Spiritual Beliefs and End of Life Care

[homedoc]

To massrn116:

I agree with you, but I respectfully disagree with my colleague and the article about "doing everything just to make the family think that you have done everything, even if it is futile".

It is ultimitely what the patient would want. If a patient wants "everything done" after being fully informed, then that certainly is the patient's right (autonomy). If the attending physician has fully explained the situation and prognosis to the patient and family, most of the time they will opt for comfort measures. There will always be a small percentage who want "everything" regardless. Unfortunately, I believe that my physician colleagues fail to prognosticate and communicate well to the patient and family. Prognostication is a lost art for physicians. We are not trained well in end of life care and don't feel comfortable talking about dying. We often feel like failures if we don't "cure" the patient. The Hippocratic Oath says that "our sole purpose in medicine is to cure.." I hope someday that we can change the "u" in "cure", to "a" for "care". (That's on my bucket list).

Keep up the good work. God Bless, homedoc.

[TonyaM73, ASN, RN]

homedoc,

If a new nurse is interested in Hospice, what would you suggest we research during the time that we are gaining experience on the floor? I absolutely love our Hospice nurses at the LTC center that I work in. They have suggested that I look into Hospice when I have gained my experience. I was just wondering, from a Hospice doctor's perspective, what you would suggest I read.

[tnbutterfly - Mary, BSN]

homedoc.......thank you so much for giving us a physician's perspective on end-of-life care. I really value your thoughts and opinions, especially in light of your vast experience in this area.

I totally agree to changing the "cure" to "care". I would think that all patients want to be cared for, even when they realize that they are beyond a cure.

I would like to invite you to share your views on a similar topic in another blog thread entitled Who is Responsible for Discussing End-of-Life Treatment Options?

[jasonakaremy]

Everyone has there own view but I think it should be the individual and family's choice.

[homedoc]

To TonyaM73,

I am happy that you are interested in Hospice! You might want to check out HPNA.org (Hospice and Palliative Nurses Association) for more resources, such as "The Nature of Suffering and the Goals of Nursing", and "To Comfort Always: A Nurses Guide to End-of-Life Care". I also would encourage you to talk more with your hospice nurse friends. They probably have a favorite book that they could recommend and let you borrow to read.

Stay the course! You have a very special calling. God Bless, homedoc.

[TonyaM73, ASN, RN]

Thank you homedoc. It took me a while to see your post, but I will check out the resourses that you have mentioned. I have been promoted to evening supervisor so I don't have contact with the Hospice nurses like I used to. I will have to seek them out when I have my experience under my belt. Thank you again for the information.

[Aurora3834]

I want to thank everyone who answered my questions. I suppose I had to reslove my own issues about death and dying before I could truly accept what I was doing. I think that when I young and excluded from the dying process of my grandfather it left a scar that was ripped open that night. Since then I have found a sense of peace and am ok with everything now. I am now ok with my prn roxanol orders. I really appreciate the out pouring of support and information I got on this subject. Thank you all for everything.

[tnbutterfly - Mary, BSN]

Aurora,

You might find it helpful to read the blog entitled

Self-Assessment of Your Beliefs About Death and Dying