Care at the Time of Death - page 8

from ajn, july 2003: care at the time of death how nurses can make the last hours of life a richer, more comfortable experience. by elizabeth ford pitorak, msn, rn, chpn ... Read More

  1. by   sharona97
    Good Morning All,

    I must have missed the history channel documentary you suggested. I was ,however to watch very early this morning a program on HBO called "Letting Go", A hospice documentary.

    I cried like a baby. I only hope that once I encounter the specialty of hospice I can hold it together much better as the nurses on the program did. Yes, there were tears from the Medical Director and ancillary staff, but I was sobbing.

    How was it for all of you, if you don't mind sharing, to begin a career in hospice.

    Sheri
  2. by   Sabby_NC
    Quote from sharona97
    Good Morning All,

    I must have missed the history channel documentary you suggested. I was ,however to watch very early this morning a program on HBO called "Letting Go", A hospice documentary.

    I cried like a baby. I only hope that once I encounter the specialty of hospice I can hold it together much better as the nurses on the program did. Yes, there were tears from the Medical Director and ancillary staff, but I was sobbing.

    How was it for all of you, if you don't mind sharing, to begin a career in hospice.

    Sheri
    Hi Sheri

    I basically fell into Hospice Nursing and really have found my niche.
    I have found it is ok to cry with your families if you are moved to tears. For the most part I can do what is necessary with my job and 'hold' the tears in. But at times I cry and I know it is ok to do that.
    I had one family say to me 'You really did love our Mum as we saw your tears' They said that gave them great comfort and love knowing their loved one affected us in that way.
    I can maintain my professionalism but still do the job that is well and truly entrenched in my heart.
    I shall check out the link that was included in the first post.

    Take care hon

    Sabby
  3. by   HeavensNurse
    Quote from sharona97
    Good Morning All,

    I must have missed the history channel documentary you suggested. I was ,however to watch very early this morning a program on HBO called "Letting Go", A hospice documentary.

    I cried like a baby. I only hope that once I encounter the specialty of hospice I can hold it together much better as the nurses on the program did. Yes, there were tears from the Medical Director and ancillary staff, but I was sobbing.

    How was it for all of you, if you don't mind sharing, to begin a career in hospice.

    Sheri
    Sheri
    I would like to say, for some reason, I became a RN for hospice. My first employer in healthcare put me through Nursing School. It has been my calling, and my heart. I highly recommend it to all nurses who are past SAVING and CURING.... Death is a natural part of life, a true continum. I tell people all the time that Hospice is the gift of time. We don't have time to wrap up our affairs and say goodbye if we have a heart attack or a tragic sudden death, BUT if someone is diagonsed as TERMINALLY ILL and offered HOSPICE then they have time to put their affairs in order, AND say goodbye. What a blessing Hospice can be. Good luck to you, and may God lead you to where you need to be.
    AMEN
  4. by   123hospicenurse
    The rule of thumb that we use for "hallucinating" patients:
    If they are happy reassuring and or pleasant experiences nothing needs to be done
    The only time our MD chooses to treat patients is to alleviate unpleasant experiences
    Last edit by 123hospicenurse on Oct 17, '07 : Reason: typo
  5. by   req_read
    Quote from 123hospicenurse
    The rule of thumb that we use for "hallucinating" patients:
    If they are happy reassuring and or pleasant experiences nothing needs to be done
    The only time our MD chooses to treat patients is to alleviate unpleasant experiences
    The potential problem for such a rule of thumb (described above) is that personal growth may not always result from happy, assuring and/or pleasant experiences.

    If, for example, a dying man is reliving ("hallucinating") about an experience in his life that was unpleasant, but resolving it could lead to personal growth, should he then be drugged, thus interfering with his resolutional processing?

    By analogy; if a child (little boy) gets into a fight on the playground, gets his nose bloodied and comes home crying, should you give him a valium or sit and talk with him about the wisdom vs pitfalls of getting into fights on the playground?

    Ideally, hospice nurses should have time to sit and talk with their pts/fams and help them work through unresolved issues. The rule of thumb (described above) seems to avoid nurse involvement either way; i.e. if the pt seems happy, do nothing... if the pt seems unhappy, drug him. In neither case does it imply that the nurse should spend time with the pt, trying to see if there is some issue that needs attention/resolution.

