How far can a hospice nurse go, spiritually-speaking?

elkpark · May 31, 2008

As healthcare professionals, we are there to support their beliefs and defense mechanisms, not to proselytize.

If someone asks you to pray with them, etc., that is up to the individual nurse whether s/he feels comfortable with that. However, it is never appropriate to push our individual beliefs on our clients. Please keep any "good news" to yourself at work.

leslie :-D · May 31, 2008

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?

pain/suffering?

going to hell because of certains sins while living?

alienation?

regrets?

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 death...at 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.

leslie

doodlemom · Jun 1, 2008

perfect answer Leslie!

MQ Edna · Jun 2, 2008

I agree with the others that it is not right for anyone to try and push their beliefs on anyone else, especially those in vulnerable situations like the dying patient. Being a Christian, like you, I can share with you a Scripture that does apply to the hospice setting and any situation in life and that is, "Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect...." 1 Peter 3:15 (the operative word being "asks" along with the display of sensitivity to do so with gentleness and respect).

GardenerGirl · Jun 2, 2008

Thanks to all of you who commented on my question. Of course respect and sensitivity is paramount in a situation like this. I don't plan to "push my beliefs" on anyone. I will never violate the patient's trust and take advantage of my position. I know it is a privilege to be their nurse, and to be their agent in comfort at this most difficult time of their lives. I only asked how much could be said if a patient was terrified of dying. I don't think anyone addressed that part of the senerio. The scripture that "Irishpooh" quoted was right on the money. Thank you for taking the time to look it up and for including it in this thread. That was what I was hoping for; sound advice. Thanks to all of you and I'll be seeing you on the forum.

Cheri

MQ Edna · Jun 2, 2008

Congratulations on your new job and welcome to the forum!!! God bless.

elkpark · Jun 2, 2008

I think that we have "addressed that part of the scenario." I certainly intended my response to. Regardless of the situation, whether it's just another quiet, routine day or someone is "terrified of dying," the nurse's role is to support whatever beliefs and defenses the client has, not to introduce her/his own beliefs.

If you feel strongly that it would be too strong a personal conflict for you to not share your personal beliefs (your "good news") with your clients in difficult, painful, emotional situations, please think very carefully about going into hospice nursing. I suggest you also discuss this with your supervisors at your new job, and establish very clearly with them what the expectations and boundaries are from the agency's perspective.

doodlemom · Jun 2, 2008

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.

leslie :-D · Jun 3, 2008

Thanks to all of you who commented on my question. Of course respect and sensitivity is paramount in a situation like this. I don't plan to "push my beliefs" on anyone. I will never violate the patient's trust and take advantage of my position. I know it is a privilege to be their nurse, and to be their agent in comfort at this most difficult time of their lives. I only asked how much could be said if a patient was terrified of dying. I don't think anyone addressed that part of the senerio. The scripture that "Irishpooh" quoted was right on the money. Thank you for taking the time to look it up and for including it in this thread. That was what I was hoping for; sound advice. Thanks to all of you and I'll be seeing you on the forum.
Cheri

i really hope i am misunderstanding/misreading your post.

citing scripture (any scripture) to a terrified pt is inappropriate.

and yes, we did answer your questions.

i'm thinking that you just didn't get the answers you were 'hoping for', except for irishpooh's, who also referenced scripture.

if this is the route you choose to go, despite professional input stating otherwise, i'll tell you, i am bothered by it.

if you're intent on using scripture, please, stay away from our hospice pts.

they are vulnerable and frail enough.

leslie

Long Term Care Columnist / Guide · Jun 3, 2008

I remember being in the hospital a few years ago with chest pain of a suspicious nature. Even as a nurse, I was scared spitless because I was experiencing the symptoms I'd seen so many times in my career.......and then some well-meaning but none-too-diplomatic lady stopped by to visit my roommate and, evidently, to bring the "Good News" to me as well.

"Dear woman," she began, "have you found God yet?"

I couldn't help myself. Dang me for watching Forrest Gump too many times.......

"I didn't know I was supposed to be looking for Him," I shot back before rolling over and trying to go to sleep.

The take-away lesson is, of course, to let the PATIENT guide us as to how to approach end-of-life concerns, especially in the spiritual realm. I'm not a hospice nurse, but even I know better than to initiate conversations with patients about such personal issues as religion and faith unless they make the first move. It's the respectful thing to do.

caroladybelle, BSN, RN · Jun 3, 2008

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?

I expect to get out that Koran and give them the good news about Allah, and the goodness of him in sending his great prophet, Mohammed to teach us.

At least, I presume that is what you meant.....wasn't it. I mean, what other great news could the dying patient want but the "Truth"..... What other truth is there?

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One person's "truth" and good news that they "know" is correct is another's myth and harmful belief. Most anyone, no matter how faithful and assured of their own beliefs in their G-d, worries at death....how their loved ones will go on, anxiety about the unknown, about pain and discomfort while dying, and about conflicts left unresolved. This has nothing to do with lack of Faith...I have seen the very religious be as anxious as atheists at times, about death. As a nurse, I focus on those issues. I do not bring up my beliefs about my "good news" unless questioned directly by the patient, and even then, I only say what I believe in, and in NO WAY, preaching what they need to believe. Nor do I indicate that they "have to " believe that to have peace after death.

If you feel that you know the only TRUE "good news" and are so moved by generousity of spirit that you MUST always share these beliefs with everyone, regardless whether it is appropriate or not, please think carefully about whether you should be in hospice. It is inappropriate to proselytyze to the dying patient. A much better option is parish nursing, doing occasional mission or volunteer work that is religiously based.

Remember the Golden rule. Would you want a satanist/wiccan/muslim/hindu trying to convert you as you lay dying? Because their "good news" is just as much truth to them, as your is to you.