About fifteen years ago, I was working night shifts in the medical ICU.
A woman in her forties had come in with newly diagnosed breast cancer, which she’d probably had for at least six months. It had metastasized throughout her body.
I took care of her often and shared a connection with her around both of us having two sons and a husband.
She deteriorated gradually, eventually on full life support. One evening, I arrived for my 7:00 p.m. shift. The nurse handing off to me told me the patient had been deteriorating and a decision had been made to prepare her to pass away comfortably and without resuscitation that night.
The doctor said to me, “Manage it however you want to. You can shut everything off at once. You can just shut off the drips. You can shut off the ventilator. However you want to do it.”
I pulled the patient’s husband aside and sat down with him. I asked, “What is going to be least traumatic for your kids and you?”
He decided not to take her off the ventilator because he didn’t want to see her struggling to breathe.
He agreed it would be best to just shut off the drips one by one, allowing her blood pressure and heart rate to gradually slow until her heart just stopped. I told him, “I don’t know how long that’s going to take. It could be minutes. It could be hours.”
The greatest thing I could do was to get those kids to be able to say goodbye to their mom.
He said, “Okay.”
Hearing is the last sense to go, and I believe that patients can hear everything up until the end. I said, “We need to say goodbye. I’ll come in there and help you.”
He said, “Okay.”
We went out and talked to the boys, who were about 14 and 16. I said to them, “We’re going to go into your mom’s room. I believe she can hear you. I don’t think she’s in any pain since we’re making sure she has pain medicine. We need to go in and give you an opportunity to say goodbye. All you have to say is, ‘I love you, mom.’ That’s enough.”
They nodded. They were in shock.
We walked into the room, and the husband went to hold his wife’s left hand. The boys were at the end of the bed. She didn’t look like their mom. She was all swollen and had tubes everywhere. They had seen her, but now they just were terrified. They didn’t want to hold her hand.
I said, “Okay. You don’t have to. I’ll hold her right hand.” Then I held one boy’s hand. He held his brother’s hand, and the brother held the dad’s hand.
I said, “Okay. We’re all in a circle. You’re connected to your mom.”
The dad went first. He said, “Honey, I love you. I’m going to take care of these boys. I’m going to raise them right.”
The boys stood there, speechless. I just started to talk for them. I said, “Your two sons are here. They love you very much. They’re going to take care of each other. They’re going to make you proud.” As I spoke, they moved closer to where I was standing. I slowly backed away and brought the closest son’s hand to his mom’s. Then the other son came in and they held it together.
I slipped out of the room. That is what we’re supposed to do. It is not our show. It is our job as nurses to facilitate things that people can’t do for themselves, to be that patient advocate. Our place is in the background because the family is the greatest connection. We may know about the drips and the critical care, but it really comes down to personal connection.
To me, the greatest blessing is to be there when somebody exits the world,
and the greatest thing I could do was to get those kids to be able to say goodbye to their mom.
I was an ICU nurse for 20 years and then moved into leadership. In my last four years of working in hospitals, I was a chief nursing officer in the Cleveland area. One of the reasons I decided to leave the hospital because I felt some degree of burnout. I wanted just to refresh myself, but still be a voice for nursing in some way. I was a Vocera customer for nine years before I joined this company.
We always say in nursing, “What’s your “why”?” For me, being at Vocera, my why is to make sure that we create an opportunity for nurses to be able to create those important experiences with patients and families.