Nurse stays by side of the dying, which she could not do for her dad
A nurse who could not get home in time to be with her father as he drew his last breath vowed afterwards not to let her patients die alone, if she could help it.
Ms Lacdaying Cherrie, 37, a staff nurse at the All Saints Home nursing home in Hougang, tries to make sure she is there for elderly residents in their last moments, staying by their side to comfort them and their families.
In 2016, her father was suddenly admitted to intensive care in the Philippines for multiple organ failure from diabetes. She got a flight home that day but was too late to say goodbye. He was 57.
Guilt set in. “I’m a nurse but why was I not there?” she asked herself.
Her dad, a paediatrician, had inspired her to become a nurse. After his death, she felt that though she was not able to be at his side, she would make up for it by being there for others.
She said: “I want to be there when there’s another person needing my help. If I wasn’t able to witness your last breath, I want to witness other people’s last breath, then I can tell you, I was with someone.”
She told The Straits Times ahead of Nurses Day on Tuesday: “I feel they are also scared if nobody is with them. But when you are there, they feel they can go on. I tell them, ‘I’m here, I will call your family. It’s okay, if you cannot (hold on), you just go, your daughter is coming’. And I see that the resident is peaceful to go.
“And when the family comes in and asks me how their mother was on her last breath, I say she was very peaceful. She was very comfortable. She was not in pain.”
Being with someone in their last moments can take its toll. When a resident she had grown close to died by her side, Ms Lacdaying cried in the toilet and needed counselling afterwards. Her nurse manager reminded her she needed to maintain a calm presence with the home’s residents.
Taking care of 44 residents in the 155-bed home can be tiring, and sometimes, things can seem to be happening all at once.
Once, two residents needed to be transferred to hospital when their blood oxygen levels dropped suddenly. She felt overwhelmed – it was the end of her shift and she had not had anything to eat.
But her nurse manager later reassured her it was just a bad day, and that she had done her job by keeping both residents safe.
For HCA Hospice nurse manager Lim Lay Choo, caring for terminally ill patients in their homes can also be overwhelming. She goes from one patient to another to assess their symptoms and administer their medications to ease their discomfort.
Often, she has to mentally “disconnect” from one patient to prepare herself to go to the next one.
“The whole process that we are in here can be very emotionally draining, until we cannot function at all,” she said.
Hospice nurses cope by sharing their feelings with fellow nurses.
Patients who are in great pain from organ failure or cancer sometimes harm themselves or commit suicide, and this is traumatic for their nurses as well.
She recounted caring for a jovial 76-year-old woman, who was often breathless from chronic obstructive pulmonary disease. She would joke with Ms Lim and tell her she had missed her when she came to visit. But one day, the woman’s granddaughter called Ms Lim to say she had killed herself.
Some terminally ill patients are as young as 28, and in those cases, she would work with a social worker to help prepare their spouse and young children.
Ms Lim, 56, was moved to take on hospice work 20 years ago when she was working as a nurse in private practice and saw a young woman sobbing about her cancer diagnosis at a staircase in the hospital. Not knowing how to comfort her, Ms Lim went back to her duties without approaching her. The next day, she tried looking for the patient but she had been discharged.
“I regret that I didn’t know how to help. Even now when I think about her, I feel sorry. But I think that she gave me the determination and the courage that if I know how to take care of her, maybe she will not feel so lonely and having someone to talk to can ease some of her pain.”
HCA Hospice is Singapore’s largest home hospice care provider and a charity which provides free services to patients. Its team includes doctors, nurses, social workers and patient care administrators.
It has 15 doctors and 45 nurses. Each nurse serves about 30 patients.
In her work, Ms Lim has to discuss care plans with family members, who can be rude and demanding. But she reminds herself this is because they are struggling with stress, anxiety and grief regarding caregiving and financial issues.
For both Ms Lim and Ms Lacdaying, knowing that what they do makes a difference keeps them going.
Ms Lacdaying, who has been working at All Saints Home for about a decade, said she is fuelled by a sense of fulfilment when residents give her two thumbs up in thanks or want to share their modest snacks with her. One resident taught her to count in Hokkien so she could tell them the time.
“When I come in, and they hear my voice, they say ‘Cherrie ah!’ So I feel like I’m being needed by someone,” she added. “I could be in any place. I can do another job. But maybe this is where I should be.”