A Final Goodbye

Tonight one of our long term patients passed away. He had been there right around a month, so we all knew him and his family quite well. At the 4 am rounds, nothing seemed to be out of sorts. Vitals were good. A half an hour later, the son comes out of the room and says that there was some blood around his IV site. I went in to have a look as my preceptor was taping her report. I didn't see anything that was unusual. Sometimes blood comes back with a flush, which had just been done a bit earlier. The son was worried he might be in some pain, so I gently asked the patient, who was not very verbal, to try to squeeze my hand. This was to see if he could follow commands. He squeezed my hand several times. So I asked him to give a good tight squeeze if he was in pain, but he did not differ in how he squeezed. I told the son that sometimes about 3 or 4 in the morning he would wake up for about 30 min to an hour and have a spell where get got a little out of sorts, but it usually passed. The son left the room for a few minutes, and I decided to wet a cool wash cloth and hold it on his forehead for a minute. I wiped his face off and the edge of his hair. Lifted up his non-rebreather mask and wiped his face under it. I could tell that this had a great calming effect on him. I held his hand and told him that he was a special man who had family that loved him very much, that they had been here with him every day. I began to notice a change in his breathing, so I watched closely for a minute. I knew that it was time. I zipped out to the hall to get my preceptor, whom I could hear at the nurse's station and told her to move it in there. She came in and a had a quick look and took off to get the son. I told the patient that his son was just outside and he would like to say goodbye before he left us for good. I told him everything was okay; he was not alone. He looked at me for a moment and shut his eyes. The son came in a bit confused, and I told him that his father was about to pass on. He immediately began to tell his father what a pleasure it was to be his son, that he was proud of him and to go be with his mother. His father took 3 more breaths before he left this world. I told the son to keep talking because hearing was the last thing to go, that it meant a lot to be able to tell someone you love them and to say goodbye. The son was amazing. I hoped that my children would do the same for me when it is my time to pass on. A few minutes later, my preceptor comes back in, checks for heart sounds. I told her there had been no respirations for about 5 minutes now. She told the son then that his father had for sure passed on. And he finally cried. And so did we. I always wondered how I would handle such a death, now I know. I am proud of myself for being there with the patient so he did not have to be alone. I am just thankful that he is suffering no longer. May he rest in peace at last.