The lights and sounds on the third floor of the hospital unit at midnight seemed surreal. The sun had long ago set over the Pacific Ocean, and the bedside lights cast a yellow glow in each room. I made rounds up and down the 42-bed unit, checked on IV (intravenous) lines, administered medication, offered extra blankets, and turned off televisions in sleeping patients’ rooms.
The calmness and hushed voices of the early hours of the shift foreshadowed the events yet to come. In room 316, Nancy returned from surgery late on the evening shift. Her blood transfusion, IV line, and antibiotic were infusing overhead. She was in pain from her abdominal surgery, and her blood pressure was dangerously low. I propped Nancy up, gave her a breathing treatment, administered medication for her pain and blood pressure, and notified the doctor on call. Nancy’s condition was very unstable for a busy unit like 3B, but all the beds in the Intensive Care Unit are full of patients on ventilators and central IV lines.
The call light came on in Frankie and Jack’s room. Frankie underwent knee surgery two days ago. His leg was elevated in a passive range-of-motion machine. The alarm on his medication machine was beeping; the tubing was stuck underneath him and blocking the flow. I helped him turn to his side, untangle the tubing, rub his back a little, and straighten out the bed sheets. Frankie was always grateful for the nursing care he received. His big Italian family visited most of the day and brought in food for him and the staff.
In the next bed, Jack was sleeping quietly. His pale, thin frame was silhouetted by the hallway light. Jack was diagnosed with a brain tumor six months ago. He underwent radiation and chemotherapy and was now hospitalized with seizures and profound weakness. Jack’s hair was wispy white, and although his eyes had hollowed since his illness, he still had a twinkle to his sea-blue eyes. Jack lived in a trailer with his dog, Sam. He had no immediate family. A kind neighbor brought Sam to the hospital patio so Jack could see him. Frankie’s family took Jack into their family circle and started bringing in plain pasta and Italian ice for him. I turned off Frankie’s light, wished him a good night, and tiptoed past Jack’s bed.
Rosa was well-known and loved by all the staff on 3B. She had been in the hospital off and on since she was diagnosed with leukemia two years ago. Rosa is a kind, generous, and willful woman. As the matriarch of her family, she cared for her own family and everyone else’s, too. Rosa’s sense of humor and determination got her through some of the most challenging situations that no one should ever have to face. She was in a private room near the nurses’ station in the final hours of her short, 58-year life. Her three children came in to visit her every day. Their grief and helplessness were palpable as they struggled to say goodbye to their mother who they described as a “Miraculous Mama.” Rosa’s friend, Isabella, visited her faithfully every day. Her strong and calming presence gave Rosa a sense of peace and security.
Rosa developed severe neuropathy in her arms and hands. She couldn’t pick up a glass or wipe her eyes with a tissue. I developed a special bond with Rosa while spending many hours with her, helping her eat, take medicine, talk on the phone, and even smoke a cigarette. We talked about her early life on a farm in Mexico, her struggles to raise her family, and the difficulties of coping with her disease and treatment. One afternoon while I cared for Rosa, I noticed a small heart-shaped tin on her bedside table. On the outside was a painted flower and the word “honeysuckle.” Rosa opened the tin, and we both shared the sweet smell of honeysuckle from the small candle inside. My thoughts drifted to my own mother and how much she loves honeysuckle. The trellis over the front door back home is covered with honeysuckle vines, and every time someone comes to visit, they inhale that sweet aroma.
Rosa was in between worlds. Isabella sat quietly at her bedside, and she stroked Rosa’s hair and whispered prayers in Spanish. Isabella reassured Rosa that she would watch over her children. I gave Rosa some pain medicine and gently stroked her cheek. I offered Isabella some coffee and then went to check on the other patients.
And so, the night went on. During the dark hour of 3:00 a.m., Nancy became feverish, Jack developed vomiting, and Rosa’s breathing became shallow. I moved from room to room, and gave medicine, a cool facecloth, or kind words of empathy. Occasionally, alarms sounded, the phone rang, or a distant cough was heard.
At just past 5:00 a.m., the first signs of morning light came through the window blinds. Isabella tearfully came to the desk to say that Rosa had just passed away. I put my arm around Isabella’s shoulder, and we walked side-by-side back into her room. Isabella and I reminisced about Rosa’s strength in the face of adversity. We shared funny stories that Rosa had told us. We marveled at her character and her will.
I walked back to the desk to call the doctor and the Neptune Society. Apparently, Rosa made arrangements to have her ashes scattered at sea when she died. Isabella contacted Rosa’s children and then began to gather up Rosa’s belongings from her room.
Later, Isabella came over to the desk with a heart-shaped candle in her hand. “Maureen, this is for you, from Rosa. They didn’t have any more honeysuckle, so we got you a rose.” As I opened the tin and smelled the distinct aroma of a rose, I marveled at the coincidence that my mother’s favorite song is “Honeysuckle Rose.” I looked at the candle in the palm of my hand and smiled: A rose from Rosa. We hugged goodbye, and I offered condolences for the loss of her dear friend, Rosa.
At 6:00 a.m., the morning sun lightened from pale orange to white. I made my rounds, checked on patients, administered medications, and recorded IVs. Nancy was asleep, her temperature was normal again, and her color was improving. Jack was also asleep. The medicine helped control his vomiting, and he looked very peaceful. Frankie called me over to ask if I would do him a favor. “Would you please take this candle down to the chapel and light it for my friend Jack here?” “Absolutely,” I said, and I thanked Frankie for his thoughtfulness.
I finished charting and gave my report to the day shift. I gathered the candle for Jack and started toward the elevator. A wave of fatigue encircled me as I stood by the elevator door. The elevator door opened, and staff bustled out. A new day was beginning. The chapel was empty, but it felt warm, as the morning light came through the kaleidoscope of colors from the stained-glass windows. I lit the candle for Jack and said a silent prayer for him.
As I exited through the automatic doors of the hospital, I was blinded by the bright sunlight. I inhaled the fragrance of flowers, moist from morning dew. As hot tears welled up in my eyes, my head felt dazed, but my heart felt full.
Maureen Groden, MS, RN, CHPN, teaches community health nursing at the University of Massachusetts in Amherst and is a member and past president of Sigma’s Beta Zeta at-Large Chapter. Her upcoming book, When a Loved One is Dying: Conversations about Care, Connection and Coping, will be published by Johns Hopkins University Press in 2026.