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aimeee 10,152 Views

Joined: May 12, '99; Posts: 3,488 (2% Liked) ; Likes: 118

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  • Jul 6 '08

    BTW, I am glad to see some apologies on this thread. Seems Christianity is one of the few things left that is unacceptable to claim...

    As a Christian whose faith is the undergirding of years of social justice work and activism--and as one who lived outside the US in a country so "new" to itself because only in the last few years has this country been out from the HUGE influence of Colonialism and Imperialism--the US being the last of the Imperialism, I've seen, up close and personal, a really ugly side of the US--AND a very ugly side of the Christianity of US Imperialism--even though both my husband and I were there as Xan missioners.

    Yes, well, there IS a piece of the truth (as Gandhi said) about Xanity being "unacceptable" in the light of the atrocities of Western Xianity particularly in light of the past nearly 8 years of a very violent theocracy. In the US, it seems that we've taken it for granted that "we" were/are Christian and in parts of the US, a one way of being Xan. When I think of the present conflict within Anglicanism (for example), I think that so much of what is being called "traditional" Xanity (by the Bible etc etc etc) was literally forced on peoples all over the world by Xan missionaries. I won't go on and on about eons of bad, wrong, misinterpreted, horribly translated via culture and power that is, at least for me, THE primary reason Xianity is considered so "unacceptable." In my lifetime, "bad" Xianity has been used to defend racism, sexism, heterosexism, murder, torture, death penalty, economic injustice...from the Civil Rights years to the Black Muslim movement to Vietnam to chemical mega agriculture, the oil industry, to immigration rights to the atrocities of US intervention in Latin America, to GLBTQKQ rights, to 9-11 and the aftermath of war, and on and on... that's a whole lot of baggage and intolerance all under the name of a masculine Christian G/god.

    I think it really shows a sensitivity and awareness for those of who are ARE Xan to be respectful of other cultures and other faith traditions. And to that hospice using the language of different faith traditions in the world today as a way to connect to families, patients/clients, and the rest of the world, I give you great HURRAHS!! And for all of us Xan to make ourselves aware of other faith tradition ways and days of celebration and sacred days--says that we really DO honor a Holy One who loves All. I don't know about any of the rest of you, but Christianity is my "way" into paganism and Earth/environmental activism.

    Please, to the hospice chaplains comfortable enough to "do" memorial services and life celebrations of other faith traditions, I send a great big THANK YOU!


  • Jul 6 '08

    You know, some people have touched on this obliquely, but I would say that some of the qualities that are helpful to be able to do hospice are:

    • A lack of a need to control things
    • An ability to meet people where they are
    • An ability to live with ambiguity
    • The ability to be non-judgmental to an extreme degree
    • A real love for families and family dynamics in all their messy glory
    • The ability to be autonomous but still part of a team
    • A commitment to self-care
    Yes, it can be amazing, beautiful, moving, uplifting, and to my mind, always an honor to be with people in this most vulnerable time, that doesn't mean you don't deal with plenty of cranky, "non-compliant," (I have that term!) people that live in chaotic, dysfunctional families with lots of very different belief systems. If you can't roll w/that, you'll be miserable in hospice.

  • Jun 28 '08


    the morning she died, my mother in law had the family priest come pray to st. theresa to let her die. ( there is a story that st theresa lets you know she has heard your prayer by sending roses in some way) quote]

    the day my father died, he was given the sacrament and the priest left. i was praying by the bedside when i had the strangest feeling that my grandmother was there with us, although she had died years before. i got up, laid on the bed beside dad and put my crucifix in his hands and carried on praying. i told him that it was ok, that gran had come to take him home...he died very shortly afterwards, peacefully and without sign of pain or distress. i later received three sympathy cards with these words...

    the rose beyond the wall
    near a shady wall a rose once grew,
    budded and blossomed in god's free light,
    watered and fed by the morning dew,
    shedding it's sweetness day and night.

