By Debbie Moore-Black, RN

She was oil, and I was vinegar. We didn’t mix. Ever. Even though we wanted the best outcome for our ICU patients, we stood on opposite poles of the earth. Sometimes, there’s only room for one alpha dog, one ultimate bully. And that person wasn’t me.

Mr. Williams, 68 years old, received the tragic news from his physician. He was experiencing strange and unusual symptoms: slurred speech, muscle weakness, lack of coordination, muscle spasms, weight loss, difficulty swallowing, tripping and falling, and the worst of all, difficulty breathing.

It was a death sentence – ALS, amyotrophic lateral sclerosis, also known as Lou Gehrig’s Disease, named after that famous baseball player from days gone by.

Upon his diagnosis, Mr. Williams gathered his loving family together. It wasn’t one of those cook-out family get-togethers. The family knew something was wrong. Mr. Williams called the meeting and explained his unusual, deadly diagnosis. It meant a progressive deterioration of his body, with no cure. He expressed his wish not to be put on a ventilator when the time came, and requested to be made a DNR/DNI. He wanted his family together when the time came – no heroics, just a peaceful passage to his hereafter.

He was admitted to our ICU, and his physician wanted the ultimate care for this patient. He arranged for Mr. Williams to have one last gathering with his family. As per the physician’s request, there was no EKG monitor, no loud beeping noises, only IV fluids slowly infusing in his vein. His entire family formed a semi-circle surrounding his bed. At times, you could see Mr. Williams looking up as if he saw the gates to heaven. He smiled, surrounded by his wife, children, grandchildren, and a priest by his side. It was a poignant moment.

I was given orders by his ICU physician to administer morphine IVP prn to ensure he wouldn’t suffer. I stood in a corner, hoping not to be visible. The family held hands, laughing about the fun times they all had growing up, reminiscing about the family man, the neighborhood father, the loving husband, and the perfect granddaddy. Laughter turned into intermittent tears, and though I was ready to crumble, my job was to prevent any suffering.

As I administered the morphine IVPush as needed, I made sure Mr. Williams was not gasping for air, that he was comfortable, and that the family was at ease. I had prepared the family for my role but encouraged them to freely talk, laugh, and cry. It was a beautiful passage.

But then, Jackie came barging into his ICU room. I was dismissed and told in front of the family members that I could not give morphine prn. Jackie claimed I was creating “euthanasia,” disregarding the orders from the ICU physician, and demanded that I leave the room. She took over.

Jackie, with her actions, had a negative impact on the family and the situation. Mr. Williams passed away two hours later, leaving the family in shock over the turmoil Jackie created. They reported her to supervision, but nothing was done, as Jackie was a workhorse and would clock in at any given time when needed by our manager.

I’ll never forget the beauty of this family, their togetherness, and their love. But I’ll also remember the shattered moment when a fellow nurse had to be in control, an ultimate bully whose ego rode on the expense of a dying patient surrounded by his loving family.

Some things we can’t forget, no matter how hard we try.

Debbie Moore-Black is a nurse.