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Best of Blog: Moral Distress in Healthcare: the Value of Dying with Dignity Pt. 2

March 17, 2013 by admin  
Filed under Best Of Blog, From Our Members

This is the second of a four-part series by 10 Million Clicks For Peace contributor, Corry Roach. We will feature the remaining two parts over the next two weeks.
Part 1 is here
.

In my work, I have had many of these quiet, calm discussions, and I try to listen with every cell of my body and spirit. I want to be sure that they are sure.

She was sure.

In expressing this fact to the nursing staff a few days later, they were unaware of this choice, despite her obscene physical state and the fact that treatment had now been stopped.  Although our continued discussion verified the accuracy of my sister’s condition, I was surprised that there had been no pastoral care intervention with regard to this. I was grateful for our attendance…

A few days pass. She was left to thrash about in semi-consciousness on bed rest now, until someone realized what the thrashing really meant, since she could no longer communicate verbally. She was prescribed Fentanyl breakthroughs every six minutes for pain, but had no way to push the button as her hands were contracted and she was no longer lucid.  Delirious, she was now bleeding from her nose, mouth and eyes. We cannot begin to clean anything, as she almost spontaneously bleeds.

Watching this, I am beyond speech. There are no words

If she was a dog, some compassionate person would have euthanized her by now to put the dear woman out of her misery.

I was so immersed in my compassion and attention to my sister’s constant needs; I had no room at all for mine. I held off, strong and caring without my own pain getting in the way…until the next day at home, when I could wail, cry and rant on my own. And let go; again and again. I was aware I needed to clear my emotions in preparation for the next visit, as they had no place when I was with her. I didn’t separate my roles as mother, sister or nurse in this situation; I just knew I was of greater value utilizing my professional skills along with my love. This, after all, was long ago not about me anymore…

As an RN who has worked in the field of death and dying for the last 25 years, I observe how we deal with death in our western culture. We regard it as a bitter enemy to be feared, fought and avoided at all cost; yet my personal and professional experiences tell me that death is not the enemy at all…

It is not the greatest tragedy that my baby and my sister died; I can accept their death. The issue I struggle with is how they died; heroic obscene struggles of suffering that made the alternative of death a gift of peace.  How sad; when we somehow regard it as a failure when all interventions are ineffective and death prevails.

I feared my sister’s body would be in the early stages of rot and decay, just as my baby’s was by the time she finally died. Why? How is it possible that this happens in 2008?

As caregivers, we sometimes lose focus from the person who has the disease, and work in isolation on curing, killing or healing a disease with which the patient is afflicted.  We forget the package deal; the two come together!  The more we advance in computer technology, the less the meaningful interventions of contact or personal care our patients seem to experience.  We become so focused on analysis of implications and indicators of pathology that we forget about the person as a whole.

In those nine hours of caring for my sister that one day, I never sat down once in attending her constant needs.  Nurses came into the room only to deal with the intravenous solutions and medications.   No one touched her of course; only one person spoke to her directly.

As a nurse, I can understand this; we need to assure medications and their administration is done efficiently and on time.  My sister had eight lines running at the time.  Again, it’s an observation, along with some deep concerns about what it means to be a nurse these days.

I’ve been around a long time, and remember giving back rubs to patients… That was another era indeed!

However, I am left helpless and bereft, as a human being and as a nurse.  This is accentuated by the fact that I remember there is a better way; it has been lost along with that personal bedside care that has been swallowed up in technology.  There is nothing that can replace the calm, soothing presence of a caregiver at the bedside of a dying patient.

In our CARNA nursing library, there are four books on the topic of death, dying and bereavement. Four. I am stunned at why we are so inept in caring for the dying in our culture. We need to take lessons from those ancestors and cultures that live so close to the earth; those who recognize grace, humility and acceptance when the right to exist has passed and the right to die has begun. Death is not the enemy; ignorance is!


Corry Roach’s website, www.ByGraceofMourning.cam offers personal and professional insight and education into the grief journey for those who mourn, from professionals to the bereaved and all who love them. Although the main focus is bereavement, loss of loved ones (or parts of ourselves) to terminal illness, dementia, aging, divorce/relationships/addictions are also discussed, as well as how to offer support. Grief resolution within ourselves is imperative, enriching our lives with personal empowerment as we work toward a life of spiritual meaning and inner peace.

Julian Kalmar and Rick Beneteau want to know if you've got what it takes to step up and be a leader in the new world transformation. CLICK HERE to find out.

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