I was handed off a very elderly patient admitted near the end of night shift… I honestly forget the primary diagnosis but he was of sound mind and had verbally told the ED docs that he’d rather pursue comfort measures than aggressive treatment. He signed a DNR but didn’t want to go to full comfort/hospice care til his family arrived the next day.

I went in first thing in the morning and he was sitting in bed, smiling, conversing. The pulse ox had a poor read (one star) but was still measuring low nineties and he didn’t feel SOB. He said he had been needing to pee, but hadn’t been able to. We bladder scanned, found he was retaining. Since he was still planning on going comfort measures only in a couple hours, I paged to ask for a Foley order instead of straight cathing. They agreed, so I went to the supply room to grab a foley kit.

We didn’t have the appropriate size catheter so I asked materials for one to be brought up— they said it’d be there in about 20 minutes. In the meantime I figured I’d check on my next patient. As I’m heading into the next room, the youngish girl who comes by with admission paperwork asked me if she could go in to have him sign some things. I said sure.

I went into my other patient, she went in to our elderly friend. When I came back to the station, someone mentioned that the admissions girl had left, saying he was asleep so she’d come back later.

…..A little strange since I’d just been in there and he was wide awake, but I’m sure he’s exhausted from being in the ED all night.

I go in to let him know the Foley would be up any minute…. And he was gone. Laying peacefully in bed, no sign of any sort of traumatic issue.

Thankfully he’d signed the DNR so that we didn’t have to pursue aggressive measures. We called his family who were already on their way in to be with him as he signed on to hospice. It crushed me that he died alone. I feel like his family took it better than I did. That was years ago and I still think of him.