Last Offices

"I am so sorry, she has died," I say over the phone to my recently deceased patient's husband. He says thank you for all the care we have given. "It is what we are here for," I finish. He says he was glad he could come in and say a final goodbye.

As I put the phone down I let out a long sigh. My colleague is across the room holding the patient's hand. I see her reassuring smile behind the mask. I get up to go get some fresh linen, towels and two body bags as she goes to fill a bowl with warm soapy water. It is time to perform last offices.

I carefully remove the pillow from behind the patient's head, apologising as I do. I slowly flatten the bed too. I do not want her to go stiff in an awkward position. It makes the process harder. I notice her swollen eyes are still slightly open. I close them. We cannot take the breathing tube from her throat as there will be a coroner's investigation. Most people will have a coroner's investigation during this pandemic. So we cap off the breathing tube. I am partly glad we do not have to remove the other invasive lines. People tend to ooze when we do.

I wet a comb to brush her hair the best I can. It is too flimsy so it takes me a while to get rid of some of the knots . Meanwhile my colleague cleans her face. Her lips are turning bluer and bluer. Her skin is turning greyer and greyer. I then start to wash the patient's left side, as my colleague cleans her right side. We explain to her what we are doing as we go, apologising if we need to move her too much. She still feels warm, apart from her blue tinged finger tips. We place the white shroud over her. We carefully pull her arms through and tie it neatly behind her neck. She looks like she is sleeping. I say to her, we are almost done.

We have to roll her from one side to another to place a new sheet and the body bags under her. We place her hands onto her stomach as we wrap the clean, crisp, white sheet over her. It is taped into place. We take our time as we zip up the two body bags over her face. We now need to use two body bags for infection control. I make sure all the paperwork is complete before I call for the porters.

They arrive with the blue covered trolley. We help them move our patient from their bed to this trolley. Before they leave, we close the curtains surrounding other patients. As they leave, I sigh again, this one bigger than the last.

It is always a difficult job. I will never forget when I carried out last offices for the first time. However in March and April, it felt like I was having to do it a lot. That is a burden in itself. Luckily it is a shared one, we never do last offices on our own.

Many people do not know it is nurses who prepare the body to go to the mortuary. If my patient dies I like to be the one that does it. It gives me closure. I can say goodbye. People ask me why I still talk to them, even though they are dead. Maybe it is habit but it is also out of respect. Respect to the deceased, but also to their family. How would I want my loved ones to be treated in that moment? It is an absolute privilege to care for someone in their last hours. I am a firm believer that everyone deserves a good, calm and pain-free death. Their send off should be no different.

Little deeds of kindness,

Little words of love,

Help to make earth happy

Like the Heaven above.

- Julia Carney

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