Transitioning Question

aimeee, BSN, RN · Nov 21, 2008

I think it is just another euphamism for dying that is coming more and more into vogue. And like the word dying, it all depends on how you define it. Dying can happen in a day or it can be a lengthy process that takes weeks. We had a discussion about the terms active dying and pre-active dying a while back. If you include the pre-active stage of dying and are utilizing term transitioning instead, it could be a two week window. Its more what's happening than a precise amount of time.

Berkshire1995 · Jan 1, 2009

It really is all very individual.It's very difficult to give a time frame as I have had some patients go 16 days with no food or fluid....they were waiting for someone. It is truly amazing to see the strength of the human spirit.

shrinky · Jan 15, 2009

This is truely an individual process as stated and can depend on whether or not a person has his/her "business" in order. Patients can start seeing loved ones who have passed or angels weeks before they die. I'm sure that all of we Hospice nurses have stories that we can tell about this process or journey as I like to call it. I also have inpatient Hospice patients at the hospital that owns us and I love it when the doc writes that the patient is hallucinating because they see people that are not there. Education is a much needed tool still in our field. I feel like a detective sometimes when I try to figure out why someone is holding on.:typing

leslie :-D · Jan 15, 2009

I also have inpatient Hospice patients at the hospital that owns us and I love it when the doc writes that the patient is hallucinating because they see people that are not there.

you love it, i hate it when md writes pt "hallucinating"...

because it is often perceived as a psychotic experience...

rather a pathological deterioration of the dying experience.

when in actuality, it is a very spiritual time and usually brings the pt much comfort.

nurses will not administer 'prescribed' meds unless pt is clearly distressed.

our med'l dir knows that now, and supports us all the way.

leslie

shrinky · Jan 16, 2009

When I said I love it, I really meant duh, docs they are not really hallucinating. They don't understand the dying process and the whole spiritual thing, they explain what they don't understand with what they think they know. I try really hard to educate them and hopefully before I retire I will accomplish my goal. Thanks for listening and for all the help you give on this site.

rngolfer53 · Jan 16, 2009

you love it, i hate it when md writes pt "hallucinating"...
because it is often perceived as a psychotic experience...
rather a pathological deterioration of the dying experience.
when in actuality, it is a very spiritual time and usually brings the pt much comfort.
nurses will not administer 'prescribed' meds unless pt is clearly distressed.
our med'l dir knows that now, and supports us all the way.
leslie

I was triage the other night, and had a call from a son, stating the Pt was calling for a deceased loved one and wanting to make sure the car was packed for the trip. The son was wanting to go for the haldol until I told him about the symbolism involved. (Another reason why Hospice Fast Facts is so handy.) The Pt really wasn't agitated, just a bit restless, and not pulling at the Foley, etc. Instead, the family sang hymns with the father, and I understand he was very peaceful when the CM visited later that morning.

Full marks for the family, who had the strength and caring to help the father in a way far better than meds.

leslie :-D · Jan 16, 2009

I was triage the other night, and had a call from a son, stating the Pt was calling for a deceased loved one and wanting to make sure the car was packed for the trip.

you know, you bring up another fascinating point...

that when our pts are truly transitioning, they almost always speak of having places to go.

whether it's in a car, train, boat, horse, foot, etc...

but that sudden urge to go elsewhere, is very telling.

afterall, no one has satisfactorily described their experiences on the other side.

they are always overcome and, at a loss for words.

even when they've left us (while sleeping), they're always at a loss as to where they've been, but are clearly comforted.

after 12 yrs, i still am in awe of witnessing these events...

the separation of spirit and body, as the body slowly shuts down.

and thanks shrinky.

i totally agree w/you.

and you too, have noticed pts trying to explain the unexplainable????

isn't it wonderful?????

leslie