    as it grew and blossomed fair and tall,
    slowly rising to loftier height,
    it came to a crevice in the wall
    through which there shone a beam of light.
    onward it crept with added strength
    with never a thought of fear or pride,
    it followed the light through the crevice's length
    and unfolded itself on the other side.

    the light, the dew, the broadening view
    were found the same as they were before,
    and it lost itself in beauties new,
    breathing it's fragrance more and more.

    shall claim of death cause us to grieve
    and make our courage faint and fall?
    nay! let us faith and hope receive--
    the rose still grows beyond the wall,
    scattering fragrance far and wide
    just as it did in days of yore,
    just as it did on the other side,
    just as it will forevermore.
    ~ a. l. frink

    perhaps these were the roses from st theresa?

  • Jun 22 '08

    Quote from Sabby_NC
    Very true and that is a valid concern... Just wonder how else we could safely destroy opioids where no roaming fingers could help themselves!!
    Am new to the site and welcome all the great feedbacks I have been reading. I can tell you from my experience that I take a "clean" diaper (and you would be surprised why I say clean..LOL.) and drain the liquid Morphine and Haldol in the diaper to be absorb before throwing out. I also disolve the pills with hot water and also pour them in the diaper. I have had in the past a blow out among a husband and son regarding disposal. The property had a septic tank so the father refused to have things flushed and the son refused to have the liquids poured on the lawn for the animals to eat. I have found this method to be the most efficient and the families are very appreciative.

  • Jun 18 '08

    Quote from aimeee
    That is what bugs the heck out of me. The hospices in Africa have to charge their patients (most of whom have next to nothing) for morphine (if they can even get what they need) and here we are dumping it out right and left. It is SO WRONG.
    Drives me nuts too. The NY Times did a big piece on pain management in Africa a few months ago - what an eye opener. They reported that a combination of expense and heavy handed narcotics laws make it difficult to get even a Tylenol 3 for a pt with end stage cancer.

    If I ruled the world I would pay the poppy farmers in Afganistan top $ for their crop and send the morphine to folks in Africa that need it. The fact that people die in pain when we have a safe and cheap way to make them comfortable makes me want to pull the few remaining hairs on my head out.

  • Jun 4 '08

    If a patient is terrified of dying, exploring that with them would be appropriate but telling them you have good news for them would be totally inappropriate. If a patient asks you to pray with them, it would be appropriate for you to do so. I think the best advice is that if you see that a patient is having spiritual distress, you should call a chaplain. They are trained in spiritual matters. If a chaplain saw that a patient was in extreme physical pain, he/she should call the nurse.

  • Jun 1 '08

    Quote from GardenerGirl
    I imagine that holding hands and listening will be a big part of what I can offer to my patients and their families, but what about God? How far can you go in comforting your patients and their loved-ones? If they are afraid of dying and you know you have good news for them,, just how much can you say?

    Cheri :heartbeat
    i have to admit, the bold is the part that concerns me a bit.
    what elkpark said, is so very true.
    and while listening, holding hands is a part of the nursing care, it is never, ever our job to offer false hopes.
    we know nothing about where we're going...none of us does, until we get there.

    when a patient is afraid of dying, an effective nurse will have the pt explore their fears.
    what are they afraid of?
    going to hell because of certains sins while living?

    once the nurse identifies specific anxieties/fears, then reassurance can be given.
    "no, we will not let you live/die in pain".
    spiritual concerns, you get the chaplain.
    regrets? about what? and what can be done now to redeem the pt?
    again, it takes sensitivity, insight and a proactive stance to bring closure to extent possible.
    (dang, i could write a book about this...)
    in summary, if you and your pt have a trusting relationship, much can be accomplished in ensuring a peaceful worst, an acceptable death.
    it will depend on how much work the nurse/pt are willing to do in getting there.
    but please, do not ever, EVER say, "have you met Jesus?"
    however, it is ok, after learning that your pt believes in God, to assure him/her with the love of God...
    something general but comforting.
    just keep in mind, it is always about them, and never about us.

    best of everything.


