We in hospice have a lot of educating to do

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This exchange took place earlier today on the thread about "choosing a date to die." I think it's clear that those of us who work in hospice need to work harder to educate not only the general public, but also fellow health care workers.

We withdraw fluids and nourishment allowing people to die slowly of dehydration and starvation. If they are alert we often forbid anything by mouth in fear of aspiration so no last meal. Some doctors and nurses are overly cautious of giving pain medications. We do a terminal wean on a ventilator patient to extubation and then try to decide whether the patient will die within the next hour or if they have to be moved to the floor to free up the ICU bed. The patients linger on and on. The family watches the patient gasps and gurgles. The family leaves the bedside stressed and often the patient dies alone. But, as long as we don't call our actions "assisted suicide" we can justify what we put these patients through.

What GrannyRRT described is what hospice does.
Specializes in LTC,Hospice/palliative care,acute care.
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I maintain my position that I want my opinion and my choice to be what determines how I deal with my own terminal illness which I hope to not have.

Exactly! My "feelings" don't enter into your choice. We really need to look at advance directives in this country. Every time a case like this is in the news (or something like Jahi McMath) it does open the dialogue across the country.This young woman's death WILL make a difference.

Specializes in School Nursing.

Granny- I don't think it was your quote the OP was taking exception with (because it is a very accurate statement for many, many patients in hospitals and ICUs). I think her post was to the response claiming that is what hospice does to patients... which I agree with the OP, is NOT accurate nor the way of a hospice company following the true mission of hospice.

Specializes in hospice.

Exactly, yes, newhospicern. Thank you. :)

Specializes in LTC,Hospice/palliative care,acute care.

Reading through some of the many discussions in this Hospice specialty section, it seems this area has many significant issues with staffing, medications and physicians (just like other areas) which back up the comment which was quoted and disagreed with in the original post.

True, too. We have a GLUT of agencies in this area and they are all short staffed. The largest one is preparing to go all BSN.They are in big trouble, the majority of their staff will be gone.

We work closely with several agencies in our LTC. Some make big commitments to the family and staff and never follow through. They say they "want to be a presence at the bed side at the time of death" but somehow that just never works out.

It's all about the bottom line.

Specializes in Hospice.

Well, it looks like I picked an interesting time to start a career in hospice nursing:) I just finished general orientation - tomorrow will start my clinical orientation. I have so much to learn!

I completely agree that there is a lot of education needed about hospice, all around. I also think that the events in the news lately can give the opportunity to start discussions about what hospice is... and isn't.

It does sadden me that Oregon's legislation is referred to as "Death with Dignity". One of the reasons I chose hospice nursing is because I feel that hospice offers dignity to the patients it serves - management of symptoms, focus on quality of life, and providing support. I've cared for some hospice patients in LTC and have witnessed so many special moments toward the end of life.

Welcome to hospice vampiregirl. You have a good attitude.

A good friend recently died of a brain tumor. She opted out of surgery because it would be risky and her quality of life would most likely be less. She went home and planted a garden and enjoyed her family and friends. She ended up on hospice and I was one of her nurses.

One of my first thoughts when I read about the woman who has a brain tumor and choosing to die on Nov 1 was that in a way she is, unknowingly, making my friend's journey towards death seem awful. When it wasn't.

Hospice, her S.O., her family, her friends . . . . we all made her journey as easy as possible with dignity. We managed her symptoms effectively. She died peacefully and pain free surrounded by her dogs and family.

My friend was a runner and she hiked mountains and she fished the oceans and she biked all over the country. She ran marathons and half-marathons. She rode in a race on her bike from SF to LA supporting HIV research. Two days ago, 25 of her co-workers and friends ran in a half-marathon in her honor, raising money for a scholarship for local kids who want to go into the medical field. It was my first half-marathon and I did it for her. She was so supportive of others.

Obviously, the young woman can make whatever decision she wants but she might take some time to at least talk to hospice.

Specializes in Emergency Room, Trauma ICU.
Welcome to hospice vampiregirl. You have a good attitude.

A good friend recently died of a brain tumor. She opted out of surgery because it would be risky and her quality of life would most likely be less. She went home and planted a garden and enjoyed her family and friends. She ended up on hospice and I was one of her nurses.

One of my first thoughts when I read about the woman who has a brain tumor and choosing to die on Nov 1 was that in a way she is, unknowingly, making my friend's journey towards death seem awful. When it wasn't.

Hospice, her S.O., her family, her friends . . . . we all made her journey as easy as possible with dignity. We managed her symptoms effectively. She died peacefully and pain free surrounded by her dogs and family.

My friend was a runner and she hiked mountains and she fished the oceans and she biked all over the country. She ran marathons and half-marathons. She rode in a race on her bike from SF to LA supporting HIV research. Two days ago, 25 of her co-workers and friends ran in a half-marathon in her honor, raising money for a scholarship for local kids who want to go into the medical field. It was my first half-marathon and I did it for her. She was so supportive of others.

Obviously, the young woman can make whatever decision she wants but she might take some time to at least talk to hospice.

