I'm about to begin a Masters research project about ICU nurses talking to brain-dead patients (oh the joys of ethics approval committees!). My interest in this started when I read 'Rethinking life and death' by ethicist Peter Singer - he described observing nurses in ICU talking to brain dead patients as though they were alive, and from that decided they did it because they didn't understand that the patients were clinically dead.
I think that nurses who talk to their brain dead patients do it for a variety of reasons, which may included (but are not limited) to issues about reconciling the apparently living body (sensory knowledge) with knowledge about brain death (intellectual knowledge). I don't work in ICU, though I do work on a nero unit; I always talk to the unconscious, and sometimes talk to patients who have died.
I was at a conference in the UK last year, and an ICU nurse educator said that she not only never talks to brain dead patients, she corrects any students who do. However, one of the anaesthetists there always speaks to his brian dead patients. They're ruining my research!
What do you all think? This isn't something that will make it into my thesis, BTW, but I'm interested in what you think about the project idea, and about your own practice.
I have never had the opportunity to be in this type of situation but my feelings are that I would talk to them. I am someone who believes in afterlife and meeting again one day. Even though they are dead who can say that their spirit isn't still around. Just my 2cents.
I want to thank everyone for their thoughtful and interesting responses. I'm in the final stages of my thesis - I am so very, very over it by now! - and this discussion has been amazingly helpful. I'm thinking about revisiting the area for a PhD in 2006, so if anyone has further comments, please keep them coming!
in a ltc facility there was a woman in a persistent vegatative state...during state survey the nurse was wrote up for failing to talk to resident while doing a tube feeding...
those who believe that the nurses were so stupid that they could not see the condition of the patient are just giving them a pat on the back...the big me little you syndrome
I really do believe that a person should be spoken to no matter what condition they are in. They may not be able to hear us, but it helps us remember that they are a human being not an object and they should be respected in life and death.
And how are we supposed to know your personal beliefs??? I may know that the Jewish faith is listed....but does that mean that you are a practicing Jew? And....what's the harm in asking??? Just because you are Orthodox...does that mean that we should automatically not even ask??? How ridiculous is that? How ridiculous of you to even suggest it!
NeuroICURN
Well, maybe you could ask a clergyman of SOME faith. They would probably recognize that the kind of Orthodox the poster is is NOT Jewish, but Christian. (The Greek population is primarily Greek Orthodox; the Romanians, Romanian Orthodox. There might have been a few other clues: Jewish clergyfolk are called rabbis and not priests; Jews generally don't talk about "salvation"; and why would a Jew compare himself to Roman Catholics?
And when someone is facing the death of a loved one, yes, there can be harm in asking. Like I say, why not try asking a clergyperson, who could put you in touch with the clergyperson from that faith, of whom you could ask questions. Really. Is a few minutes like that such a big deal when someone is facing the death of their loved one???
As for heart transplants, Orthodox believe that the heart is where sanctification takes place. Since sanctification is the "work" of the individual person (in cooperation with God), transplanting that sanctification into another person is deemed incorrect. May seem stupid to you, but is that what matters?
Always....I figure even if someone may not be able to comprehend, they might hear or just feel some sort of comfort. And there have been times (rare) when a patient who has been determined brain dead has not been. As for me, I took care of a coma patient for several months and along with talking to him as I washed him up and cared for him, talked to coworkers who were in the room with me helping. When I talked with them, they would chuckle when I would excuse myself to him for talking over him or mention the co workers name and that I we were going to have a conversation while caring for him. When he did wake up, he asked me about my son and many aspects of myself and various co workers who had been talking either to him or each other throughout the duration of his care. It amazed me. And Lou Gerigh?ALS patients can comprehend because you can see it in their eyes...I just imagine how I might feel if it were me.
Sometime ago while a new nurse, I had a CVA patient who everyone thought was brain dead....There is a piece here in the threads about him ( pseudonym) called, "Mr. Albercoss"....I had the feeling then and now, that he "knew" I was there...
KR
307 Posts
I talk to all my patients regardless. And yes, that even includes my patients that are dead, that I am doing post mortem care on. Hope this helps!