Our patient, B.B., a retired minister, was admitted and received confirmation diagnosis of ALS. His condition was deteriorating and he could not speak but was able to write notes and communicate. The day the neurologist came to discuss and confirm the diagnosis, B.B. was quiet. His nurse, Kathy, had been present when the neurologist discussed B.B.'s options. After the MD left the room, Kathy said, "There is a better life out there, isn't there?" B.B. took her hand.

Later that day, B.B. communicated with his family and informed them of his decision to begin terminal weaning the following day. The family was very overwhelmed and most concerned that B.B. might endure pain and/or suffering. Kathy informed B.B. and the family "please do not worry about this. This will not be a problem and you [B.B.] will be comfortable and unafraid. Everything will be done according to your wishes."

On Saturday night, B.B. was asking his son if Kathy was there. Kathy was not there and was not scheduled to be there the following morning. But Kathy did work on Sunday and was able to be with B.B. and his family upon his passing. The family was overwhelmed with appreciation for all that Kathy did for B.B. and for the rest of the family. She held true to her promise and took excellent care of her patient to the very end.