nursing concepts, death and dying,

Sour Lemon · Nov 14, 2018

I need to write a small paper about an "ah-ha" moment I had in clinicals this semester. The only thing I could come up with is, one of the last senses that a person loses before they die is hearing. I accidentally asked a RN how long a certain patient had left while I was in the room with that patient. The patient was mostly non communicative. I was reminded that the patient can still hear me. . Anyway, I would like to write about that, minus patient identifiers of course. But, the requirement is I have to come up with 3 concepts dealing with this. I am lost in what is meant by this. I am a first semester nursing student. Please help. This about one of the easiest assignments I've had all semester. lol

What is the exact wording of the assignment and its requirements?

monkey3369 · Nov 14, 2018

The instructor just said the article should be about a page and half long. And it has to be on something that me go "ah-ha" during my clinical experience. Then I need to use 3 nursing concepts that go along with this "ah-ha" moment. We then need to do a 5 minute presentation on this paper.

We only had 3 clinical days. So, I didn't really get any such experience. The only thing I could come up with is the one about dying patients losing their hearing last. Nothing else happened during those days besides that. What I was thinking about is talking about patients on comfort care and that even if they cant communicate they can still hear what is going on around them. I was going to look in my Foundations book under death and dying and seeing if that section may help me.

FolksBtrippin, BSN, RN · Nov 14, 2018

The instructor just said the article should be about a page and half long. And it has to be on something that me go "ah-ha" during my clinical experience. Then I need to use 3 nursing concepts that go along with this "ah-ha" moment. We then need to do a 5 minute presentation on this paper.
We only had 3 clinical days. So, I didn't really get any such experience. The only thing I could come up with is the one about dying patients losing their hearing last. Nothing else happened during those days besides that. What I was thinking about is talking about patients on comfort care and that even if they cant communicate they can still hear what is going on around them. I was going to look in my Foundations book under death and dying and seeing if that section may help me.

Usually you get a written explanation of an assignment though. If you can post that word for word here, that will help us help you.

Davey Do · Nov 14, 2018

Near Death Experience (NDE) is an interesting subject on these lines which encompasses mental, physical, and emotional or spiritual aspects of the individual's being, monkey3369. There are LOTS of studies on this phenomena. NDEs have been discussed several times here on AN.com.

In pertaining to the various aspects of NDEs, the spiritualists think along the lines of a glimpse of the afterlife, while the physiologists tend to interpret the phenomena as the voluminous release of endorphins as the body shuts down.

Having had experienced an NDE and reading studies done by Raymond Moody in his book Life After Life and Sherwin Nuland's perspective in How We Die, I can identify with both.

On your subject of hearing, I can say that when I was in a coma for 3 weeks after an MVA, I encompassed what was said to me into sort of "dreams". Upon regaining consciousness, I could recall what was said to me, but the situational imagery was not congruent with reality.

For example, while I was unconscious, my older brother told me that I had been in a motorcycle accident. In my memory, he was standing on a bridge that was near my childhood home.

The process of death and dying is an extremely fascinating one, monkey3369. Here's to hoping you enjoy and have several "ah-ha" moments!

The best to you!

Aliens05, ASN · Nov 14, 2018

Not to jump too far off subject here but speaking of NDE, Josh Gates just did a fascinating 4 part series on the afterlife, including NDE from a handful of people and it was beyond words entertaining and incredible. This was on his show expedition unknown on Travel channel.

On topic now , when you say 3 concepts are you referring to a specific 3 concepts? Did you guys get a nursing concepts book that has different nursing concepts? I believe we had a book with a massive list of concepts if i recall correctly. A quick google search turns up some different things depending on the website in relation to nursing concepts.

psu_213, BSN, RN · Nov 14, 2018

What is meant by a "nursing concept." Considering the breadth and depth of nursing, that could potentially mean you could include a lot of things. Or, do you have a list of nursing concepts that you are restricted to.

What about communication? That can certainly be one of your themes.

Daisy4RN · Nov 15, 2018

For a dying patient think, patient, family, environment. The patient as a human with physical, social, spiritual, and psychological needs. Same for family. Environment is very important for patient and family and should be kept how pt/family would like, everyone is different but could mean changes like soft music, family pictures, enhanced visiting hours, food, incorporate cultural/spirtual, etc, things that assist pt/family and decrease stress. This is a difficult time but there are things nurses can do to help alleviate some of the stress for family and interventions to keep the dying patient comfortable. From your experience obviously pt teaching (to family) re: the fact that pt can hear them would be helpful. Hope this helps.

Daisy4RN · Nov 15, 2018

Near Death Experience (NDE) is an interesting subject on these lines which encompasses mental, physical, and emotional or spiritual aspects of the individual's being, monkey3369. There are LOTS of studies on this phenomena. NDEs have been discussed several times here on AN.com.
In pertaining to the various aspects of NDEs, the spiritualists think along the lines of a glimpse of the afterlife, while the physiologists tend to interpret the phenomena as the voluminous release of endorphins as the body shuts down.
Having had experienced an NDE and reading studies done by Raymond Moody in his book Life After Life and Sherwin Nuland's perspective in How We Die, I can identify with both.
On your subject of hearing, I can say that when I was in a coma for 3 weeks after an MVA, I encompassed what was said to me into sort of "dreams". Upon regaining consciousness, I could recall what was said to me, but the situational imagery was not congruent with reality.
For example, while I was unconscious, my older brother told me that I had been in a motorcycle accident. In my memory, he was standing on a bridge that was near my childhood home.
The process of death and dying is an extremely fascinating one, monkey3369. Here's to hoping you enjoy and have several "ah-ha" moments!
The best to you!

Sorry you had to go through that. NDE is very interesting and your experience/example of you hearing your brother is fascinating, our brains/bodies are quite a mystery sometimes.

Daisy4RN · Nov 15, 2018

Not to jump too far off subject here but speaking of NDE, Josh Gates just did a fascinating 4 part series on the afterlife, including NDE from a handful of people and it was beyond words entertaining and incredible. This was on his show expedition unknown on Travel channel.
.

Love that show and saw those too, very interesting!

Editorial Team / Admin · Nov 15, 2018

Moved to Nursing Student Assistance forum.

Golden_RN, MSN · Nov 15, 2018

I think it is presumptive to say that hearing is the last sense that we lose. I think a better premise is that patients in a coma, vegetative state or other condition that warrants them seemingly unconscious may still hear. Without knowing the assignment details, here are some concepts:

1. No matter how patients look or behave, they may hear family/staff.

2. As a nurse, encourage family to continue to talk to the patient.

3. As a nurse, tell the patient what you are doing. "Mrs. Smith, I am going to turn you onto your left side now" etc.

4. As a nurse, talk to the patient while you are in the room. "Mrs. Smith, it's a rainy December afternoon." Some sort of orientation to what is going on is a nice gesture.

5. Never talk about the patient as if they aren't there.

6. Never gossip in front of an unconscious patient. (I had a patient with a severe head injury who seemed unconscious for months. He regained consciousness & remembered some of the gossip he heard!)