I was sitting there holding her hand feeling hopeless, helpless. I wasn’t ready for this, even if she was. I had given her that dose of morphine when her breaths were forty per minute. Now they were becoming fewer and farther between, almost too hard to count. I brushed her hair away from her face. She was always so vain, even up to those last days. She made sure her hair was done before her son came to town for what she knew would be the last visit. She knew, but she didn’t tell anyone else. Stubborn as ever. I checked her vital signs, and her blood pressure was too low to register. The rise and fall of her chest was happening only two or three times a minute. Her fingers felt so cold and they looked bluish under her red nail polish. I remembered learning about this somewhere in clinicals. I saw the ugly purplish color creeping up higher in her legs. So that’s what mottling looked like. I felt like I should be doing something. I adjusted her oxygen mask that was too big for her face. It looked like she had shrunk in the last few minutes. She seemed smaller anyhow. She turned her head away. I knew she hated that mask. I figured it really wasn’t doing any good at this point anyhow, so I took it off. I told her, “It’s OK Antonia. You can let go.” She looked relieved, peaceful. Or was that my imagination?
Her son had come to visit from out of state. He had just gotten there the day before and they were talking and visiting for a long while. He had business to take care of, and he wasn’t there now. He knew she didn’t have much time left and was having a hard time dealing with it. I’d left him a few messages and he hadn’t called back. He was in a meeting, I knew. I hoped he wouldn’t be mad at me. I knew he wouldn’t get there in time. How was I going to tell him she was gone? He was going to blame me.
Then, just like that, she died. I sat staring for a few minutes, staring at her chest to see if there was any more movement. I listened to her chest with my stethoscope and heard nothing. I had to call the doctor to have her declared dead. The clinician took over, so professional. No blood pressure, no respirations, no pulse, no signs of life. The doctor gave the time of death and the order to release the body to the funeral home. Then I had to call Ernie, her son. As I reached for the phone, I jumped because it rang before I could pick it up. I just knew it was him. I said hello and there was a pause on the other end. “Um yes, hi. This is Ernie. You called? What’s wrong? How’s Mom?”
The words started coming out of my mouth and I started crying. I felt like I was rambling and couldn’t find the right words I wanted to say. I felt so unprofessional. “Ernie, I’m so sorry. She’s gone. She just passed away. She was peaceful and didn’t have any pain. I sat with her the whole time. I held her hand. I’m so sorry. I tried to call you. I’m sorry, so sorry. She hung on for a while, but then she stopped breathing. I’m sorry.” The line was quiet for a moment and I didn’t know what happened. I thought he had hung up or the call was lost. Then I heard this grown man sobbing on the other line. He was crying, I was crying. I didn’t know what else to say. “I’m sorry, I’m so sorry.” He gathered himself and began to thank me. I felt like crap. I didn’t know why he was thanking me. I felt like I should have done something, not sit there. He told me how much he appreciated everything I had done and he knew how much I cared about his mom. He was so grateful that she was so well taken care of. He said he was glad I was the one who was with her. He knew this day was coming, she had told him yesterday that he wouldn’t see her anymore. She never lied to him, ever. He should have known that she meant what she said. The whole time he was talking I was thinking, “No. What? Wait… Why is he thanking me?” He didn’t want to come and see her. He said he just couldn’t. I told him that was OK and I would call the funeral home. He thanked me again and hung up.
I was numb. Then I was angry. I went to school to help people, save them. They sure didn’t cover this part. Death. Did I do everything I was supposed to? Should I not have given her that morphine to ease her breathing? Would she still be here if I didn’t? Was this my fault? I felt guilty. I felt sad. I had known her for only about a year but had seen her 40+ hours a week. I was at her 90th birthday party. It was just me and Marie, the lady who had done her hair for years. Marie had brought in balloons and a huge cake, enough for the whole nursing home. She did Antonia’s hair and make-up. We had our picture taken together.
About a week or so after Antonia died, Marie came to the nursing home and gave me a big hug. She gave me that picture of me and Antonia from her birthday party. She said Ernie wanted me to have it. She also brought a letter from Ernie. It said how thankful he was for the wonderful care his mother had gotten, especially over the last year. He was able to rest easy at home in Florida knowing his mother was being watched over by the incredible nurses and staff. He said how much she liked it at our nursing home. He was glad she was able to die at home like she had always wanted. He said he was glad she was with family when she died.
I sat and stared at the picture of me and Antonia. I saw a pretty lady who was happy and smiling. I began to realize that I had done something the day she died. I simply was there with her. Nursing was not all about saving people and treating the disease. It is about caring for people at all stages in their lives. They say it gets easier, and in a way it does. Some are easier than others. You can read all of the books you want about pharmacology, anatomy, pathophysiology, microbiology, nutrition, and assessment. Sometimes all of that science goes out the window. You’re not just a clinician, you are a nurse. I realized how important what I did that day was. I did do the right things. I cared for my patient until the very end.