Think of everyone's life as an incredible story. As wonderful as any book is, there is always a last chapter. As nurses, our primary role is to ensure that the last chapter is:

1. Defined by the patient rather than imposed by the institution or family members
2. Consistent with how they lived their lives (i.e., the theme of their story)

Here are some questions a nurse can ask to help with a difficult time:

• What is most important to you right now?
• What does comfort mean to you?
• Is there anything you are concerned or worried about?
• Can I answer any questions for you?

And here are a few tips for nurses:

• Be willing to "go there." Be present at this time in the patient's journey.
• Let your patient be your teacher. You don't have to have all the answers.
• Listen. Listen. Listen. Be comfortable with silence.

-Kathleen Bartholomew, RN, MN