Dear Julie
i know you are aware that this is exactly the scenario Rob and i faced.when his neck broke open under his chin and across his larynx,you could actually see the artery with the naked eye.
Robs mucous was thick and choking and required vigourous coughing to expectorate.We knew that every time he coughed,the artery could rupture,and every where in the hospice we went we had to carry dark towels and an emergency buzzer.The staff said the end would be very swift for him but very traumatising for me if i was with him at the time.
The fear of dying from a ruptured artery,caused his first real problems, and he became very agitated and distressed,He was more than happy to die, but not in such a horrific way so he too was started on valium.This had very little effect,and as his agitation increased so did the risk.
A medical decision was made to offer Robin varying levels of sedation which would ultimately result him becoming semi comatose and eventually comatose so he could pass away quietly in his sleep,and he chose a low level of sedation to start with.This took away all the anxiety and fear of rupture and once his mind and body had relaxed nature swiftly joined in and took its course.From the start of the sedation to the end of his life was less than 36 hours.
The Relief that i would not have to face watching him die such a gruesome and horrific death was gargantuan,and Julie NO ONE nurse or civilian should ever have to cope alone with such a thing.

YOU ARE NOT HIS NURSE YOU ARE HIS WIFE .
shout scream do anything you have to make people realise that you need care and support just as much as he does and no matter what the letters after your name say you are emotionally attached to Richard ,not a cool,calm detached professional.
The staff at Robins hospice treated the whole family not just Robin.I was shown care,compassion,considertation,i was involved in every discussion and every decision and given counselling and ministry.
All the staff knew i was a registered nurse and anything i did in the way of caring for Robin they were grateful for but never expected,and they downright refused to let me be responsible for some of the bigger issues we had to deal with because they realised the difference between being attached and detached.

Julie talk to someone very soon and tell them you love the man and cant function in RN mode at this time,you need to be his partner and support,not his physician.

Please please e- mail me if i can do anything to help you through this.It is such a short time ago i was filling your shoes and i know exactly what you are feeling.

love and best wishes Liz