It is an honour to give someone the ‘right’ death
Caring for a dying patient and providing last offices helped nursing student Tristan Crombie realise the importance of ensuring dignity in death
Caring for a dying patient and providing last offices helped nursing student Tristan Crombie realise the importance of ensuring dignity in death.
Before I started training to be a nurse, I had no experience of caring. Other than my nephew, I’d never washed someone, nor helped them to the toilet or fed them.
My first placement was on an acute stroke unit, and on my first day I cared for a male patient with a reduced level of consciousness. Every day, I gave him a full wash, dressed him and changed his bedding.
I shaved his face, brushed his teeth and combed his hair, changed his incontinence pads and recorded his bowel movements and fluid output. I also turned him in his bed to inspect his pressure areas.
When he seemed in pain and his eyebrows furrowed, I would hold his hand and he would squeeze mine. I felt overwhelmed at how helpless this patient was, and realised how privileged nurses are to be in a position to help patients remain comfortable and retain their dignity.
I also realised that behind every patient there is usually a family. The patient didn’t speak once while under my care, and while it was sad to see him in this way, it gave me a little more detachment, which made it easier. But the patient’s wife came to visit him every day, and speaking to her and seeing the pain she was going through was difficult. I tried to make life more comfortable for her by making her cups of tea, sitting and talking to her and supporting her while looking after her husband.
Sadly, the patient’s condition deteriorated and he died. I had expected him to look different after he died, but he looked the same, just calmer and more at peace. While conducting his last offices, I found covering his face a particularly difficult experience, because it seemed to dehumanise him.
This experience made me realise that the dead deserve all the dignity of the living. It is an honour to be able to give someone the ‘right’ death, in the same way it is a privilege to give someone the right birth.
When the patient’s wife arrived, I comforted her and supported her. It was difficult to see her grieving, and I felt a bit broken, struck by the solemnity of the situation.
But I soon learned that in the workplace there is not much time to process a death. Another patient will need a bedpan, or their blood pressure taken, and you have to get on with the job. I found this difficult at the time, and still do now.
Other nurses told me that your first patient death is the hardest, and you remember it. They said it gets easier over time, but I’m not quite there yet. It still makes me sad to think about this patient and his family and I don’t see how it gets easier. I imagine you just learn to accept it.
Tristan Crombie is a second-year nursing student at Plymouth University