    Michael
  6. by   123hospicenurse
    You are absolutely correct. As I reread my response, I realized I did not answer clearly. I was addressing the ethical question of medicating a patient for hallucinations not the treatment in general. I knew what I was thinking in my mind but answered quickly not totally. Thank-you for the clarification
  7. by   tyler3222
    Hello all
    Excellent posts and insightfull. I am a newbe nurse comming up on 1 years, and i must say I am disgusted and dialousined ( spelling?) with nursing. I work nights on a med-surge uint- 6 patients. It is run run run...no time for talking to Pt's or spending time with them. etc etc. If I had known the reality of nursing.....I would not have done this. ( and 3 of my classmate's have said the same thing to me).
    However I am trying to get into Hospice as a last dash chance to do some "real nursing" and actually spend time with Pts. or at least more time. I liked and see the truth in the comment about there are 3 kinds of nurses:
    1. those that got out of nursing
    2. those that want out.
    3 and new nurses.

    I am surrouned by #2 where I work , just about everyone I talk to falls into that boat. Its a shame,,, health care in this country is like re-arranging the chairs on the deck of the Titanic!!!
  8. by   req_read
    brian3222…

    I thought I would wait to see how others might respond to your post. It’s been nearly 2 months now, so I guess that is a long enough wait.

    This thread was initiated by an article written by a nurse with a Ph.D.; presumably, a leader in our field. So where, in your estimation (as a new nurse) are we being led to?

    Oh… and one other thing I’ve been pondering.

    We all know there is a nursing shortage… actually there is no nursing shortage at all, just a shortage of nurses willing to work (as nurses amyway.) But anyway, I keep seeing this TV ad sponsored by Johnson & Johnson with a corny background song that goes, “You’re a nurse…etc.” What I don’t get is why Johnson & Johnson is spending money trying to get people into nursing. Do they own hospitals & nursing homes? I thought they were in the bandaid & baby oil business.

    It seems to me that large companies would have better luck acquiring and retaining nurses if they treated them well… as opposed to having second-rate musicians sing patronizing songs on TV.

    Michael
  9. by   Allow Mystery
    Hello Michael, Merry Christmas!
    I've seen the Johnson & Johnson ad, although they do not
    run it much in my area. I'm not sure of their agenda, although
    I'd reckon they have one, most of these big companies do; but,
    would agree, money may be better spent.
    Best wishes!
  10. by   req_read
    Allow_Mystery...

    A funny thought just struck me. Not so much funny Ha-Ha... more funny as in- ironic and sad.

    I guess Johnson & Johnson is still in the bandaid business. We are hemorrhaging nurses and they have come up with a bandaid for the malady; i.e. a patronizing jingle.

    I asked brian3222 (a couple of posts back) where he thinks (as a nursing student) our nursing leaders seem to be leading us. He sounded rather disenchanted. Maybe by now he has changed his major and left nursing before even getting into it? In which case I would ask any nursing students who may have wandered in to comment.

    Do articles such as the one which initiated this thread inspire you? If you have an interest in hospice nursing, where did that come from? Did it come from “leaders in our field?” Working nurses? A personal experience? A patronizing jingle? Other?

    Michael
  11. by   RNnamaste
    Bravissima!
    I have been a hospice nurse for many decades-studied with Kubler-Ross. Now I study with Frank Ostaseki of the Metta Instititute. Finally, FINALLY I can be honest with my patients (oops, clients) and meet them where they are in their experience. I can get pretty close through listening and knowing that they are me and I am them. I used to be all bravado and Catholic but felt as though I was convincing myself when I was asked the questions from those who are close to death. Now, I sit, wait, breathe. I summon the buddhas of compassion. I meet the clients-if they are suicidal, I research their suicide technique with them. If they are scared ,we speak of the the fear. We face it head on.
    I am also a Reiki Master teacher and practitioner and also do the Reconnection. The results are beyond my imagination. I am grateful, humbled, blessed. I walk with gratititude and humor.
    I am proud of your work, your intense interest in the so-called mystery.Keep going, keep going and be still.

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