End of life

Turning off life support

It was in a controlled, peaceful environment, and the family were present. I’m a critical care nurse before things get misconstrued.
I’m writing about what happened because I find it helps me dissect my thoughts clearly and logically. It’s good to work through the thick fog of emotion. I also don’t think that palliation and end of life in the UK is talked about enough. Death is a part of life, but that doesn’t make it any easier to deal with when it does happen to those it directly and indirectly affects. Death is scary, I’m scared of dying, I’m scared of losing my nearest and dearest; most people are, right? But talking about it and sharing positive experiences may help remove some of the associated negativity and fears.

I witnessed my pap die and patients I’ve cared for during their end of life journey, it never gets any easier. It is highly emotional and can be mentally jarring. Having a role in the last days, hours or minutes of someone’s life is quite a privilege (given the circumstances); to be able to ease the transition for that person and their loved ones is part of my role as a nurse. We are there to give holistic care in every essence of the word; benevolence and non-maleficence is at the core when caring for any patient.

The patient I’m writing about was incredibly poorly. There was nothing more that could be done to save them, the complication was unexpected and understandably very distressing for the family. Unfortunately, medical intervention and the best doctors in the world can’t save everyone. And for this patient, there was no alternative.
The family had time with them, many tears were shed. Prayers were held and the love, admiration and adoration for this person was incredible. They were so lucky to have time to say their goodbyes, unlike so many that don’t have that chance.

Overall the patients last day was incredibly busy for me as a professional and at times overwhelming. The overwhelm didn’t last long because I was fortunate to have amazing colleagues that day. I had my game face on, and no matter what, I was there to do the absolute best I could for the patient and their loved ones through a difficult, sensitive and emotional time.
I kept going. Making sure I did everything right. Good communication, compassionate, empathetic and maintain candour. I was asked by colleagues if I was okay. But it wasn’t my loved one dying, so I knew how I felt in that moment didn’t matter, it wasn’t about me.

The day was coming to a close and the patient was deteriorating fast despite having the highest level of support, they were sedated and had all the appropriate medication to keep them comfortable. When the final conversation happened with the family, and told that I would turn off the life sustaining treatment, the patient would inevitably die was surreal.
We didn’t know how long it would take for the patient to pass away but we didn’t think it would be long.
I turned off the cardiac monitor so there was no indication for the family to see numbers dropping or flat lines; next I turned off the inotrope and vasopressor infusions, the haemofiltration machine, and finally, the ventilator.
That exact moment of turning off the ventilator was pivotal for me because the ventilator helps people breath, it gives their lungs oxygen…and I took away that breathing support. That moment will stay with me for a long time.

I was supported by a specialised nurse who was involved with turning off the support and I will be forever grateful for her presence that day.

The family were present, sedation and analgesics remained running and the patient passed away very quickly. Peacefully and with no signs of distress.
It was sad and seeing the family upset was difficult, I wanted to take away their pain of losing someone so dear. I did try and offer some comfort that their loved one was in no pain, that they were all present and got to say goodbye. Offering my condolences and that I was so sorry I couldn’t do anymore. I wished so much that the circumstances could’ve been different.

Turning off life support isn’t at all how it’s portrayed in the movies or medical dramas we’ve grown to love.

It’s visceral.

Related posts:

Since the start of the war between Russia and Ukraine, the sanctions placed by Western governments as well as companies on Russia had majorly affected the economy of the country. The ruble (Russian…

Drilling rotary and vibratory hoses (High Pressure Drilling Hoses) are designed as API 7K spec for pumping mud at very high pressure in oil drilling and exploration. They are also known as kelly…

You have decided you want to be less judgmental. Congratulations on taking this step towards self-improvement! Change takes focus, practice, and patience. Don’t be discouraged if it does not happen…