The Nurse's Refuge

02/10/2026

It's amazing how sometimes patients will hold on just long enough for that one person...
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I used to be skeptical about the idea that comatose or actively dying patients could actually will their body to keep fighting until something they're waiting for happens. I mean, how often do we see people die unexpectedly in this world, never getting a chance to say goodbye or live a full life? But after this past weekend, I'm convinced even comatose, actively and imminently dying unresponsive patients can sometimes find the strength to stick around until they decide they're ready.

We get very, very sick patients on my unit. In fact, we relatively often have patients end up on hospice or comfort measures if they aren't upgraded to ICU first. Usually, these are patients too unstable to transfer to home or outpatient hospice because they are expected to die literally any minute. So we take off their monitors, stop treating them medically, and focus on making them as comfortable as possible, both physically and emotionally. This usually involves some pretty heavy medications for agitation, difficulty breathing, and pain. This weekend, I had one such patient. It was sad to show up to work on Friday and see him on hospice, because I had him the week before and he was talking and moving. Confused, but still talking and much more alert. In fact, he was so strong last weekend he ended up in restraints because he kept trying to get out of bed and pull off lines and monitors. He loved to talk to himself, and honestly even though you couldn't really understand what he was saying, he was really cute. I did not expect to see him in a nearly unresponsive state when I returned to work a few days later. I will call him George.

George's family spent the week coming to terms with the fact his body was shutting down and there was nothing more to do. Based on the notes by providers, it took a few days for the family to accept the inevitable outcome and allow switching George to inpatient hospice. The family said it was hard to see him like he was, and I have to agree. I was assigned him this weekend, and he really looked like he was at death's door. He was pale and stiff, unable to speak or move more than small fidgeting movements occasionally. His breathing rate slowed significantly, and I was fully convinced he would pass over the weekend. According to the hospice notes, the family had even stopped coming in and would instead call to check on his status each day. They all agreed they said their goodbyes and couldn't handle seeing George in his state. I can't say I blame them.

As the weekend went by, he continued to deteriorate. By day two, he was essentially comatose. No response to pain, breathing 6 breaths per minute, no movement, eyes stuck open. We had to start adding eye drops because his eyelids wouldn't stay closed and his eyes would start to dry out. His blood pressure hit lows that I don't think I've ever seen in a living person over my 6 years as a nurse. On day three, his record blood pressure was 40/19 with a MAP of 26. He had been hanging out in the 40s and 50s for days. With all the morphine, va**um, haldol, and versed he was getting, I was absolutely dumbfounded that by the end of my third shift, he was still breathing. I went in to hold his hand and talk to him a few times throughout my time with him.

"Your family has said their goodbyes. You can go whenever you're ready, George. I'm here, you're not alone." I checked on him very often, watching for agonal breathing or end-of-life agitation so I could be with him in his final moments. But those signs never came. Before leaving him this morning, I sat next to him again. "I have to go home... I won't be back for several days. I'm sorry I couldn't be here for the end of your journey, George. I don't know who or what you are waiting for, but I hope you find peace so you can move onto your next life." It genuinely perplexed me that George was still holding out. He hadn't eaten or had any fluids in a week, was bleeding internally, was getting no blood perfusion to his brain with that blood pressure, his kidneys had shut down. It made no sense that he was still alive knowing all that.

Day shift arrived, and I told our nurse educator how his vitals were and that he's somehow still alive.

"He's waiting for someone," she replied knowingly.

"But his family has already come and said goodbye. Who could he be waiting for?"

"I don't know, but he's clearly not ready. He's holding on for someone."

I thought about George all the way home, wondering what he was holding out for, and how long he could possibly keep waiting. When I woke up tonight, I texted the day nurse assigned to him asking if he was still alive. His reply shocked me, and left me genuinely in awe.

