfortable and peaceful he could be. Maybe his heart just said enough. I hope that as I encounter more death in the hospital I never get used to it. If I never see it as normal or routine, I am hopeful I can hold on to the sense that the experience of a physical life ending and a soul going on to find rest with God is sacred.