Molly Carroll

Last night I stepped into my bathroom for the mundane, repetitive act of getting ready for bed. The moment I splashed water on my face I was surprised to find that my face was wet with tears as well. I thought I would’ve cried by now, 30 hours had already passed.

People don’t talk about it enough – losing a patient, especially as a new nurse. I came into work and overheard my colleagues discussing the possibility of an autopsy, the sister would have to decide. As this was my third night shift in a row caring for this angel of a man, I had already been holding my breath for nearly 48 hours, wondering if it would happen while he was under my care. Wondering if it would happen at an inopportune time while I was caring for one of my other patients. I wanted to be there.

I met this patient during one of my first weeks of orientation back in July of this year. Nonverbal and completely immobile, he remains a patient with one of the biggest personalities I’ve cared for. My inexperience at the time must have been apparent, he laughed at me as I struggled with everything from IV tubing to his television remote. 

He would continue to embark on the ambulance journey to and from his nursing home a total of five or six times before I admitted him to my unit for the last time. He was loved by the entire staff of my floor. Nearly all of my colleagues had cared for him at one time or another.

Upon his last admission, I told him we needed to stop meeting this way. He didn’t laugh this time, just a hint of a smirk with exhaustion, fear, and pain written all over it.

He passed right before I started my third shift of the week. There were twelve hours left. I had to be on top of my game for my other three patients. Once he was safely transported from the unit to the morgue, I turned around and went about the rest of my night.

Maybe it was the act of washing my face – caring for myself instead of someone else – or simply the exhaustion from only sleeping three hours after my overnight shift. Or maybe it was because that was the first moment I had to myself to process everything that happened the night before. I should have known the tears were coming since they hadn’t yet.

It’s strange, though. I felt guilty for crying. It’s not about me. There were people closer to him – his sister who wasn’t able to be there the moment he took his last breath, his power of attorney and close friend, the caregivers at the nursing home who knew him for over a decade and called each day to check in. I felt I did not hold the right to cry, it was selfish of me. Selfish to show weakness or experience pain over his passing. His pain was greater than mine.

On the other hand, I felt guilty for not crying earlier. How dare I continue on with my day, lay my head on my pillow at 8:30am after my shift and fall asleep immediately without first sending him thoughts of love, peace, and restful relief.

I finished washing my face, and climbed into bed. I let myself continue crying, still deciding if I should allow myself to feel the grief or turn it off. Then I took a deep breath and said to him:

“I’m sorry this happened. I’m sorry you experienced such pain, that your body failed you. I hope you have found relief and rest.

I’m sorry if any of your needs were not met in the end. 

I’m sorry I could not understand you fully, that you were unable to communicate what you needed to me. 

I’m sorry if I did not do enough to alleviate your suffering, if I did not take enough action to make you comfortable. 

I’m sorry if you did not feel like yourself in the end. 

I’m sorry if I didn’t put on the right TV shows, play enough games with you, or give you head rubs long enough for you to fall asleep. 

I’m sorry I could not give you my full attention, that I had other patients to see. 

I’m sorry I could not be there the moment you passed. 

I’m sorry if you were scared, or felt alone.

I apologize to your caregivers, who so desperately wanted to be with you, for not being able to transfer you back to them. I’m sorry you had to pass with us, in the hospital, instead of at home.

I send you all my love and gratitude for being an incredible patient with such a ferocious spirit. You are one of the many reasons I do what I do, thank you for making me proud to be a nurse. I hope I was able to make a positive impact in your life, large or small.

Please know you will always live fondly in our memories, and we will remember you forever. Keep smiling and laughing up there.

Rest easy,

Molly”

Losing a patient is never easy, but the job doesn’t stop. The hours keep ticking by. There’s always more patients to care for, more people that need our attention. But it’s important to remember that we, as nurses, are allowed to take a step back to feel the grief. To honor those that live on as only a memory, who remind us of the fragility of life. My experience with death in my field of work has taught me how essential it is to be gentle with ourselves and others, that everything we feel is valid, and in order to show up in the best way possible for my patients and myself, it’s necessary to feel it all. Then, make the conscious decision to keep going, because being there for patients both in their healing and in their passing is more rewarding than anything I’ve experienced before.