Notes & Quotes: The In-Between by Hadley Vlahos R.N.

The following are my favorite quotes from Hadley Vlahos's (R.N) The In-Between: Unforgettable Encounters During Life's Final Moments.

  1. I made a note to myself that if I were in a position like this in the future, I would instead explain what I going to do and why, and assure the patient that I would finish as quickly as possible.
  2. I reminded myself to live for today, not the fears of tomorrow--a promise I had made to myself when I started working in hospice.
  3. The voice of one of my favorite nursing school instructors popped into my head: Meet them where they are.
  4. "The surge of energy almost everyone gets before dying," he said, as if this was a well-known medical fact. I now know that the surge is a common occurrence. Often, loved ones who witness it think that the patient is somehow miraculously in the process of recovering. But to those in the know, it's a sign that death is imminent and will likely occur within the next few days.
  5. Maybe sometimes people didn't need more--maybe, sometimes, they needed...less. Maybe sometimes all they needed was a bit of comfort.
  6. I started thinking differently about patient care. I started to reframe my work with the understanding that something doing "nothing" (as I would have thought of it in nursing school and my previous jobs) was doing something. It was being there, offering comfort and solidarity--and that mattered. A lot.
  7. While I was never trained for it in nursing school, I knew that watering Sue's plants, making her sandwiches, helping her use the internet, and mailing letters for her were just as important as any other work I've done.
  8. When the time comes, we all want the same things: care, comfort, and connection.
  9. I am continually amazed at how life just continues on as usual, despite the tragedy that exists all around us.
  10. One of the more stunning and beautiful things I've witnessed as a hospice nurse is the way in which people choose their time of death. So many of us can't choose when we go to sleep at night, and yet we seem to have some control over when we die. I've had some patients intent on dying alone, stealing away in the matter of seconds they're left to themselves while a loved one goes to the bathroom, and others, like Sandra, who hang on until the moment when a loved one reaches their side.
  11. Professor Lopez was one of those people who really saw me, who believed in my worth, and who made a difference. It's amazing how even those people who are in our life for just a short time can make a lasting impact.
  12. Although it's hard to explain, this shift is one that every hospice nurse and person who has witnessed a death has experienced--the tangible shift in the air in that moment when a person leaves their body. It's not unlike when you walk into a room expecting someone to be there, only to discover you're alone. Sometimes that shift is more pronounced than others, and sometimes this moment occurs before their physical death, while other times it's after.
  13. I'm often asked what I believe in. As you've read, it's been a journey. I have cared for enough end-of-life patients with varying religious backgrounds to believe that how you live your life is more important than what you believe in.