Nursing When No One Else Is There: Honoring National Nurses Month

In late 2023, I became Executive Director of the Massachusetts Nursing Council for Workforce Sustainability. With over a decade of nursing operations experience, the Nursing Council was very much a new endeavor for me. Nevertheless, I embraced the challenge, moved by the desire to make a difference in the nursing profession and help other nurses improve the quality of their patients’ lives the way I have been able to. I want to share a story that deeply affected my view of nursing and my career path.

As a critical care nurse working in the cardiac unit, I was living my dream of working at a top-class healthcare facility. I had both the pleasure and responsibility of caring for some of the region’s sickest cardiac patients.

One night shift began as countless others I had experienced. I met my patient, and within the first hour of my initial assessment, understood that this was likely their last night on Earth. The patient’s indicator lights were on, and I knew that this meant they would probably pass away during my shift.

It was not unusual to lose a patient, especially because our patients were so vulnerable, often incredibly sick, and supported by multiple machines and medications. Sometimes, these patients passed away quickly. Other times, their passing was gradual. This patient was passing away steadily but slowly; death always felt like an inevitable presence looming in the room when this happened.

As critical care hospital rooms go, the patient’s room was typical. Medications were hanging from a pole, and a few machines provided some dim lighting and bursts of sharp background noise. The patient had made the decision not to proceed with life support, so their breathing was supported by a high-pressure oxygen mask.

When I spoke with them, the patient was kind and fully alert. This mental acuity was somewhat rare, but I had witnessed it before in patients who were soon to depart. The patient remained like this for the entire night. They didn’t say much, though, and I wondered if they could also feel the looming presence.

As the night went on, my earlier assumptions proved correct; my patient was moving into a great unknown. Dutifully, I made the doctors aware and then poised myself for a phone call to the patient’s family. I always found it best to communicate with families in easy-to-understand but very honest terms. I used the same technique in this discussion, and, given the gravity of this conversation, ensured that I applied empathy and understanding.

As a nurse, one thing you rarely know is what your patient’s journey entailed before they arrived at the hospital. Hopefully, the patient experienced a lifetime of love, family, and friends. Sadly, sometimes we were reminded that some have had a more challenging path.

At the end of this phone call with the patient’s family, there was simply the request from them to “Call us when it’s over.” The last step in this patient’s life journey would be alone in a hospital room; no family or friends would be present. While there were instances where my patients passed away suddenly and in solitude, such occurrences were rare throughout my career. Usually, there was someone present in those final moments of life to provide some solace or sense of peace. On this night, peace seemed unattainable with the patient’s family, but I did not want them to be alone during their last breath.

I was not sure what I was going to say, and it was a surreal and frightening experience. I remember feeling uncomfortable, but I pulled up a seat beside the patient’s bed and began to talk. They listened.

I used the same principles that I used in the discussion with the patient’s family earlier; I was empathetic, simple, and honest. I had never told a patient face-to-face that they were going to die before, but this patient wanted to know. They understood. At that moment, I made the patient a promise and said, “I will be here with you the whole time.”

I spent much of the remaining evening doing exactly that. I completed my charting in their room. I moved my desk space that night into their room. I spent every extra moment in their room watching, talking, and listening.

When the time came, I was there. I knew that death was near. I sat next to them, and I talked to them. I held their hand in one of mine and placed my other hand on their chest. Then, it was over.

My patient’s last experience was not the dreary hospital room or the glowing monitors, but it was me. It was my voice they heard telling him, “I’m right here. You will be okay.”

Our profession is full of life and loss, but nursing school never fully prepares you for these moments, Experience helps and offers guidance, but more often than nurses like to admit, many of these situations leave you trying to find your way.

No one completely understands the full scope of what nurses do. The gap that nurses stand in every day is an abyss between life and death, sickness and health. Nurses are ordinary people who do unthinkable, extraordinary things as a matter of routine.

After this patient’s death, I completed all the nursing duties that must be done when something like this happens. Within an hour, the room was empty. Within two hours, it was clean. Another patient arrived thirty minutes after that, and I stepped in to help bridge yet another gap. Routinely doing extraordinary things.

I became a nurse because I wanted to provide care and support like I did that night. I became a nurse leader because I wanted to help other nurses do things like that. I do what I do today because nurses are indispensable. The future of healthcare hinges on them.

It is vital that we advocate for our nurses to ensure that they are educated and supported. It is critical to address nursing workforce shortages so that nurses can focus on their most significant role—excellent patient care. We must bolster nursing school capacity to help build a strong nursing pipeline and mitigate faculty shortages. We must achieve employment equity for nurses and aim to prepare a skilled workforce to help support our current and future nurses.

The healthcare crisis presents undeniable challenges, and at times, the obstacles to our workforce seem daunting. However, nurses are experts at innovation and adaptation, always finding solutions despite the odds.

So, thank a nurse today. Better yet, encourage a nurse today. Most importantly, help us support our current workforce and make clear pathways for the next generation of nurses who will step up and stand in the gap.