Nursing Times blogger Clare Aubrey on dealing with death.
I’d already witnessed someone passing away on the coronary care unit but in the commotion of the emergency, I’d not really had time to take it all in and be really aware of what was going on. The machines, the equipment, the shouts for this and that, the oxygen, the angle of the bed, pulling the curtain round – it all needed dealing with and in that moment every minute task became the most important thing in the world, and quite rightly. However, these practicalities ultimately meant that I couldn’t sit beside the patient, comfort him, calm him or relate to him and I certainly could not mourn him afterwards – there was still so much to do…
I did not realise the impact of this until my second death, which personally allowed me to finally mourn that first poor patient, whose passing had been so fraught. And I finally realised the importance of taking that time to cope with these things, especially as a student. I realised that I’d coped in the first instance through sheer activity but in that, I had not allowed myself any feelings and by the time the second passing came, I had all that emotion bottled up inside.
The floodgates opened when the second person died – a little old lady who had just run out of time. It was inevitable really that I was able to let myself go, despite feeling entirely conspicuous. The staff were wonderfully supportive but I must admit, despite their kindness, I felt guilty about having so much attention on me when this lovely lady had just passed away. I left the area to cry so that people were dealing with her and not spending time comforting me.
However, I did go back to help with the last rites as I thought it was fitting for me, having spent that time with her as she lay dying. It was as the other staff began to put on their aprons and gloves that I realised what had just happened. Whilst the patient had been deteriorating, we had all worn our personal protective equipment, however, I now realised that as the patient had begun to die, we had removed our gloves and held her hands, skin on skin. It was that contact, that touch that had allowed us to feel like we were connecting with that patient and we were there to support her in her last moments.
I realised while reflecting that there must be so many occasions where it’s appropriate to slacken the rules a little, to prioritise support over infection control, to really give the patient the respect and comfort that they deserve. I felt consoled by the fact that as I grow as a student nurse, I am learning to use my best judgement. And this is why placement is such an important complement to university because I am able to see things in a real context, real people with all their problems and baggage. This allows me to see nursing for what it really is – the art, not just the science and now I have faced death and seen how to cope, I hope that I can go on supporting patients in their most vulnerable moments and always choose the best course, not necessarily the textbook one.