Dear Family of a Stroke Victim,
To you it may seem that the medical personnel taking care of your loved one are giving up fighting for the man you see lying there in the hospital bed. When we hold gentle meetings with you telling you with great tact and empathy that for the sake of your loved one, we recommend that you change his status from Full Code (no holds barred if his heart stops and he stops breathing) to DNR (do not resuscitate). Please for his sake, let him go when his body says its time to go. Just because that purple DNR band is on his wrist, trust me when I say this does not color our care of him. My promise to you, as his loved ones, is this: I will still treat him with utmost care. I will give him the gentle touch and the dignity that I give to all my patients. He won’t suffer, that’s my pact to you.
I know it frustrates you that we see the broken shell of the man you know as a being full of vitality. I know reality is hard to face and hope is much easier to cling to than to face grieving permanent loss. I know every second you are with him, you search his every move, you watch his eyes willing him with every fiber of your being to morph back into the man you know he once was. This ogre called a stroke – it’s infuriating. I want to beat it to a pulp right along with you. Every stroke victim breaks my heart. Every time I see another family’s loved one claimed by a stroke, inside I cry. I carry on strong because of you searching my face, listening to the tone of voice I use when I talk to you about your loved one lying there, critiquing my body language, my touch when I’m taking care of your loved one. I carry on strong because you deserve my full attention and you deserve my gentle honesty at the present time. I carry on strong because I honor your hope that you cling to but my duty to you for your sake is to gently lead you to the place where you begin to face reality so you can be prepared when the inevitable happens. I carry on strong because I remember the nurses that carried on strong for me and my family.
But dear family of my stroke victim patient, what I don’t tell you is this: I’ve been there. I’ve been beside the bed of my loved one, looking at a broken shell of a man who was my superhero. Even though I was a grown woman, I still believed my dad was invincible. I too thought that we were giving up on him too soon. I didn’t want to face reality; I wanted to hang on to hope that just maybe that silent shell lying in front of me would somehow morph into who I knew my dad to be if only I just willed him to with every fiber of my being. Did I mention each stroke victim patient I have breaks my heart? That’s because my heart is still broken and a fragile kind of healed from my loss. And looking at it from the other side, I am so grateful for the medical personnel who gently led us to the place of letting go.
What you hear me say is, “Please consider what your loved one would want.” And we tell you what the outlook is for a victim of this major of a stroke. It’s a long haul that most likely will never lead to quality of life for your loved one. I tell you to consider your loved one’s wishes because if you do what you want in the emotional moment, perhaps later you will wonder just what you’ve done to your loved one. That’s what you hear me say to you. But I want to tell you that yes, it tears you apart to agree to let him go when he’s ready but in the big picture it’s what is merciful to him. Yes, it hurts to the bone to have him gone, but at the same time you let him go – you didn’t force him to stay on just for your sake even though life is not even a mere fraction of what he enjoyed before the stroke put it’s claws around him.
We know your emotions are shouting the loudest right now. That’s why we are here by your side. That’s why we give you our professional recommendation. No we aren’t heartless. It pains us to have these conversations. You don’t see us crying in our cars on our way home after our shift. You don’t see us lie awake when sleep won’t come, thinking about your loved ones CT scans, brain MRIs, diagnoses and prognosis. We hurt for you, dear family. So again I plead with you, let your loved one go. Let us give him his dignity in leaving this world. Please don’t make us break his ribs to brutally bring him back when his body says it’s done. Please, I beg of you, let us care for him gently in his last days of life. Let us give him the respect and the loving care that he deserves. But please don’t make us bring back this shell of a man. It breaks our hearts to bring back a shell of a person when we know there is no quality of life. But alas, our duty is to respect the family’s wishes so when you call us at midnight to request that we return his status to a full code, we will do so. But it breaks our hearts in a way that is hard for you to understand.
To you we may appear heartless, but truth is our hearts are so bruised from the pain we absorb for all our patients and their families. The heaviness in our hearts goes with us when we walk out the door at the end of a long shift. Please don’t write us off as not caring – our duty to you is to carry on strong even when it breaks us to pieces.
At the end of the day, with tears threatening to spill, I beg of you let your loved one go.
–Your Loved One’s Nurse