I didn't get to say goodbye

I woke up yesterday morning prepared to visit a patient whom I knew was nearing her end. I texted her son and said I was on my way. He texted me back and said she had just passed. My first reaction was to cry because I truly felt a loss; a deep, painful loss from losing someone I had grown to care about. Something happens when you spend time with a person at the end of their life, and in our case, three times a week for about two months. We talked about our kids, our grandkids the men we loved, the friends we’ve lost, the things that inspired us and brought us joy. We shared open and honest conversation about our personal thoughts about life and death, mostly death.

My second reaction after receiving this news, was this horribly painful feeling of guilt. I didn’t get to say goodbye. I had promised her I would be there through her entire process, and all I could think about was that I wasn’t there at the end. But I reminded myself about conversations I have had with social workers, chaplains and fellow nurses who have all experienced this feeling. And what we remind one another, is that our goal is to provide beautiful, kind and compassionate care and do whatever we can to ensure that their landing is soft and that those closest to them, feel supported and have the education and resources to be there when they need them the most.

Sometimes we are there at their admission, sometimes a few weeks into their process, sometimes only when they take their last breath. But collectively, in hospice, it is about the team and the work we all do to provide the beautiful care. And I feel most certain that as a team we did everything she needed and deserved and I am proud of us for that.

A few days before she passed away, I sat down with her sons and I told them I felt she needed a higher level of care and encouraged them to bring her to our hospice house where she could have around the clock nursing care. With her in agreement, we were able to move her to our hospice house and true to what I had promised, she received the most wonderful care. I need to hold that within and know that while I wasn’t there at the end, I did provide her with the very best of care and I am okay with that.

Today I felt a little off, despite my attempt to move through my day with some semblance of grace. I couldn’t quite shake the fact that I hadn’t yet grieved someone I grew to care about and was truly saddened by her passing. I got into my car, selected my Simon & Garfunkel playlist and made it through The Sound of Silence but when Bridge Over Troubled Water played, I broke down and cried. I reached out to someone I love and confessed my break down. He asked me why. I shared. He responded with “you have a big heart and I hope that never changes”. Despite the ache, I hope he’s right… I cannot imagine doing the work I do without giving my whole heart, but with that comes some ache. So as I learn and grow, I am learning to count on people I love to help me work through my losses and my grief. We cannot do this work alone, whether it is with the support of our team or our family of loved ones, we too need to grieve, to feel and sometimes break down and cry. I know in my heart I did some really good work. I know that we, as a team, did some really good work.