The woman who is choosing to die on nov 1 has nothing to do with your friend, and to make her choice a reflection of your friend seems unfair at the very least. It sounds like your friend met death on her own terms, relatively painless with friends and family by her side.

That is what this woman is doing, but the difference is the symptoms and pain are making impossible to have the good death your friend did, so she is legally taking matters into her own hand. You don't know that she hasn't talked extensively with hospice, you don't know that she isn't already on hospice. Making assumptions about her choices and path really belittles her. No one judged your friend for not having the surgery, did they?

I'm sorry about your friend, and I'm glad she had the love and support she needed. Just like I'm glad the Brittany will have the love and support she needs on Nov 1.

The woman who is choosing to die on nov 1 has nothing to do with your friend, and to make her choice a reflection of your friend seems unfair at the very least. It sounds like your friend met death on her own terms, relatively painless with friends and family by her side.

That is what this woman is doing, but the difference is the symptoms and pain are making impossible to have the good death your friend did, so she is legally taking matters into her own hand. You don't know that she hasn't talked extensively with hospice, you don't know that she isn't already on hospice. Making assumptions about her choices and path really belittles her. No one judged your friend for not having the surgery, did they?

I'm sorry about your friend, and I'm glad she had the love and support she needed. Just like I'm glad the Brittany will have the love and support she needs on Nov 1.

Hi - I said "unknowingly" . . . . and I acknowledged that this was MY reaction when hearing the news. My particular bias comes from caring for a friend who died of brain cancer recently and from having just run a half-marathon in her honor. I'm surrounded by my friend right now in many ways.

To make this crystal clear, this is MY reaction when I first heard the news. I winced inside.

This thread is about misinterpretations that people have about hospice and about dying. So, I wondered if Brittany had talked with hospice and I wonder now if she's talked with other people who have brain cancer? I haven't read anything in-depth about her journey. Just "talking" out loud about how this made me think.

That's all. Really. Thanks for the good words for my friend.

Specializes in Critical Care.
Welcome to hospice vampiregirl. You have a good attitude.

A good friend recently died of a brain tumor. She opted out of surgery because it would be risky and her quality of life would most likely be less. She went home and planted a garden and enjoyed her family and friends. She ended up on hospice and I was one of her nurses.

One of my first thoughts when I read about the woman who has a brain tumor and choosing to die on Nov 1 was that in a way she is, unknowingly, making my friend's journey towards death seem awful. When it wasn't.

Hospice, her S.O., her family, her friends . . . . we all made her journey as easy as possible with dignity. We managed her symptoms effectively. She died peacefully and pain free surrounded by her dogs and family.

My friend was a runner and she hiked mountains and she fished the oceans and she biked all over the country. She ran marathons and half-marathons. She rode in a race on her bike from SF to LA supporting HIV research. Two days ago, 25 of her co-workers and friends ran in a half-marathon in her honor, raising money for a scholarship for local kids who want to go into the medical field. It was my first half-marathon and I did it for her. She was so supportive of others.

Obviously, the young woman can make whatever decision she wants but she might take some time to at least talk to hospice.

I don't think you can really compare the clinical course of two people with "brain tumors" since "brain tumor" is very non-specific. There are more than 120 different types of brain tumors, and of those there different sub-types. Depending on the specific type/sub-type of brain tumor, one person with a terminal brain tumor might be able to expect a fairly comfortable progression to death, and others might likely experience the opposite.

Specializes in Emergency Room, Trauma ICU.
Hi - I said "unknowingly" . . . . and I acknowledged that this was MY reaction when hearing the news. My particular bias comes from caring for a friend who died of brain cancer recently and from having just run a half-marathon in her honor. I'm surrounded by my friend right now in many ways.

To make this crystal clear, this is MY reaction when I first heard the news. I winced inside.

This thread is about misinterpretations that people have about hospice and about dying. So, I wondered if Brittany had talked with hospice and I wonder now if she's talked with other people who have brain cancer? I haven't read anything in-depth about her journey. Just "talking" out loud about how this made me think.

That's all. Really. Thanks for the good words for my friend.

I doubt she just took the diagnosis and ran right to death with dignity. Like I said for all we know she is currently on hospice to help manage the symptoms till Nov 1. I can't imagine having to face this type of situation and I'm glad that Brittany and your friend were both able to choose what would be best for them.

I don't think you can really compare the clinical course of two people with "brain tumors" since "brain tumor" is very non-specific. There are more than 120 different types of brain tumors, and of those there different sub-types. Depending on the specific type/sub-type of brain tumor, one person with a terminal brain tumor might be able to expect a fairly comfortable progression to death, and others might likely experience the opposite.

Oh my gosh, really? You are going to yank my chain about that? :facepalm:

I meant brain cancer. Cancer of the brain. A terminal illness.

Specializes in Emergency Room, Trauma ICU.
Oh my gosh, really? You are going to yank my chain about that? :facepalm:

I meant brain cancer. Cancer of the brain. A terminal illness.

Wow, the other poster was just trying to point out that there are a lot of different types of tumors and cancers, all with different symptoms, even if they are both terminal. I think you're overreacting a bit because this is so personal for you.

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