When death is imminent (long).........

[scoochy]

When I graduated from nursing school, my mother (who is now a retired nurse) said to me, "Never forget a patient's religious/spiritual needs when death is near." I have kept this with me throughout my thirty one years as a nurse. As the decades have past, I have noticed that many nurses I have worked with, as well as those I currently work with, view religious/spiritual needs as an "afterthought."

I currently work in LTC; many of the residents I care for attend weekly Mass, pray the Rosary every Friday, and attend the non-denominational service every Thursday evening WITHOUT fail. (The facility where I work is not affiliated with any specific religion; it has tremendous recreation/social services depts. that seek to fulfill every aspect of a resident's needs). When any of these services is canceled for some reason or other, the residents are disappointed.

That being said, when a resident is actively dying, I will ask the nurse caring for the resident if the resident has practiced any specific religion. Sometimes the nurse looks at me as if I have two heads; other times the nurse will be honest and say "I really hadn't considered it." Without stepping on toes, I talk to the family and ask if they think their loved one would like a blessing or receive the sacrament of the sick. The MAJORITY of the time, the family and/or resident (if they are able to express their desires) is so grateful to have this need met. I will hunt down a priest, minister, or chaplain until I find one.

One nurse I work with used to laugh at me, but she has since become more conscious of this need. I am not forcing religion down anyone's throat; I am thinking about a need that often falls by the wayside.

What are your thoughts on this subject?

[Tait, MSN, RN]

I believe that if it brings comfort and closure to the patient and the family it is well worth the extra effort.

Tait

[ZooMommyRN, ADN, RN]

It really is a need that has fallen through the cracks in many facilities, thankfuly I work for a faith based organization whose mission statement is to extend the healing ministry of Christ, we are given all the tools and people needed to assist anyone spiritually. Our community is so small that we have the ability to contact almost any denomination church if so requested by the patient or the family and have our own on call chaplains at all times. Employees are also offered extra training to become spiritual ambassadors to further aid patients as well as coworkers in times of need. Keep up the loving work, families & residents appreciate it more than you may ever know :)

[twinkletoes53]

I agree with you 100%. I have been an RN for 35 years. I work in a NICU, where we frequently have premature babies, or sometimes older, chronic, infants die. Usually the older infants have severe irreversible chronic lung disease, and we may have had them for close to a year or more.

The hospital I work in routinely calls in our hospital Chaplain for all imminent deaths, 24/7, but before he arrives, I ask the family if they would like to have their baby blessed, dedicated, or baptized. Sometimes the family is not with the baby, and I'm talking to them on the phone. Because sometimes the Chaplain cannot get there in time. I am Catholic and have done an Emergency Baptism on more than one occasion. I also have prayer books in English and Spanish to read for the baby, if the family is not there.

I think meeting a family's Spiritual needs ranks way up there with meeting their physical, psychological, and emotional needs.

[loriangel14, RN]

The hospital I work in has religious affiliation and needs as a part of our admission information.When i started there par tof orientation was how to get a hold of the chaplains or whoever the family needed be it a priest or whatever.

[KaroSnowQueen, RN]

I think its wonderful that you think of this and try to help them in their last days/hours. Addressing the dying patient's spiritual needs OUGHT to be a priority, as it often helps the family as much as the patient.

[happy2learn]

This is something I just never thought about. Thank you for writing this thread. I will always keep this in mind even as a student nurse.

[leslie :-D]

the only thing i would suggest, is not to wait until death is imminent.

many of these pts would appreciate divine companionship, as they journey through their dying process...

even if that involves talking with the chaplain once a week, or whatever is deemed necessary.

not all pts mind you, but it's always ideal to ask (and not push it, if they refuse).

leslie

[TonyaM73, ASN, RN]

We don't have a policy to contact a priest or minister during the last hours of life. (Our facility leaves that to the patient's family.) Something that I have done since I first started there was to ask the family if they would like to pray over the patient. I have not had one turn me down yet! :) I have only had one family member comfortable enough to pray themselves, so I have prayed out loud for them. I have NEVER been a vocal prayer in my life, but God gave me the push and the words that first time and a nudge here and there. I really feel that this helps the patient and family let go and starts the healing process. I will stick with this plan throughout my nursing career

[Penelope_Pitstop, BSN, RN]

We're not a faith-based organization, but on admission there is a question regarding spiritual needs. We also have a way for the patient to request pastoral care on his or her own, and I show each new patient how to do just that.

The chaplain on-call is notified during code blues. I lost a patient in October during a code. It was about 1 AM, and the chaplain came. It was a terrible situation and I couldn't have done without her. I don't even know if she prayed with the family, or anything like that. But she was amazing. She knew the words to say to these grieving people (it was a sudden, unexpected death of a relatively young person) and listened to them as well.

I think it's very important to address during the end of life, and after life has ceased - support for the living...

[TDCHIM]

It sounds like a decent idea, as many people have such needs when they stand near the threshold. The only issue I worry about is the patient's family members pushing pastoral/religious visits or prayers onto an individual who would not seek one of his or her own volition but is no longer in a state to voice any protest. For instance, my mother and I don't see eye to eye on religion. If I were in a critical state and she called in an evangelical minister to pray over me, I'd hate it. So if the resident is not capable of expressing his or her own desires, I'd walk carefully and do everything possible to determine the actual resident's views, rather than the family's.

[leslie :-D]

So if the resident is not capable of expressing his or her own desires, I'd walk carefully and do everything possible to determine the actual resident's views, rather than the family's.

thank you, thank you, thank you!

so often, the pt's wishes are overlooked.

and, they often will not speak up, whether it's r/t reluctance, illness, hopelessness, etc.

for whatever reason and more often than not, it is the family member(s) whose wishes are honored.

and while i appreciate that these folks are grieving, it is the pt's death...bottom line.

excellent and critical point made, tdc.:)

leslie