‘An Immutably Personal Process’: A Hospice Nurse Contemplates Uncontrol

Megen Duffy, RN, BSN, CEN, currently works in hospice case management. She writes AJN’s iNurse column, which focuses on technology and nursing.

by mark ahsmann/ wikimedia commons

by mark ahsmann/ wikimedia commons

I started my day the way I often do: watching sunlight begin to filter in and softly illuminate the sunken face of a person who would die, not later, but sooner. I sat curled in the chair I’d been in since 3:00 AM, wrapped in my sweater against the institutional chill, and waited.

This is, perhaps unbelievably, my favorite part of being a nurse. In hospice, there is no deadline. No one needs the room right now. The patient does not have to go to the floor in the next 30 minutes to avoid throughput delays. I do not have five other patients claiming my time. No, I have the gift of being able to sit quietly with only one objective: to do everything I can to make sure this person leaves this life without pain or fear.

I am not bored. It may appear as if I am doing nothing, but that is far from true. I am watching and listening for every breath, every movement, every toe that turns a deep bruised purple, every expression that may say “I am hurting.”

I am merely cooperating with death, and death’s agenda is never known to me. My job is to wait for death to make a move and see how my patient responds. I am fascinated to see how this particular dance will go between death and my patient. I find deep peace in knowing that this is an immutably personal process that will occur the way it occurs and when it occurs. I appreciate the reminder, every time, that I have no power over it. It helps me to remember that I can find similar peace by relinquishing my illusion of control over the rest of my life.

As the sun rises, the emaciated, elderly face sinks a bit further into the pillow. The mouth that has sung songs, kissed children, and said a thousand prayers gapes a bit wider, and then the features relax into a craggy panorama of black shadows and white sunlight.

I straighten her sheet and wait a few minutes. As the psalm says, it is the hour of our death, not the second of our death. And after those few minutes, I must arise from my nest and bring the noisy activity of life back into the room. I will finish this early morning by helping to load her body into a van, and then I will go to work.

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2016-11-21T13:02:06+00:00 August 27th, 2015|Ethics, narratives, Nursing, nursing perspective|9 Comments

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  1. thomapl September 16, 2015 at 2:56 pm

    The hospice anecdote was quiet, respectful, and absolutely recognizable. Well done.

  2. […] Source: ‘An Immutably Personal Process’: A Hospice Nurse Contemplates Uncontrol […]

  3. confusionandknitting August 29, 2015 at 3:16 pm

    None of us have control over healing either. To a large degree, it is up to the patient. Still, this post is amazing.

  4. amygetter August 28, 2015 at 10:02 pm

    Thank you, Megen, for sharing so beautifully the immeasurable gift of sitting quietly at the bedside of the dying. Indeed, we are not in control of any of it, and are so often in awe.

  5. Nurse Care August 28, 2015 at 3:54 pm

    Doing hospice care is one of the most amazing and yet hard things to do. Taking care of someone who is in their end stages of life is by no means an easy task.

  6. Mary Anne Rizzolo, EdD, RN, ANEF, FAAN August 27, 2015 at 4:53 pm

    I can only hope to have someone like Megan Duffy with me when my death approaches. And this line -” It helps me to remember that I can find similar peace by relinquishing my illusion of control over the rest of my life.” – is sound advice for us all. Thank you Megen.

  7. Vickie Lannie August 27, 2015 at 1:27 pm

    So well written and expressed. I was a hospice nurse for 30 years and this nurse is right on in her assessment of the timing of death. WE stand by and comfort totally at the control death has over us all.
    I thank this nurse for her insights and perspective.

  8. Maggie Schneider August 27, 2015 at 11:30 am

    I find this one of the best gifts I have to give to patients . I have seen nurses that love the rush of other skills . I find peace being with patients at the end of life.

  9. Vivian August 27, 2015 at 11:30 am

    Beautifully said…

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