Letting Go

(Excerpt from my published article)

Redefining ‘survival’ in a profession that does so much business with death.

I remember when I was still untouched by death-when I was a child who believed in immortality and invincibility. It all changed when I became a nurse and came face to face with the harsh realities of death. Suddenly, the finality of it forced me to see us as the mortals we are. I dealt with my patients’ dying by maintaining a “qué será será” attitude. It didn’t mean losing my humanity; it didn’t mean that I cared less for my patients. It just meant survival for me in a profession that sees a lot of suffering and death.

Until Mr. C came to the ED to die.

It was a warm spring day, and on Bed 3 Mr. C  lay dying. Brain cancer with metastases-and the devastation of the disease was finally taking its toll on his 80-year-old body. He was unconscious, but a single tear clung to his right eyelashes.

The ED staff knew him as one of our “frequent fliers.” He liked to be called “Abuelo”-Grandpa. He was always pleasant, even when he was in pain. His wife, Rosa, was a proud and feisty woman, and a bit protective of her husband. She used to complain to hospital administration that we were slow in giving him pain medication. “Why can’t you give him more attention?” she grumbled.

Now, Rosa sat with hunched shoulders at the bedside. She looked tired and resigned. Her face reflected her fears; her eyes, unspoken misery.

The cardiac nurse told me that the family had signed the DNR papers. Marco, the couple’s only child, stood vigil on the opposite side of the bed, gently caressing his father’s wrinkled forehead. His face was in agony, but I sensed a quiet strength within him. He would need it now.

I tried to leave to give the family some privacy, but Rosa held on to me with her other hand. “We’ve said our good-byes. Now I’m letting him go. He wants to die in peace. We’re all ready now.” Rosa’s voice quivered. I nodded because I knew that Marco had reconciled with his father four months ago after a long estrangement.

I removed the  intravenous line and the foley catheter as per the family’s request.  We all stared in silence at the flickering cardiac monitor, mesmerized by the even graceful strokes. Sinus bradycardia … pulse 50 and thready. BP steadily going down … now barely palpable at 70 systolic … respirations shallow. Abuelo was at the threshold.

The numbers held our attention. Heart rate 40 … 34 … 29 … then asystole. The ED resident shook her head. A gasp escaped from Marco, and Rosa broke into sobs. I stood transfixed as a life ebbed away and the single tear rolled down Abuelo’s cheek.

His face stunned me. I expected to see suffering, but instead I marveled at a face that in death looked peaceful, almost ethereal. He died in peace, surrounded by love.

Rosa hugged and kissed her husband of 50 years. I tried to say something that I knew would comfort no one but me, but there was a lump in my throat. I just hugged her and we cried together for this wonderful man whose life had made such a difference. “Thank you for everything,” Rosa finally said. Mother and son then walked away to begin a new life, and I said a silent prayer for the family.

I remember them to this day, several years later. I hope that their memories of togetherness sustained them through their grief. And I’m thankful that it was a quiet day in the ED, and that I had time to listen and to grieve. From them, I learned what strength there is in just letting go.

 

http://journals.lww.com/ajnonline/fulltext/1998/08000/letting_go_of_abuelo.44.aspx

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About Jo Cerrudo 39 Articles
Clinical Nurse Specialist in NYC. On a new journey of discovery. Author, "Nursing Vignettes", published Aug. 2012 (available on Amazon). E-mail: [email protected] Blogs: http://jcerrudocreations.blogspot.com/ http://jo-cerrudo.blogspot.com/
  • Anonymous

    Thank you for sharing your experience.
    There is strength in letting go.

  • Anonymous

    i cried…

  • Anonymous

    teary eyed..

  • BETH ATENCIO BSN R.N.

    SAD BUT BEAUTIFULLY EXPRESSED ….WE ALWAYS LEARN HOW TO DEAL WITH LIFE`S STRUGGLES AND HAPPY MOMENTS THROUGH OUR EXPERIENCES.

  • Anonymous

    i can relate this story..crying..

  • Anonymous

    Life is a struggle and dying is part of living.However, it will always be painful to see and witness death. Thanks for sharing,well said and yet touching…we needed more nurses like you that cares…more power to you..

  • Anonymous

    nurses are supposed to show empathy not sympathy, yes, but in the end, we realize, we are humans after all.. there will always be a memorable story in each nurses' life..and we learn..

  • Nino Opulencia

    Life is wonderful. Indeed, we must appreciate every little thing we share together with our love ones. Live to the fullest, happy and stress free. Forgive those who sinned against you. This is how we must live our lives rightfully.

