Quote from Maine Critical Care
I loved the old book "Who Dies?" by Steven Levine. That book made me realize that we have very little to do with the outcomes of what we do. We do everything we can and have to let go of the consequenses. I also think we need to advocate for the dying patient as much as possible. To be able to relieve suffering and ease the fear of dying is as much part of our job as anything else.
Until my own family started to die, I really didn't 'get it' about death of my patients. Now that my grandparents and dad are all gone, I can keep my heart open. Unless I grieve for myself fully over my own losses, I am useless to my patients and their families. The trick for me is to stand with people who are going through the most intense pain of loss and separation and just stand there. That kind of pain has its own integrity and honoring it is really powerful. If I can stand in a fire with my heart open, I can be emotionally available to the family and patient in a dying situation.
If I squirm, and try to move away, I am useless to them. As long as I allow their grief to be theirs, and I have taken care of my own grief issues, their grief won't push my buttons and spiral me into a place where I have pain of my own. That way I can stay with them, support them, and feel better for having been there instead of worse. The trick is I have to keep my own energy as clear as possible. I have to be centered and not fighting my own pain. Then being with others who die is an honor and a pleasure to me.
My patient's know that I'm not the one who says "not on my shift" and they often crump and die once I get in the room!
That standing is what I think of as "holding the space" for the family or the dying person. I had the honor of doing this for an elderly woman who was dying, and her daughter who attended her death this past week. I was very conscious during our interactions while I was assessing her mother, that something more was going on. To me, it felt like time had stopped during this interaction. The daughter, as family members frequently do, wanted to know if her mother was going to die that night. I explained the expected signs of impending death, and we began to discuss what happens physically, and spiritually. Because this is LTC, and our current case load is very demanding, I would normally have only spent a few minutes for my assessment and went on to do the million and other tasks I would have to accomplish, but this was different and, it was not only out of deference for the dying process and its participants. Again, I was very conscious that time was meaningless during our interactions, and that I was "holding the space" and that it was a sacred space. Whatever time was needed for this woman to have her questions answered, and to feel that her mother was OK even though she was dying, was what was given. Because I was in that space also, I felt no pressure, no hurry, and was content to be there supporting this family. I felt centered also. This woman had a very peaceful death. It was a beautiful experience that I am very grateful to have been a part of. I know that her daughter felt validated and protected in this space.