  • Feb 9 '08

    I have been a Nurse for 27 years. That seems like so many years, especially if you are a new graduate nurse. Yet, for me, the years have passed very fast. Many times I have wondered how my nursing career could have been different. You see, I am one of those nurses who could never seem to find my niche in the many areas available to us in the profession. In fact, when I was in nursing school, I wasn't even aware of all the areas available. I thought you went to nursing school, graduated and went to work in a hospital...on a medical/surgical floor at that.

    In the last year however, I did find my niche. Actually, it found me. You see, I believe in God and His Hand in my life. He actually opened a door for me that I would never have opened myself. In fact, I was faced with the door before, and I did not open it.

    My new found home in nursing is Hospice. There is a local, nonprofit Hospice agency in the small town I live in. Several times throughout my nursing career I would go by and pick up an application, but never completed it. Then one day last April, I was leaving the hospital, after sitting with my father-in-law for several months while he was a patient. Going down the stairs, the door opened in the hall at a small office where just a few nursing staff worked. My curiosity got the best of me, so I stopped and questioned them as to just what they did.

    The staff explained they worked for Hospice and that this was a small inpatient unit. I had no real idea of what Hospice was or what it meant. But I thought, I might be able to do this! As I left the building, I was met by someone I worked with years earlier and not aware of whom she was, we talked and when she asked me what I was doing, I told her I was on my way to apply for a job at this Inpatient Hospice facility. I still was not aware that the person I was talking to was the Executive Director of the Hospice Agency. Within days I found myself being hired as the Director of the Inpatient Facility.

    During my interview with the Clinical Director, the last thing I told her was that I did not like working with dead people. She of course was taken aback and stated that Hospice was in the business of dealing with death and dying and that the nurse was the person who pronounced the deceased. I explained to her that in all my years of nursing I had never taken care of a deceased body by doing postmortem care. I always let the nurse aid do the care. I didn't even want to go back into the deceased room when they had been pronounced.

    To my surprise, I have come to view death as a part of living. Giving care to someone who is in the last stages of their lives has become one of my greatest blessings. To be able to share this most intimate time in one's life and the life of the family has become viewed, by me, as a privilege. To be there, perhaps holding a dying patients' hand or their love ones' hand, I feel is the last thing I can do for this person as they leave this life. Any fear or anxiety I may have had with death and dying has been totally alleviated. I don't even think of my position as being a job, but more so a ministry.

    Hospice nursing is truly holistic in nature. We have a team of professionals who work closely together, trust each other, and value each others' expertise and opinions. Our team consists of nurse, nurse aid, social worker, chaplain, physician, bereavement coordinator, as well as the most important people, the patient and family. Each person is listened to, helps plan patient/family care, and come together when comfort and encouragement and just listening is needed.

    You may think that working in Hospice will "weaken" your nursing skills. This is so far from the truth. Not only are our patients facing the end of life, but they also have many medical and physical conditions that continue to require intense nursing assessment, planning, care, and evaluation...just like any other nursing area of care. I have found that teaching is one of the most critical aspects of the nursing care. Teaching on dying and the changes to be expected to family is one of the most challenging areas. Families worry about patients being in pain, of starving and dehydrating when they begin to refuse nourishment. Teaching must be done quickly, repeated frequently, and done on levels that families are ready to hear and deal with.

    If you want to really know that you made a difference in someone's life at the end of the day, that what you did mattered, that your very presence made a difference, then I challenge you to give Hospice a career chance.

  • Feb 9 '08

    Sometimes, a family member's behavior is so clouded by the grief and shock of a loss that we must be courageous enough to practice outside the box.

    My patient had been ejected from his car after hitting black ice. His prognosis for any recovery was a hairs-breath above zero. We knew he would never again walk this earth.

