I believe in a good death. As an ICU clinical nurse specialist, I have seen a lot of bad deaths, and a few very good ones. In a bad death, the patient lies immobile in a hospital room, attached to machines and tubes, sedated to the point of not being able to communicate with loved ones. There are no loving goodbyes, there is no eye contact, and the family is banished to the waiting room except during short visiting minutes. There has been no discussion of the death beforehand, and differing opinions on what should be done and what the loved would have wanted lead to tension and conflict. A bad death takes a long time.
One of the best deaths I recall was the death of a much-loved elderly wife in an ICU in South Carolina. I can’t quite recall the nature of the illness that landed her in the ICU in a coma, but her husband was never far from her side. What made it a good death was the reactions of my nurses, all young, all uncomfortable with the presence of the husband. One of the nurses, who had recently lost her own mother to cancer unexpectedly, stepped forward and volunteered to serve as the primary nurse. She asked the husband to tell her stories about how he and his wife met, and their life together. As he reminisced, he began to grieve for the old age he and his wife had envisioned spending together. He asked the nurse if his wife would survive the ICU, and they both cried when she told him she did not think so. He consulted with his family and his minister, and they decided that his wife deserved a quiet, painless death. We removed our machines, and she died with her family around her.
The thoughtful, kind presence of that nurse helped the stunned husband review the life he’d had with his wife, and recall the principles that governed their life together, and that governed her death. At the funeral, the nurse was introduced fondly and proudly as “Mom’s Nurse.” It was a good death.
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