I was told twice this week by different families “I could never do what you do.”

I will take this as a compliment. I will take this as “I see you. You work hard, you deal with difficult and sometimes traumatizing life and death stuff. You hold it together when you want to melt down, when you want to cry, when you want to snap back at someone for snapping at you, but you know you shouldn’t, and can’t.”

You know they are going through quite possibly one of the worst days and/or weeks of their lives right now. You know you can’t hold anything they’re saying against them. They’re scared, they’re full of anxiety. Sometimes they feel so out of control of the situation that they try to control whatever it is left that they can.

You think to yourself “ today I will let it slide. Today I will give them grace, I will have patience, and stay kind in my response.” Today we will stay silent and let them have a moment. Sometimes no response is needed. Just holding their hand, or a hug. We will smile warmly and reply “I can’t possibly imagine what you’re going through right now. This must be so hard for you.” We answer their questions, more than once. Then we do it again the next day or with the next family member. We get them ice water, coffee, more coffee. A warm blanket. It doesn’t matter. These are the least of things we can do for someone watching their loved one die in front of them. They’re physically and emotionally drained. They can’t even think straight. They forget to eat. They’re on autopilot. They’re holding on to every last strand of hope they can. Every eye flinch, twitch or movement, they hold onto.

Sometimes I don’t have the heart to tell them it’s a reflex. Who am I to shatter their last piece of hope. Sometimes they need to hear it directly, and sometimes it’s better to let them hold onto whatever hope they have left.

The patient’s family asked me “How do you DO your job?” At first I was taken aback, not quite sure where he was going with this. He said “I appreciate you so much for what you’ve done to take care of my dad. I don’t know how you do this all the time. I could never do this job. Thank you so much.” This time I was fighting back the stinging I felt in the corners of my eyes. I couldn’t break down right now. I was the strong one. It is THEIR dad lying in that hospital bed, breathing loudly, having recently been removed from the ventilator. I looked at my patient. I saw his long gray hair that I had spent 30 minutes washing and combing, and picking the glue out of that held all the little wires in place. The wires that told us his brain was so severely damaged that he will likely never make a meaningful recovery. They removed the wires yesterday and unwrapped his head to reveal this long gray hair that I had no idea he had. Yesterday, I knew today would be “death day,” as I called it in my head. They had planned to remove life support and make him a “comfort care” only. I had to make him look nice and presentable for his family the next day. The day he was going to exit this earth. I washed, and I combed every last little tangle, and smoothed it down, and he looked nice and clean. I Washed the crusties out of his eyes, washed the dried saliva from the corners of his mouth. I Cleaned the dried blood off his hands so his family members can hold them. It will make them feel better, I told myself. I tidied the room, and cleared out any equipment we weren’t using. I Replaced the suction containers full of bile and mucus. Yuck. They don’t need to see that stuff. I turned on the soothing guitar music they had requested the previous day. It was nice. I grabbed three boxes of tissues. I knew they would be needed.

I looked back at his son. I told him “It took me a long time as a nurse to come to terms with death and dying, and really be ok with it. I know sometimes death is not the worst thing to happen to someone.” I am here to help people die with dignity and ease their pain and suffering during the transition. I am here to walk grieving families through this difficult process. I hope that by doing what I do, it makes this horrible day a little less painful for you and for them. I try to give you the answers to questions you didn’t even know you had. I try to make it so you don’t have to think so hard about the “stuff” and just hold your loved ones hand. I try to make their transition out this world as comfortable as possible. I facilitate families however they need, trying to anticipate needs. I grab chairs, I call chaplains, I grab tissues, coffee, water. I hold hands, I give hugs. I answer questions. I do it all with warmth and a smile.

Then I go next door to my other patient and pretend I didn’t just leave a room full of crying people, or we didn’t just pronounce someone dead. And now I will smile and take your dinner order, and give your medication, and help you to the bathroom. I will listen and apologize as your daughter complains about how long they had to wait for me to get in the room to take your dinner order. I can’t tell them what I’ve been doing, just “I’m so sorry, I have been with another patient, yes, you are important to me too, yes I understand this is the ICU. I’m very sorry you had to wait so long for me. I am here now and happy to help you. You have my undivided attention.” All still with a smile.