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Journal of Nursing

Dear Mr. R

Lauren Rathbun [email protected]



If you could write a letter to that patient you just can't forget, what would you say?

Dear Mr. R,

I am so sorry you died alone. I tried to stay with you but I didn't know when it was going to be your time, and with other patients to tend to, I left you. I will always regret that. I hope you felt my presence at your side while I was there, I didn't know what to say so I just held your hand and told you it was okay if you were tired and wanted to go to sleep.

I don't know if you were a religious man or not. I'm sorry I didn't say anything about God or Heaven. To be honest, sometimes I'm not so sure of those things myself. If you believed in them, then I hope that's what you have found now.

The heaviness I feel in my heart is lessened just slightly when I think about your last good day: Friday, do you remember? I gave you a bath and wrapped you up in your robe. Another nurse and I struggled getting you into your wheelchair, you couldn't even stand, but I was determined to get you out of bed. Finally, I had you all tucked in and was ready to wheel you out into the hall when you looked up at me and said clear as day, "I shit myself." You caught me off guard as these were the first words I heard you speak all morning.

The nurse and I stared at each other in disbelief for a moment until I looked down and sure enough there it was, all over your robe, running down your legs, and pooling in your socks. Unwilling to accept defeat, I gave you another bath while you sat up in the wheelchair, new gown, fresh socks, another blanket draped around your bony shoulders. "Alright, take two," I said, and you flashed me a rather devious grin. ‘Atta boy.

I brought you to sit in front of the nurses station for a little while, a common practice on our unit for either our most difficult patients or our most loved, you fell in the latter category for me. I hope you enjoyed this. I like to think that you did, you watched the people passing by you while alternating putting your glasses on, then holding them in your lap. You seemed content.

A couple of hours later, we had you settled back in bed, and as I was about to slip out the door I heard you quietly say the last words you would ever speak to me, "thank you very much." At the time, I didn't feel the magnitude these words would have for me. I simply paused, offering you a smile before closing the door behind me and continuing on with my day. What I want to tell you, Mr. R, is you’re welcome. You’re welcome, and I will carry your words of thanks in my heart, so I can refer to them when I inevitably care for patients who forget to be grateful.

If I could go through all of that effort again and again, I would, but you didn’t have that kind of time. By Monday when I returned to work, it was a struggle for you to even breathe and we all knew it wouldn't be long, and it wasn't. I don't know when you were born, but you died at 6pm on Monday, November 4, 2013. I don't know what you did for a living, or the people or things you loved, but this is what I'll never forget: the sound of your voice whispering thank you, the tin of Kit Kats I found hidden in your bedside table after you were gone, and the blue of your eyes as I closed them for the last time.

Goodbye Mr. R

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