Last offices: maintaining dignity in death

Caring for a patient at the end of life, and performing last offices for the first time, was an emotional but ultimately rewarding experience for nursing student Richard Porritt

When I started my nursing degree last February, I set myself goals I wanted to achieve by the end of my first year.  One of these was to care for a patient at the end of life and perform last offices. 

Four weeks into my second placement, which was on a rehabilitation ward for elderly people in a community hospital, I experienced this when I helped to care for a female patient, who I will call Elizabeth. 

Elizabeth, who was in her mid-seventies, had breast cancer and had been admitted to hospital after a fall at home. She was a lovely lady and well-respected in her community, which was evident from the many cards and flowers around her bedside.

Final days

When she asked me what I did before studying nursing – I am a six foot, 19-stone rugby player – she smiled as I told her about my previous life as a construction worker. 

Initially, Elizabeth was mentally strong and able to communicate well, but as the weeks passed her condition began to deteriorate and she was unable to eat. 

When I asked one of the staff nurses if I could try to feed her I was told, with the utmost compassion, that she would not respond and was nearing the end of her life. 

Elizabeth had told my mentor that when the time came, she wanted to spend her final days in the hospital as it was the same hospital where her husband had died. 

When her family arrived to sit with her I left them alone. I was worried that my lack of experience meant I would not know what to say, or I might say something that could upset them further.

Dignity and respect

After Elizabeth had passed away and her family had said their goodbyes, we left her in the room for a moment with the window slightly open. She had said she wanted to fly to heaven to meet her husband and her friends. 

I asked if I could help with last offices, and was pleased that I was encouraged and supported in this by my mentor. After we had finished, I reflected on the experience during a debriefing session with my mentor, who commended me for my mature and professional attitude and for treating Elizabeth with the dignity and respect she deserved. 

This was an emotional experience for me, but rather than feel embarrassed I am glad I have the compassion necessary for the emotionally demanding career I have chosen. 

I was honoured to have helped prepare Elizabeth for her next journey, and hope she felt as well cared for in death as she did when she was alive. 

I will never forget her or my first experience of last offices.

 Richard Porritt is a second-year nursing student at Plymouth University