Death is a journey

by jadelpn 5,320 Views | 17 Comments Guide

When you are a nurse who takes care of patients who are actively dying, it can be not only very rewarding, but a profound experience of the heart, mind and spirit. It is a process. And like any process, needs a guide. And as nurses, you may find yourself a guide into a patient's whole being. What someone may have been in an active life can and does change when one is looking death in the eyes. It can be up to a nurse to say that it is OK to let go...

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    Death is a journey

    It is always a good thought when one decides they would like to die at home. Surrounded by loved ones, in their own beds. But as the time grows near, many decide that they would rather be in a hospital room, surrounded by loved ones, with a nurse who gives the medical care so that the patient and the family can connect, remember, and say all of those things that they ever wanted to say in a focused way.

    The job of the nurse needs to be non-obtrusive, but consistent. Which is not always an easy task. Often, nurses are the "control" in what is otherwise a non-controlled situation. Communication is essential, as family reacts better when they can help make decisions (if you think that your mother is uncomfortable, please ring for me, otherwise I will be back in a half hour). There are patients who react poorly to pain medication, as if they are a "type A" in control person, the feeling of being on a "trip" is something that they don't like, and will often fight. So go easy. It is a well choreographed ballet of pain control and functional level until the patient is able to learn to go with it, and fall into the ebb and flow of comfort and peace. I always remind myself of a little rhyme my grandmother used to say "Very softly I will walk, very softly I will talk". The nurse is the leader in the atmosphere in the room.

    Patients are really very vulnerable when death is staring down at them. But some of the things that they will say to you is so profound, rich with life lessons, that it can be the most rewarding time for them, and for you.

    It is so important for a family to say that it is OK for someone to let go. Which is a heart wrenching process, but never the less an important one. The ultimate goal is peaceful. As pain free as possible. With people talking and singing and guiding or silence and praying and the sunlight streaming in.

    Really listen, and you can hear a brilliant mind at work. Some patients will give you every bit of advice that you would ever want, what you should be cooking for dinner, get your haircut honey to you need to be married and have kids. Other patients will reminise about the time in their lives they were young and fun and full of life. Still others will tell you that their loved ones who have passed are just right there waiting for them, and take their last breath.

    In the end doens't matter if as a nurse, you are religious, non-religious, spiritual or non-spiritual. You will, however, feel like you have taken a surreal journey. What matters is that the patient experiences peace, and is able to die in the way they would like to, whenever humanly possible, and as nurses, it may come a time that you can make that happen for someone.

    They say that life is a journey. I would add that so is death. You begin to face things that you never may have thought possible. It is a journey of the spirit, if not a spiritual journey.
    Last edit by Joe V on Apr 30, '13
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  3. About jadelpn

    jadelpn joined Nov '08 - from 'Massachusetts'. Age: 48 jadelpn has '25' year(s) of experience and specializes in 'ER, Med Surg'. Posts: 3,232 Likes: 6,976; Learn more about jadelpn by visiting their allnursesPage

    17 Comments so far...

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    Such a beautiful writing.
    jadelpn likes this.
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    I agree with everything you say here. I would just like to point out that when a pt dies at home with hospice, a nurse is still providing care. We experienced that this month in our family and it was a very meaningful and peaceful experience. It is what our family member wanted, and it is what we wanted as well.

    I just don't want to short-change the nursing care provided by the hospice team. The nurse was absolutely wonderful, as were the other team members.
    Nurse_Diane, poppycat, and jadelpn like this.
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    Quote from Sadala
    I agree with everything you say here. I would just like to point out that when a pt dies at home with hospice, a nurse is still providing care. We experienced that this month in our family and it was a very meaningful and peaceful experience. It is what our family member wanted, and it is what we wanted as well.

    I just don't want to short-change the nursing care provided by the hospice team. The nurse was absolutely wonderful, as were the other team members.
    You are absolutely correct Sadala!! And I honor those nurses who do this work at the patient's home. My personal experience is in a hospital setting, however, I aspire to retire and do home hospice.
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    This is a hauntingly beautiful, expressive essay on one of the most sensitive topics we deal with as nurses. Well done!
    jadelpn likes this.
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    My dad took his final journey in March, dying on Good Friday. He was admitted to an inpatient hospice unit the Tuesday before he died. Little did my sister & I know that this unit is staffed with nurses who float from the rest of the hospital & have no training in hospice philosophy. Two nights in a row dad had nurses who refused to give him adequate pain medication because they "didn't believe" in giving very much. They didn't want him to be "out of it". Are you kidding me?! The whole point of him being in hospice was for pain control. Not until 10 hours before he passed away was his pain actually addressed effectively. This whole experience has put hospice in a very bad light with me. I only hope no one else's family has to go through what we did. He suffered more in hospice than he had been at home.
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    Quote from KarenfRN
    My dad took his final journey in March, dying on Good Friday. He was admitted to an inpatient hospice unit the Tuesday before he died. Little did my sister & I know that this unit is staffed with nurses who float from the rest of the hospital & have no training in hospice philosophy. Two nights in a row dad had nurses who refused to give him adequate pain medication because they "didn't believe" in giving very much. They didn't want him to be "out of it". Are you kidding me?! The whole point of him being in hospice was for pain control. Not until 10 hours before he passed away was his pain actually addressed effectively. This whole experience has put hospice in a very bad light with me. I only hope no one else's family has to go through what we did. He suffered more in hospice than he had been at home.
    That makes me incredibly sad. Please know that not all hospices are like this. It is certainly something I would encourage you to share with the nurse manager of that unit. my condolences on the loss of your father.
  10. 1
    Great piece of work, I appreciate the reading.
    jadelpn likes this.
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    Great article. I had to do the hardest nursing of my life when my mother was diagnosed with pancreatic cancer. Less than 3 months from diagnosis until her death. I live in New York, she lived in Indiana. Granted we have not had the best of a relationship, but I feel made up for that when she knew she was not going to beat it. I went into gear, worked with hospice, and she died peacefully at home, pain free and with her family surrounding her. I give credit to hospice nurses. They rock! They gave me everything I asked for without hesitation.
    I was the 'guide' for my whole family as my brother said "we could of never done this on our own". Probably the most rewarding and 'saddest' moment of my nursing career. My mother fought it as she still had plans here on earth,but in the end working together with my family and hospice got my mom where she needed to be.
    jadelpn likes this.
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    Thank you for the beautiful article, jadelpn. I am just starting nursing school and would like to become a hospice nurse. I've had several experiences, while volunteering for hospice and while helping my own mother through her (peaceful, at-home) death, that have led me in this direction. I welcome your advice or that of other nurses here about anything I might keep in mind as I go through the BSN program and afterward. Are there classes I should be sure to take or internships you recommend? Should I get years of bedside nursing experience first? Etc.?

    Thanks again for sharing your expertise.
    jadelpn likes this.


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