    The family was large and streamed in and out of the room. All were polite and respectful. The wife dutifully provided explanations and “stability” for the large family and the throng of visitors.
    From the periphery, I observed her. She kept her emotions in check, only occasionally tearing up. It almost seemed she were “hostessing” the “event”. But her slow-motion movements belied a simmering grief that needed to be processed.

    Having worked in ICU for ten years, I knew there was nothing humanly possible to change his course. I knew soon his heart--the heart that beat for so many years in unison with the woman--would stop, and the body that warmed her would grow cold, and the soul that united them and breathed life into her, would slip away.

    The family and friends were “there” for the wife but they seemed unaware of the need I saw simmering just beneath her expression. And as the people kept calling I could sense a growing need within her. She began seeking my approval about letting anyone else in. I told her these would be the last. There was something we needed to do. The final visitors let the others who had gathered in the waiting room know that visitations would now cease.

    I led the woman into the room. I rearranged the mechanical lines of life support and gently pulled the husband over to one side of the bed. I let down the rail.

    “You need to lie beside him,” I said.

    She looked at me with utter astonishment. It was as if I had just told her I could bring transport her back to the day before when her husband was home and alive and this place never existed. Her tears streamed down her cheeks. She cried and cried as I helped her in beside him.

    I assured her she would not be disturbed by anyone, for any reason. She could emerge from the room when she was ready and could stay as long as she needed. I would guard against any disturbance.

    I covered her with a blanket and put chairs against the bed as a reminder to her that the railings were down. I handed her the call bell and closed the door and curtains behind me.

    Some weeks later I received a letter from her. She had difficulty describing the torrent of emotions that enveloped her while she lay with her husband that final afternoon of his life. But she said that being able to fully embrace him provided her a comfort and peace that would warm her for the rest of her life.

    It’s so simple, yet too often we lose focus on what really matters.

    Have the courage to let your humanity lead the way.

  • Dec 19 '07

    Funny, got into a lively debate a week or so ago at a meeting and we agreed on only one thing: Stereotypes run rampant out there.
    For Profits are greedy and don't provide care. Non-Profits are sloppy because if they do poorly they have a fundraiser. Neither is always true. I think it is all about the program, the mission, the leadership, the staff, and expectations being managed. One for-profit I talked to did 5% of their gross as charity, and a non-profit was proud to announce that they kept their charitable care below 2% by aggressive management of admissions. The for-profit took out a loan, the non-profit had millions in the bank. Another for-profit had RN caseloads of 21 on average. A non-profit at 13 (my hospice is currently at 12)

    Yes, we non-profits do have a built-in advantage, and yes, the for-profits might be able to recruit superior staff, but the exact opposite can be true too.

    It is a lively debate, but it seems to me that it is about spin for marketing, or our personal pride in our programs (or a bad taste from a bad program). Is it to naive to think we would be better served to make every company, regardless of IRS status, raise its standards in order to be competitive - and weed out the bad programs?

    Its like when I play my harp, sometimes a bad artist can destroy a beautiful piece of music.

  • Sep 6 '07

    As a long time LTC nurse, I whole heartedly agree with all of the above posted. We have several hospice patients in our long term care. We have been extremely fortunate to have a "dedicated" team assigned to our facility (meaning we get the same group of hospice nurses/aides on a routine basis). This has brought fantastic continuitiy of care to our residentsand brings real peace to families.

    As said before, our regulations are so "extreme" (for lack of better term) that we become very hesitant with what we preceive as larger doses of medications - hospice comes in and suddenly we, as a group, are REALLY allowed to do what is best for the resident without the intense scrutiny.

    As LTC staff, we simply do not, and never will, have the time to "foo-foo" over a resident on a continued basis. I'm not saying it should be this way, but it is a reality! The hospice staff gives so much of the extras that that resident deserves.

    I absolutely love our hospice group and couldn't imagine not having them as a part of our team.