The Final Word

Here is a link to an article that I published on all nurses.com.

http://allnurses.com/hospice-nursing/end-of-life-969849.html

Words matter all the time. It’s just that at the end of life, there are so few of them left, that we must count carefully to make sure there is no waste. That awareness keeps us from using them foolishly. As we leave the bedside of the dying, may we carry with us the desire to use our words carefully, every day, not just on the final ones.

End of Life: The Final Word

“If anyone is never at fault in what he says, he is a perfect man, able to keep his whole body in check.” James 3:2

I reach down to touch Anne’s* hand, my own fingers still chilled by the outside morning air. Her eyelids flutter, letting me know she was aware of my presence. I speak gently, trying to not disturb the threads of silence that hang heavily in the room.

“How are you doing?”

She does not voice a response, but the furrowed brow tells me that she is thinking of how to answer my question.

As a hospice nurse, I come on the stage of life when others have played their parts and now stand silently in the wings, witnesses to life and death. The chemo team is gone, the transfusions are mostly over; the doctors with their serious pronouncements have faded into the background. Standing beside the bed are the one best friend, two of the six children, and a few others that come and go to leave their gifts of steaming soup or fragrant flowers, attempts to brighten the long journey home.

Anne’s eyes open and she looks at me, focusing through the curtain of pain and the blessed numbness of opiates.

“I’m ok,” slides out in a whisper.

I stand by, struggling to find the best words, the question that might help her along the way, the voice that will not hurt, but instead help. At times like these, everything matters and the burden of that knowledge, keeps my mouth still, waiting for the Holy One to fill it with direction.

The others leave the room. I hold her fingers in mine, while palpating her pulse, assessing her color, monitoring her respirations, checking her skin for signs of breaks. As I wait, the question spills out, “What is the one thing that bothers you the most about all this?”

A single tear, creeps down her tissue dry cheek and she answers, “I’m afraid of leaving the children. I’m afraid that they will grow apart after I am gone. I won’t be here for them to come home to.” She speaks with some effort, but as the words well up, expressed from her spirit, they also relieve some of the pain, pent up in her aching heart.

I have no response. None is needed. Saying the words and shedding the tear, seem to ease the crack in her heart. Her respirations even out, her eyes close, apparently more focused on the beyond.

Words matter all the time. It’s just that at the end of life, there are so few of them left, that we must count carefully to make sure there is no waste. That awareness keeps us from using them foolishly. As we leave the bedside of the dying, may we carry with us the desire to use our words carefully, every day, not just on the final ones.

Dear God, Grant me your words today. Let me be silent or let me speak only at your prompting. Give me a renewed awareness that words matter. Amen.

*Name changed to protect privacy.

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