When dialysis is the only means of survival for your patients, you know, as a hemodialysis nurse that despite the quality of care you give them, sooner or later that day would finally arrive—death in a hemodialysis unit.

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1. Dealing with our patients

And I’m not just talking about patients because in a hemodialysis unit, our patients have become friends and families. Being regularly in contact with us, a special bond is developed and shared between us which involves celebrating their birthdays and important events in the unit if not; they even invite us to join them outside hospital premises. So imagine, how much pain we go through by the time that day comes—death in a hemodialysis unit.

2. Dealing with other patients

And when one of our patients dies, it’s not only them we are going to deal with but also the rest of the patients because if we are able to develop a close bond with our patients, then the bond between patients is even greater. They are the ones who can relate to each other. The old patients are the best teachers for the new ones who are clueless to their condition. So by the time they mention the name of the patient who just died, imagine the difficulty as how we are going to tell them? If it was that easy to say that he or she died, we would have not waited to be asked but just announced it anyway BUT IT’S NOT.

3. Dealing with questions

And the hardest part is when they ask us about their impending death. How long should they expect their death? How many years would they still live and survive? Most of these are usually asked after every patient’s death. And it’s hard in our part because they are asking as if we are God who is in control of their lives BUT WE’RE NOT, WE’RE JUST NURSES.

4. Dealing with watchers

And what’s even the hardest is when you are just about to head to the unit to start your shift but you see the stainless bed with the cadaver bag on it and you try to search the surroundings and you see a familiar face—your patient’s watcher. As much as you want to give everything just to comfort them, a pat on the back is the only thing you could do because as nurses we try to be brave for them (I hope we could) BUT DEEP INSIDE WE’RE NOT.

5. Dealing with ourselves

After all, death to most people is a major life event but in nursing, it can become a daily occurrence. And when we visit the wake to pay our last respects for a patient, that’s when reality hits. Despite of that, it’s also in the same place when we learn how we were able to touch their lives for every story their family members tell us, reminiscing one by one the moments we had with the patient.

6. Dealing with reality

I hope we get to have the time to grieve but we have to go back to reality that there are still patients who are waiting for our care and service. That even if it was just yesterday when one patient died, we have to put back our smiles again for our remaining patients. Worst case scenario is when death and birthday happen in the same day. I can’t even explain the feeling when the first shift scenario had given you a heavy heart but you have to let it all out because here you are, greeting for a birthday celebrant during the last shift of the day.

And this is how we roll, the part we say that the death of a patient is a harsh reality in nursing.