Managing symptoms for a “good death”

whoa.

For you, Introspective:

Sometimes, when I am not sure how to help a patient, I just spend time sitting quietly with them. For me, this has broken down barriers and helped patients tell me how I can help them. A gentle reminder, it is the patients' life, death, etc. I certainly think you are on the right track.
God bless.

Yes… exactly true… just spend time sitting with them… being with them. That is the key. Humans “being”… as opposed to… humans doing.

I had not thought of this for years, but the lady I spoke of earlier (who crossed consciously) talked to me of her childhood. Her parents had been members of the Ku Klux Klan. But she grew up with her closest friend being a little black girl.

When she was older her politics were very “left.” Her husband (an actor) was “black balled” during the Joseph MaCarthy era. But they managed to scrape by and make a living. I could tell you some of the movies he was in… but that would be telling.

I spent many hours sitting and talking with her. I loved her (which is past tense… actually I still love her… present tense.)

She taught me a great deal… much of which I am still trying to incorporate into my life.

We like to think we are there to teach others… to help them… to “manage” their cases. But often it is they who are teaching us.

try encouraing patients to be a feather on the breath of God
http://palliativedrugs.org/download/...JUN%202002.pdf

I am still curious about how many hospice nurses have seen or been involved with patients who have crossed over consciously.

It is clear that hospice nurses are sympathetic. If someone starts a thread asking for prayers or sympathy there immediately rises up a great cry as a herd of hospice nurses comes thundering in… each trying to out do all the others with expressions of sympathy.

Hospice nurses are also very knowledgeable about symptom control. Raise a question along those lines and the responses will be plentiful, thorough and very professional.

But raise an existential question and you can hear a pin drop. Why is that?

Is it because there is such pressure for productivity that nurses just don’t have the time? Is it because of the pressure to focus on symptom control that your heads are swimming with details about drug effects, side effects and possible interactions? Is it because you are taught to not get involved with the personal/spiritual lives of clients? Is it that you are not trained to focus on or think about such things?

Or is it because existential questions seem too heavy, too philosophical, too deep?

Actually, these kinds of things can be pretty funny sometimes. For example; metaphysicians say that time, as we understand it, is an illusion… that in reality past, present and future all exist simultaneously. We just perceive them one at a time… rather like music CD’s. You have a drawer full of CD’s but only play one at a time. If you played them all at once it would be very confusing… at least it would for me since I am male and not very good at multi-tasking. You ladies would probably be better at that sort of thing but us guys can walk or we can chew gum but not both at the same time.

Quantum physicists are thinking along the same lines as the metaphysicians; i.e. that there are parallel universes which exist simultaneously. They call them “membranes” (“branes” for short) and picture them like separate slices of bread in a loaf.

So where we are depends on where our attention is focused. When here on Earth our attention is attached to a physical body… which anchors our attention in time/space. As we are dying that attachment begins to come loose and we begin slipping around in time space.

One day I was sitting, talking to a (dying) patient when she suddenly asked, “Well… aren’t you going to answer the phone?”

I said, “Ah-h-h-h… the phone didn’t ring.”

Just then the phone rang. She looked at me like I was a perfect idiot and triumphantly exclaimed, “See!”

Now… because I think about such things this little incident caught my attention. I had a very good laugh over it… and it made me keep my eye open for other such clues as to how dying patients start slipping around in time/space.

But it doesn’t strike me as being heavy or serious or philosophically weighty… it’s fun!

How about this for an existential question…

If a man is out in the forest and says something out loud but no woman is present to hear it… is he still wrong?

But seriously… do you mean to tell me that you have never seen or had a patient who died consciously?

Always, these discussions lead me somewhere else. An interesting experience I once has was when I was suggesting to a family they get lemon drops fpr the patient who had a very dry mouth. The patient and I had a lovely rapport, and as I described to the family in what way this would work, the patient was going throught the motions of opening something, then popping it into her mouth. She then took my hand and said, you always know how to help me...
what can I say?

BTW, req_read, us left handers have a far harder time writing things and try to avoid it, tht's where the right brain vs left brain comes in! Have a great day!

req reader, I'm not sure where you want to get to, but obviously
you are not getting there. You certainly have a right to your
opinion and to share your experiences, but I don't think you
should insinuate that other Hospice nurses are too ignorant
or inpatient to be able to distinquish/enabable a patient to "cross
over"; I believe you are being presumptious. All of us are "crossing
over", push, shove or jumping. Maybe I, and others,
have experienced unusual deaths, I'd imagine most experienced Hospice nurses have, but that doesn't mean that they wish to share the experience with you or this forum, and doesn't make them less of a Hospice nurse
for not doing so. Enough already, Hospice is pallative care, maybe
you should try the psych forum or start a "new age" forum to promote
your books and beliefs.
By the way, I'm left handed too!

Well, so much for trying to inject a little levity into this conversation. Self analysis is usually fertile ground for humor… assuming one has a sense of humor.

I have received a few private messages from participants in these threads warning me not to be too open… lest I be attacked. Now I am beginning to see why there is a reluctance to share personal experiences in this forum.

How sad… especially in a field where one’s ability to support one’s clients is dependent upon an ability to accept them… as opposed to attacking them; e.g. for being “new age” etc.

When I am in hospice (as a patient, not a nurse) I wonder what it would be like to ask a nurse, “What do you suppose it would take to die consciously?” Then have her respond, “I believe you are being presumptuous. All of us are crossing over, push, shove or jumping. Maybe I, and others, have experienced unusual deaths, I'd imagine most experienced Hospice nurses have, but that doesn't mean that they wish to share their experience with you…”

Okay… well, so much for sharing.

Ow, I am such a right winger (tho left handed) and really enjoying this thread. I cn't imagine being new Age!!!
I think a lot about the times I share with patients and like to talk about this stuff. I think stimulating conversation and ideas is good, even if it makes some people uncomfortable!!!!
I don't know where else I could exchange ideas on this stuff. If you don't want to play don't. Nothing here is hurting anyone.
my 2 cents