Full text of DOI:10.1089/109662102760269823

JOURNAL OF PALLIATIVE MEDICINE
Volume 5, Number 4, 2002
Personal Reflection
©
Mary Ann Liebert, Inc.
Angels Among Us
KIM HARCROW
WHIP MY HAIR up into a ponytail and run out daughter. She tells me her brother is on a flight
the door for another clinical day. I am thinking from St. Louis and will be here around 2:00 PM.
I
of what challenges I will meet today. I hit the Throughout the day, I assess Mrs. Jones, hold her
med/surg floor, drop my bag, and head for my hand, stroke her hair, and talk to her. Her daugh-
assignment. Looking at the list of patients and ter shares stories about her mom and sheds tears.
their diagnoses, I decide I can meet my objectives
I am here. I am the one to lend my ears and my
for altered cardiac output by choosing Mrs. Jones, shoulders. I am the support Mrs. Jones and her
an 87-year-old woman with coronary artery dis- daughter need. It is me, all me, and it is okay. My
ease. I head to report with my primary nurse and uneasiness has seemed to pass and I am strong.
she informs me that Mrs. Jones is actually in con- Although I feel my heart strings being tugged, I
gestive heart failure and at the present time she hold myself together.
is comatose and expected to die soon, most likely
on this shift.
I medicate Mrs. Jones with morphine at any-
time she seems distressed with her breathing or
I feel the blood flush from my face; my heart when her daughter feels she may need it. I feel
picks up the pace a bit and a sense of distress runs awkward, a strange place to be. Is she suffering
through me. “Oh, I didn’t realize this,” I tell the or just a natural part of the dying process?
nurse. “I will run this by my instructor.” I head
I decide that it is appropriate to leave Mrs.
out to the hall and locate my instructor to inform Jones and her daughter alone for a few minutes.
her of the news. “Perhaps I should choose some- I encourage her daughter to speak to her mom
one else,” I manage to mumble. “No,” she tells because she can still hear. I head to the break
me, “I think this will be a good experience, keep room to take some time to think about things and
Mrs. Jones as your patient for today.” What?!?!? to be alone; just a few minutes later I hear my
Oh no . . . she cannot do this to me! I’ve dealt name being called. I head out to the hall and see
with death but only as a certified nurses’ aid Mrs. Jones’ daughter, she is teary-eyed and says
(
CNA), not as the nurse! “Please God,” I start to “Kim, she’s gone.” I am speechless and motion-
pray, “don’t let her die on my shift!”
less. What do I do? I left them alone for less than
I’m feeling a little overwhelmed, so it is time 5 minutes! Did I do the right thing? Should I have
to regroup; I somehow manage to pull myself to- stayed there every minute? I stop questioning
gether. I review Mrs. Jones’ chart, get report from myself and tell her, “I’m sorry.”
my primary nurse, and head to Mrs. Jones’ room.
We proceed into the room together. The once
My palms are a little sweaty and I feel queasy. I shallow gasps for air have stopped and there is
knock on the door and slowly push it open. The complete silence other than the oxygen running
room is dimly lit and quiet, so quiet. There is a through the mask. I check Mrs. Jones for a heart-
pale, elderly woman lying on her bed on her back. beat and breathing. I turn off the oxygen and turn
She is wearing a nonrebreather mask on 100% to Mrs. Jones and stroke her pale face and white
oxygen. Her eyes are closed and her breathing is hair, “Rest in peace darling, it’s okay now,” I tell
shallow. Sitting at her bedside is a middle-aged her. I turn back to her daughter and offer my arms
woman with salt and pepper hair. She looks ex- to hug her. She accepts me openly and begins to
hausted. She raises her head and gazes at me. cry. She steps back to take a breath as she says to
“
Hi,” she says quietly, trying to force a smile. I me, “She’s in a better place now, I can’t believe
introduce myself and now my day has begun.
it’s finally over.” I sit quietly with her for a few
The woman at the bedside is Mrs. Jones’ minutes until her daughter arrives. They share
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HARCROW
tears and hold each other. I tell them I am going fer their support and reassurance. I lean on them
to leave them alone and I will be back shortly.
and cry about the heart-wrenching experience I
I step into the hallway and proceed to take a had today. I share my feelings with the primary
deep breath as I see a middle-aged man step off nurse and with my instructor.
the elevator. He seems hurried, looking around
The day is over. I made it. When I started this
everywhere. I look at my watch, it’s 2:05 PM. “Oh morning I thought, “Please don’t let her die on
no,” I think to myself, “This is her son; he didn’t my shift.” Now, after several hours of care and
make it in time.” I feel a lump in my throat as I just plain being there, my feelings have changed.
approach the gentleman to ask if I can help him. I am glad I had this experience. It was a hard
He informs me he is looking for his mother, Mrs. thing for me to go through, but it is real life. I can
Jones. I motion him down the hall to her room as think about this and share my feelings with
I introduce myself. He stops just short of the door others.
and turns to ask, “How is she doing?” What do
A week goes by and I still think about Mrs.
I say now? Oh, this is so hard! No one around to Jones. I seem to have a hard time processing this
bail me out of this one . . . “I’m sorry,” I begin. and it is taking a while. I feel okay now, better
He needs to hear no more. “She passed on a few than that day, anyway. My alarm rings and off to
minutes ago.” His eyes well up with tears and he another clinical day I go. Today I am in en-
walks away. “I can’t go in there right now,” he doscopy. Nothing seems out of the ordinary un-
tells me. After a few minutes he decides he is til someone asks for me to come to the desk.
ready to see his mother and greet his sister and Standing at the desk is Mrs. Jones’ son. He is car-
niece and I escort him into Mrs. Jones’ room. He rying a large basket arrangement of beautiful
hugs his niece and his sister and he goes to his flowers in all the brightest colors. He smiles at me
mother and speaks softly to her, kissing her on and says hello. We talk for a minute and he pro-
the cheek.
ceeds to tell me, “My family and I cannot thank
My heart is aching. I do not know what to say. you enough for what you did for our mother and
I feel so horrible for them. I feel that Mrs. Jones us; we hand picked these flowers from the funeral
is at peace and this is a good thing—except for arrangements and made this basket special for
the family. The family is always left behind to you. Kim, you are an angel from heaven, thank
bear the heartache. They feel relieved that their you.” He hugs me for a moment and hands me
mother is no longer suffering but they are so sad the basket with a thank you note. He tells me he
to have let her go.
I ask them if there is anything I can do or get couldn’t leave without seeing me one more time.
for them. They of course say no and thank me for
Wow! What a feeling! I have touched someone
is heading back to St. Louis this afternoon but he
the “wonderful care” I gave their mother. I ask and made a lasting impression. I do not know
to give them each a hug and express my deepest that I feel like an angel, but to them, I am. This
sympathy. I hug the niece, the daughter, and experience will be with me forever and I believe
lastly the son. The son reaches for my hands as that the true angel, Mrs. Jones, will watch over
we let go and he says, “See, Mom, there are an- her family and has taken a piece of me with her
gels everywhere, just look at this one right here to heaven.
in front of me . . . “ I thank him kindly and say
good-bye to them and once more to Mrs. Jones
before leaving the room.
Address reprint requests to:
Kim Harcrow, R.N.
I can barely hold myself together as I walk
briskly down the hall to the break room. I sit in-
side and silently allow the tears to run down my
cheeks. My fellow classmates come to me and of-
77A Cleveland Street
Manchester, NH 03102
E-mail: Kimmy1228@cs.com