Dying Fast and Slow: Improving Quality of Dying and Preventing Untimely Deaths, Introduction to the Symposium Edition

Abstract

Death became my professional acquaintance just after my twenty-second birthday. An eager student nurse working the night shift on New Year’s Eve, I was assigned to an actively dying patient for whom all curative interventions had been discontinued. He was utterly alone in the final moments. Death arrived before the new year. I stood in the room and watched his last breath—a scared, unprepared, and shame-filled trespasser at his death.

We didn’t cover this most basic and undeniable reality of hospital-based nursing care in school—as if death were an exceedingly rare and unexpected issue we were unlikely to encounter. Instead, I learned only by living through it. After he died, I gingerly washed away the evidence of his medical ordeal, scribbled his name on the paper tag and looped the string around his big toe. I hesitantly zipped up the body bag—the whole time feeling not quite alone and not quite in the presence of another person.

As staff voices faintly counted down to the new year, I pushed a suspiciously sheet-draped stretcher down the hallways as a co-worker ran ahead to close the doors to patient rooms. We were, by policy, required to do so: we were charged with protecting patients from the reality of death.

Keywords: death, dying, advance directives, health care