Your Granny's Nurse: Frank and Emma

Being a nurse, dying is part of my everyday life. I see death in many forms. Quick and unexpected, slow and lingering, peaceful,  and agonizing. Recognizing the signs of impending death are a learned talent, one that any seasoned nurse can readily see, but I am not talking about clinical signs and symptoms here. Any nurse worth her salt can rattle those off, but the little things, the small seemingly insignificant idiosyncrasies that makes a patient just "different" that day.  

I had known Frank for about four years.  He was a feisty old coot, in his mid eighties, a widower of about ten years.  He flirted with all the nurses and even had himself a girlfriend in the "home", a spry young chick of seventy two, or so he boasted. At one point we had to have a serious meeting with him and his lady friend, Freida, to let them know that the nursing home's lobby was not the place to bare one's breasts for the tasting. Ole Frank was always good for a laugh, and his antics kept us in stitches. 

Unfortunately, Frank was also prone to Pneumonia and Congestive Heart Failure, a buildup of fluid around the heart. Whenever Frank would become seriously ill, he would have visions of Emma, his deceased wife. Some of the staff passed his visions off as febrile hallucinations, but I knew better. He had told me after once such episode that Emma had told him that she loved him, but it was not his time to come with her, and to "Take your damned medicine." I could see her saying that, as she had been my patient too.  He recovered nicely, and was feisty as ever.   

One afternoon, about six months later, I had taken my charts into Frank's room during one of his "episodes" to just be near him, as I thought his time was getting close. His only son, a lawyer had said he would be in that evening, as he had court that day.  Having never let a patient die alone on my watch in over twenty years, it was second nature to take my charting into a patient's room and hold their hand and talk to them while I documented the events of the day. It had been storming that day, and I had brought a large "H" tank of oxygen, a big green behemoth resembling a torpedo, into the room, as the power had gone off in the storm and his electric powered oxygen concentrator was useless. He opened his eyes and started having a conversation with, what I thought, was the oxygen tank. "I'll be home in time for dinner, dear... Meatloaf?.. She's just fine... Just give me a minute," I asked Frank who he was talking to. He squeezed my hand, ever so lightly and said, "My Emma", nodding to the foot of the bed. "I'll be heading home with her tonight, I think". I documented this conversation in his chart, but I knew at that point that this would be the last time I would be sitting at Frank's bedside, charting with one hand and holding his hand with the other. He passed peacefully that evening. I truly believe his Emma had come to ease him home, just as she had come to allay his fears in earlier illnesses. 

I have sat with many a patient as they breathed their last, and each one is unique. It is my belief that no one should die alone, in a nursing home, but it is sadly the case in many instances. Whether miles, fear of death, or mere inconvenience, many children, brothers, or sisters  do not come until their loved one has passed on, although we keep them posted to every little change in their loved one's condition, and tell them when the time is becoming imminent. Death is not an easy thing for anyone to handle or witness.. I have never gotten used to it, and still weep for many of my patients, as I care for them as if they were my own family. Especially the ornery ones.