The son decided to visit one more time today. Keep in mind, no one had visited George in 4 days. During those 4 days, he remained practically comatose and alone, hanging on by a thread. It was almost unnatural. It wasn't until his son visited that he finally decided he was ready. George passed away with his son at his side. I'm still in awe and my eyes are still full of tears as I write this. He was completely unresponsive for days, with unreal vitals that defied all reasoning, all because he wanted to die with his son by his side. There's no other way to see it in my opinion. He wanted to feel his son's presence before he left. Sure, we can be skeptical and think it was just luck... But I've actually seen this before and it never ceases to amaze me. I choose to believe George just wasn't satisfied dying alone, so he waited until his son was there. I know now George is looking down from above, no longer stuck in bed, no longer in pain, no longer confused. And I'm so happy for him that he was with his son when it happened.

RIP George. I'll never forget you and how you fought to feel your son's presence one last time.

01/28/2026

A while ago, I wrote a couple of posts about night shift, especially about how patients can get at night. On my unit, many of our patients are older and very sick, and because of that, they often become confused and combative overnight. Usually, that looks like throwing things, scratching, swinging, or kicking. It’s unpleasant, but it’s generally limited to the patient’s room. We can usually dodge it or simply leave the room.

If a patient is a danger to themselves, we’ll call a safe team to help manage the situation. But most of the time, the threat to staff doesn’t extend beyond that one space.

This one night, though, was very different. I remember it clearly because it felt like a full moon kind of night, one of those shifts where something is always happening. I never actually checked if it was a full moon, but it sure felt like it. All night long, we were hearing emergency calls, safe team calls, and trauma alerts over the overhead system, far more than usual. It was like half the hospital’s patient population collectively decided to lose it all at once.

At one point, I was in the break room eating when I heard yelling. Yelling isn’t uncommon on our unit. Someone is usually screaming at some point on most shifts. But this was different. This was raw, full-volume screaming, like someone holding absolutely nothing back. It was incredibly loud, almost primal.

I got up and ran toward the sound, and there he was: a patient standing in the doorway of his room, completely naked, screaming obscenities and insults at the top of his lungs. I’ve had plenty of screaming patients before, but this was next level. It was actually impressive, in a terrifying way. We could all see that the situation was escalating quickly, so we called the emergency line and requested a safe team.

For context, a safe team usually includes security, behavioral health specialists, sometimes doctors, and administrative staff. They come together to secure the situation and keep everyone safe, whether that means restraints or, in extreme cases, escorting someone out. It all depends on the patient’s mental status, what’s happening in the moment, and how sick they are.

While we were waiting for the safe team to be announced overhead, the patient continued screaming threats and obscenities. I ran around the unit closing everyone’s doors because the screaming was so loud. He was still standing in the doorway with a couple of nurses behind him, swinging at anyone who came close.

Unlike most combative patients, who are usually confined to their beds, this man was very mobile. He was walking around, and for the first time in a long time, I genuinely feared for our safety. I then realized one of my closest friends and favorite nurses to work with, who is close to retirement age, was trapped behind him in the room. I had to grab her arm and pull her out because I was terrified he was going to hurt her. He then marched out into the hallway, dragging his lines behind him. He yanked out his IV, so he was bleeding everywhere (I later found out he was HIV+). Still naked. Still screaming insults at us, calling us horrible names.

And still, no overhead announcement.

“Did someone call?” I asked. They said yes. Several minutes had passed by then, which is not normal. So we called again and asked if our safe team request had gone through.

The dispatcher told us they were handling multiple safe team calls at once and that we would have to wait.

I remember thinking, Can you come here and tell the patient to give us a minute? Because we didn’t have a minute. He was in the hallway, physically threatening us, and we didn’t feel safe.

It was a terrifying moment that really drove home how chaotic and dangerous this job can be. I understand that resources can get stretched thin, but it’s deeply unsettling to realize that security and emergency support can be completely maxed out, leaving you to wait for help that may not come right away.

Eventually, the overhead announcement was made, but by the time security arrived, the patient had already retreated to his room. He didn’t calm down so much as exhaust himself. He laid in bed, refused to let anyone near him, still naked, with no IV access and no monitor. If anyone tried to approach, he would swing, but he no longer had the energy to roam the halls.

By the time security arrived, the worst of it was over. If they had arrived five minutes earlier, they would have seen absolute chaos.

