As a nurse, I see dying people most of the time. I see how people struggle to breathe eventhough their body's already tired and weak. The scenario's not good to see, but we, nurses, stay with them 'till their last breath. We were taught how to help them die with dignity. But, is there really such thing?
Death: the permanent termination of the biological functions that sustain a living organism.
Signs of death:
- Cessation of breathing
- Cardiac arrest (No pulse)
- Pallor mortis, paleness which happens in the 15–120 minutes after death
- Livor mortis, a settling of the blood in the lower (dependent) portion of the body
- Algor mortis, the reduction in body temperature following death. This is generally a steady decline until matching ambient temperature
- Rigor mortis, the limbs of the corpse become stiff (Latin rigor) and difficult to move or manipulate
- Decomposition, the reduction into simpler forms of matter, accompanied by a strong, unpleasant odor.
My first encounter with a dying person was when I was in 3rd year college. I think it was about one o'clock in the afternoon when we heard the nursing assistant shouted "code blue!" [Code Blue (emergency code), a hospital code used to indicate a patient requiring immediate resuscitation.] I got scared, really. The nurses rushed to the patient, did CPR, pushed epinephrine and continue to do so until the doctor finally pronounced him dead. Then, as we always see on TV, the relatives cried and became hysterical. I almost cried after seeing their grief.
Yeah, I'm a cry-baby. :c
When we were in school, we were taught how to help families cope in situations like that. However, it's really not easy to apply in real life.
We were also taught how to deal with patients who are just waiting for their last breath. I mean, those who already know they're gonna die sooner or later. But, how do you really talk to them? Would you say, "It's ok...you'll be in God's arms..." How do you know that? Hmm...
According to Kubler-Ross, there are Five Stages of Dying, namely:
- Denial — "I feel fine."; "This can't be happening, not to me."Denial is usually only a temporary defense for the individual. This feeling is generally replaced with heightened awareness of possessions and individuals that will be left behind after death.
- Anger — "Why me? It's not fair!"; "How can this happen to me?"; '"Who is to blame?"Once in the second stage, the individual recognizes that denial cannot continue. Because of anger, the person is very difficult to care for due to misplaced feelings of rage and envy.
- Bargaining — "I'll do anything for a few more years."; "I will give my life savings if..."The third stage involves the hope that the individual can somehow postpone or delay death. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle. Psychologically, the individual is saying, "I understand I will die, but if I could just do something to buy more time..."
- Depression — "I'm so sad, why bother with anything?"; "I'm going to die soon so what's the point... What's the point?"; "I miss my loved one, why go on?"During the fourth stage, the dying person begins to understand the certainty of death. Because of this, the individual may become silent, refuse visitors and spend much of the time crying and grieving. This process allows the dying person to disconnect from things of love and affection. It is not recommended to attempt to cheer up an individual who is in this stage. It is an important time for grieving that must be processed.
- Acceptance — "It's going to be okay."; "I can't fight it, I may as well prepare for it."In this last stage, individuals begin to come to terms with their mortality, or that of a loved one, or other tragic event.
Persons undergoing the above stages are hard to deal with. You need to have a lot of understanding and patience in order to make them feel fine somehow.
Maybe you're wondering, "Do I forget my patients who died?" Actually, the answer is NO. I remember them all. I can't just forget how those people became part of my life as a nurse. I already wrote some stories about them HERE. HERE. HERE.
It's good that I've never met relatives who blame the health care team for the death of their loved one. This is because, we always do everything we could to save them or atleast help them die peacefully.
As of today from the day I started working in the hospital, 5 people died before my eyes. I feel really sorry for them but maybe, just maybe, God took their earthly lives so they could live peacefully with Him.