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  1. Smith, Ellen RN, MSN/Ed

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TEACHING NURSING STUDENTS is as unpredictable as it is rewarding. I'm going to tell you about an unexpected experience that taught me as much about nursing as it taught my students.


One evening, I was with a group of first-year students in a unit's hallway when a patient's daughter approached me. She asked if we'd like to come into her mother's room, which struck me as odd because we weren't caring for this patient.


She explained that her mother was terminally ill with metastatic breast cancer and might die within hours. She went on to explain that the family believed that the students could learn from seeing someone near death. I asked her if they were sure this was something they wanted to do; I didn't want to intrude or take away precious family time. She assured me that it was fine and encouraged us to visit her mother.


As I gathered my group of students, I explained what we were about to experience. I described the diagnosis and how the patient might look. I asked if anyone felt this might be too difficult. One student stepped forward and explained that her mother had died of the same disease years ago. I asked her if she'd like to remain outside the room, assuring her that whatever she decided would be fine. She decided to enter the room with the other students.


We walked into the room as a group and thanked the family for inviting us in. As we approached the bedside, we could clearly see that the patient was experiencing Cheyne-Stokes breathing. Her skin was very pale and her extremities were mottled. I addressed the patient by name and introduced myself, then explained to the students that patients can hear even at the end of life. As I held her hand, her daughter encouraged me to show the students how her body looked. With the family's permission, I gently pulled down the covers. At the same time, another daughter started to tell us about her mother.


That's when we learned that our patient was a nurse herself. At the time her illness forced her to retire, she'd been a nursing professor. As our eyes filled with tears, her daughter explained that her mother loved teaching and despised the fact that she'd had to stop doing what she so enjoyed. She told us that teaching these students would have made her extremely proud. As I looked around at my students, I knew they were learning a lesson they'd never have found in a textbook. My student who had lost her own mother to breast cancer was so moved that she had to leave the room.


As we stood by the bed, I spoke softly to this woman who was losing her life. I told her of my love for teaching and thanked her for what she was teaching my students today. I also told her that I was certain she'd been a wonderful teacher and that I was honored to be with her now. I gently stroked her forehead as my students reached out and stroked her hand and thanked her as well before leaving. She died several days later.


Sometimes a patient becomes our teacher, and we learn more than we ever expected. This teacher gave us the gift of one final lesson before she died. My hope is that she took enormous pleasure in conducting her last class in her final hours of life.


An unplanned experience taught my nursing students a life lesson that will stay with them forever.