Care at the Time of Death

Specialties Hospice

Published

[color=#001a66]from ajn, july 2003:

[color=#001a66]care at the time of death

[color=#6666cd]how nurses can make the last hours of life a richer,

[color=#6666cd]more comfortable experience.

[color=#001a66]by elizabeth ford pitorak, msn, rn, chpn

[color=#001a66]https://www.aacn.nche.edu/elnec/pdf/palliativecareajn8.pdf

Specializes in Med-Surg, ER, ICU, Hospice.

IRISHPOOH…

I got the message. Thanks.

All…

It really is interesting to see how little notice is taken when some new thinking pattern comes along. Believe it or not, what quantum physicists have learned will revolutionize western thought from top to bottom. There is a relatively small group of people paying attention but overall the reaction is more along the lines of, “Huh? So what?”

After the 2nd plane hit on the morning of 9/11 my wife & I agreed; “The world just changed.”

However, what quantum physicists are telling us now is even more far-reaching and significant than 9/11… yet the general response is “Ho-hum” at best. The lack of response is surreal.

One might well associate the realizations of modern science to the “second coming.” As stated in a previous post, Christ tried to get it through our thick heads a couple of thousand years ago that we are all connected and not just bodies. He was not the first to make that point of course, but made a concerted and well-documented effort. Now, all this time later, we (via our scientists) have figured it out on our own. You would think that might capture our attention, but the average person seems to be more aware of how many guys claim to be the father of Anna Nicole Smith’s baby.

What we pay attention to and think about is really quite fascinating.

Michael

However, what quantum physicists are telling us now is even more far-reaching and significant than 9/11... yet the general response is "Ho-hum" at best. The lack of response is surreal.

One might well associate the realizations of modern science to the "second coming." As stated in a previous post, Christ tried to get it through our thick heads a couple of thousand years ago that we are all connected and not just bodies. He was not the first to make that point of course, but made a concerted and well-documented effort. Now, all this time later, we (via our scientists) have figured it out on our own. You would think that might capture our attention, but the average person seems to be more aware of how many guys claim to be the father of Anna Nicole Smith's baby.

What we pay attention to and think about is really quite fascinating.

Michael

michael, while i appreciate the content of your post contextually, i am not convinced there is little interest from its readers, citing the lack of response.

certainly the media's focus may be national enquirer mentality.

that we do know.

but we do not know the minds of our audience.

speaking for myself, i fully understand and appreciate this oneness we all share.

it is a philosophy i live and experience every day of my life.

but to talk about it???

no, never.

that's not me.

everyone has different learning styles.

some are communicators and teachers, such as yourself.

i see myself as a student, reading and absorbing as much as possible.

anything i learn is in hopes of benefiting myself and others, here on earth.

but it's something i choose not to talk about.

it's something i am and will be.

so please, do not take a lack of response as a lack of interest.

that just is not true.

for those who are receptive, you give much to think about:

but not necessarily talk about.

leslie

Specializes in IM/Critical Care/Cardiology.
P.S.

There is a really good program on the Tibetan Book Of The Dead playing on the history channel. Check it out.

Michael

I looked and looked for times playing and was unsuccessful. Do you have any soecifics like time of day or dates? Thanks!

Sheri

Specializes in Hospice.

AMEN! Keep doing what you are doing. It works! I have been with hospice since 1989 and LOVE it... Truly hospice is my heart, and don't ever let anyone talk you out of "counseling" aka listening. I have been with too many dying people to discount what they experience. It has changed the way I live my life. KEEP CARRYING THE TORCH!

Specializes in Med-Surg, ER, ICU, Hospice.

Sheri…

The Tibetan Book Of The Dead things was on the History channel… 2 or 3 days ago. But they replay things so keep an eye out. Also, there are 2 History Channels so if you only get one you may miss it.

Leslie…

You are right of course. You’re a lot like my wife in that regard. She could probably use some help keeping me on the straight & narrow.

Michael

Specializes in IM/Critical Care/Cardiology.

Thanks for the info Michael. Are both channels called the history channel? Sounds like I don't even know how to work a TV for goodness sakes, Huh?

Specializes in Med-Surg, ER, ICU, Hospice.

One is History and the other History International.

Michael

Specializes in IM/Critical Care/Cardiology.

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

Specializes in ICU, SDU, OR, RR, Ortho, Hospice RN.
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 :)

Specializes in Hospice.
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;)

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

Specializes in Med-Surg, ER, ICU, Hospice.
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

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