  • Anonymous

    I can relate to this story though Im not RN, I have witnessed my mother during her dying moments. yes there's strength in letting go. Its too difficult for people like us to accept the fact that they're already gone, but you can see on your departed loved ones that they have a smile on their face as they approached God in heaven. Thank you so much for this, by this, I can still see how my mother suffered on her deathbed but at the same time, how happy she is seeing her beloved husband waiting for her though we cannot see them literally.

  • Sylvia Pineda-Alfonzo

    my father died of a heart attack at the age of 76/15 years ago. The whole family was able to say goodbye to him & we learned slowly but surely how to let go….what really hurts the most is when my 42 year old brother traveling home from NYC to Rockland County(40 minutes away from NYC)to celebrate christmas. He was in Palisades Parkway car accident due to snow & sleet. The whole hamily was in church for celebration while he was holding on to few minutes of his dear life. We didn't even had a chance to say Merry Christmas & final goodbye. That was 7 years ago. Lesson learned is that we should not harbor ill feelings & to stay in touch at all times. His name is Melicio Pineda and he belongs to the proud Fire Dept.in Queens NY.They proudly served as volunteers for two months under the WTC 9/11 disaster….

  • Anonymous

    I can relate to this, being an RN for 20 years, I watched my mother struggle with Cancer trusting and hoping that Medicine could save her but in the end, it is just too much for her frail body to take. What with Chemo and radiation which just makes her more weak everyday. I finally signed the DNR papers but it was really very very painful to watch her go. To think that I'm a nurse and should be used to these already but nothing can really prepare you for the passing of your loved one. In the end we just have to learn to let go……….

  • Bheng

    No matter how many times I read this article, I can't help but feel the lump on my throat and the tears that keep falling on my cheeks…very touching story.

  • nightblastz

    Beautifully written. The words expressed everything that needs expressing. A sad yet moving story. Thank you for sharing!

  • embapatero1

    I cried when I read this article….I've witness death in my arms not only once but four times,,,,my Mom,kuya Eddy, ate Erlinda..and our neighbor mang Romy.I'll tried so hard to rescue them but sad to say…I can't make it…

  • Anonymous

    BRAVO!!! A simple but very relevant story….

  • Jocerse, ED RN

    Thank you for all the comments. As nurses, we try to steel ourselves even as we try to comfort the grieving loved ones of our patients. But somehow, a few patients still manage to touch us more than the others.

  • Anonymous

    I was teary eyes after reading this article it was very touching thanks for sharing.

  • Anonymous

    i was teary-eyed.im an RN myself and being assigned in the AICU made me very depressed because i was facing my ultimate fear and foe almost everyday- DEATH.yes,i know were meant to be compassionate yet strong in very emotional situations, however I just can't.I would end up crying when i get home.thanks for sharing your story.

  • Gelli Mae Gamul

    what a great sharing!
    that was awesome. I’m a first year nursing student and from your article, i learned so much. I would bring that learning as i have my work in the hospital. I noticed in the article that you were able to apply Henderson’s theory which is 14 Basic Human Needs. You helped the person achieve a peaceful death. And there is also interpersonal relations wherein you were able to established rapport with your client. I awe you a salute.

  • b.o.b

    death and dying is still a very sensitive issue for me to deal with no matter how long I am on the hospital setting, it touches me deeply..

  • Mai

    So touching. Thank you for sharing this story. For 4 yrs of practicing my profession as a nurse, all I’ve witnessed are sudden and unexpected deaths mostly caused by accidents. So, I could say I don’t have moments like that of a nurse who had really become so attached to the patient and his family.

    I have never experienced losing a dear one in my family. God forbid! Yes, I lost my uncles, niece and grandma but it’s a different agony and feeling when you lose your own parent, sister, brother or child. I can’t relate but as a nurse I can only empathize.

    Death is my greatest fear though. My prayer is may God give me or my loved ones a peaceful death like that patient had experienced. Such a wonderful exit when you are ready to face your mortality, surrounded by loved ones whom you have shared your life with.

  • mash

    you’re a very good writer.

  • daisy buaquen

    awesome,nicely expressed story…yeah right…there is a deep strength in us in letting go and facing new phase of life..that’s life there are so much to discover in letting go… thanks for sharing,i think it helped me as well.. nurses are really talented good luck to all of us!!!

  • shirley

    Great writing. Very touching.

  • lou

    Thanks for sharing. Being an ER nurse myself, it’s really hard to find time to stay longer with a patient/family. We can only try our best. I’m glad you were there for them.