In the hierarchy of health care professionals, I supposedly stand on one of the lowest steps of that ladder. Some say I am just a CNA. Some say I am the backbone of nurses and physicians. I say: I am a strategic part of this ladder. I do not have the medical knowledge or skills of a physician nor of a nurse. But what I do have is a heart and soul that is dedicated to my patients. I live and breathe my CNA world. And along with that comes the complexities and heartfelt knowledge of the inner cogs in the wheel of my main concern: the patient.

After years and years of being a dedicated CNA, I finally felt the incredible sadness of one of my patients. Sam. He was on a long journey of poor health in this hospital, four months to be exact. I saw his deterioration every day. I saw how his family would never visit. I saw his loneliness. I saw how his physicians attempted many times to contact the family. But with no success.

His four-month journey in this hospital, I watched his mental and physical health deteriorate and it was me that he looked at with pleading eyes. Eyes of sadness and abandonment. I was his lifeline. His only connection. He knew that it was me that cared for him. Sam’s diagnosis on this medical floor was terminal bone cancer. Eventually mets to his brain. Every day, I gave him his breakfast and lunch, his morning bath, getting him out of bed even walking him down the hallway. Every day he would look down the hallway and wait for a family member to peak through. But that never happened.

Sam was a happy-go-lucky guy. He talked frequently of the past. He loved watching “Wheel of Fortune” on TV while he ate his lunch. I looked forward to going to work each day so I could take care of Sam. He was so full of laughter and chit-chat. On the second month, he became more confused. Day after day. There was a confirmation of mets to his brain. Brain cancer. Each day became his worst day. Screaming out: “Help me, help me, help me mama.” A small dose of morphine, sometimes Ativan, would only last for maybe one hour to quiet and calm him.

On the third month his pain continued. He was losing weight drastically and his desire to eat was minimal. He now had a foley. His physician attempted many times to call his family, recommending that Sam move to Comfort care. His daughter said to the doctor: “I will pray about it. God bless you,” and she hung up.

By the fourth month, he would continue to scream in pain, severe confusion, pulling his IVs out, and refusing to eat. He begged for mercy. He was begging to die. His pain meds barely touched him.

A resounding moment in my CNA career was listening to the sound of suffering. A sound I can never hear again. No one deserves to die in pain. No one should have to beg their loved ones for mercy. His family refused comfort care. They refused to make him a DNR. They refused to change his status. Four months seemed a lifetime to me. His family never visited him but dictated his care.

And it was me, his CNA, that held his hand as he lay in bed. “Wheel of Fortune” quietly in the background. No family. Just me and my buddy Sam. Holding his hand as he looked up to the heavens and took his last breath.

Sam was finally without torment or pain. I silently cried for all of the suffering and sadness Sam had gone through. Four months. I shared his heart and soul. I had become “his family.” I was just a CNA.

This article was co-written with an anonymous CNA.

Debbie Moore-Black is a nurse who blogs at The Critical Care Nurse.