What still alarms me is the fact that we had to wait for an emergency team to even be called. At the end of the day, we’re mostly a group of young women with inhibitions. We can't restrain people however we want. We don’t have weapons. We can’t physically fight back. All we can do is dodge, stay out of the way, and hope help arrives in time.Meanwhile, this was an unhinged and uninhibited patient, bleeding, enraged, screaming, and swinging, holding nothing back. What are you supposed to do in that situation? What do you do when the resources meant to protect you are maxed out? When the emergency line is too busy to answer your SOS? When the system simply can’t handle it?

I guess all I can really say is we were lucky he tired himself out. That could have gone much differently.

Moral of the story: Healthcare has the highest rate of workplace violence of all fields, and while facilities try to have ways to protect staff set up, it's not always enough. At the end of the day, every staff member has to look out for themselves first. We spend so much time protecting and healing others, but we can't do that if we aren't protecting ourselves first. Never be afraid to run or resist an imminent threat, especially when you're just out of options.

Bella, RN

01/28/2026

Hi everyone! 🌟 I enjoy working on my website, but there are monthly expenses involved with this so I want to humbly ask for your support. If you see value in providing a safe haven for healthcare providers like The Nurse's Refuge and have the means to support it, you can do so by sending me Stars - they help me earn money to keep making content you love. Whenever you see the Stars icon, you can send me Stars! If you can't afford to support financially, just sharing my site with others is also extremely appreciated!!

01/28/2026

In memory of Alex Pretti, the ICU nurse shot and killed by federal officers on January 24, 2026. As one of his colleagues put it, he spent his entire career running towards danger to help other people, and so he did one last time even off the clock. RIP Alex, the nursing community stands behind you.

Note: The pricing for this product is set with NO markup. I do not feel comfortable profiting off of someone's death. The cost covers production costs ONLY. My intent here is to celebrate Alex and his legacy.

Express yourself in a meaningful way with top-quality pin buttons. Dedicated to the memory of Alex Pretti, the ICU nurse shot and killed by federal law enforcement in Minnesota on January 24, 2026.• They come in a set of 5 • Made of tinplate• Scratch and UV-resistant mylar coating• Glossy fi...

01/13/2026

What happens when the emergency line is tied up with urgent calls? Our latest blog explores the realities of night shifts in healthcare, especially dealing with older patients who may become confused or combative. Check it out:

A while ago, I wrote a couple of posts about night shift, especially about how patients can get at night. On my unit, many of our patients are older and very sick, and because of that, they often become confused and combative overnight. Usually, that looks like throwing things, scratching, swinging,...

12/08/2025

Hi everyone :)

I'm trying to get more traffic to my website. I want to be able to help others, so if you could support me by sharing this website with anyone you know, I'd super appreciate it.

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12/08/2025

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11/27/2025

Hi everyone!

We are excited to announce that we’ve started a collection of nursing-themed print-on-demand products for our shop! These items are created with fellow nurses in mind and make perfect gifts for students, new nurses, and experienced nurses alike. I have only added a handful of items so far, but lots more is to come, so check back often!

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11/14/2025

🌙 Ever thought about working the night shift? It comes with its own set of pros and cons! 💼 In my latest blog post, I delve into my experiences with night shift, the good and the bad. Curious to know more? Check it out here: https://wix.to/LNq6rnN

Hi again! I thought I'd write a post about the good and bad of night shift, since I see people ask on forums what it's like and all. I've been working nights exclusively since almost the start of my career six years ago, and there are distinct pros and cons to it. It's definitely not for everybody,....

09/29/2025

Visit us at nursesrefuge.com! We are now adding products to our shop, and lots more are to come!

08/10/2025

Feeling overwhelmed is a part of life, but being on the other side makes us stronger. After 3 months out of work due to new cataplexy, I'm back to share my journey and insights. Discover how to turn struggles into strengths:

Wow, I've been out of work for 3 months now. I have suffered from narcolepsy for almost 10 years, but this year for some reason, my body decided to start having cataplexy episodes. It's been a long, long road, but this post is about describing my experience as a patient on my own unit.At the beginni...

07/18/2025

I'm so sorry for disappearing! I have been out of work for over 2 months now because I have developed cataplexy and was collapsing at work and at home. I'm hoping to return to work upon starting my new medication!