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STUDENT BLOG

‘Accept you are powerless. That's the skill to end-of-life care'

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I had never been exposed to death, either personally or during my first year of training so I was incredibly worried about stepping into the unknown with a placement on a palliative care ward

I wasn’t sure I could handle the idea that my patients wouldn’t get better and go on to live long, healthy lives. How would I cope with the mixture of emotions that would undoubtedly follow the death of a patient?

”No amount of words can prepare you for caring for a patient who is weak, vulnerable and scared of dying”

As part of our training to become nurses, the Nursing and Midwifery Code becomes our bible and it is this we encapsulate and practice as student nurses throughout our journey to qualification. But the past eight weeks have brought the realisation that until you have actually had the experience of nursing someone in their final days of life, no amount of words can prepare you for caring for a patient who is weak, vulnerable and scared of dying. The feeling is overwhelming and simply too hard to describe.

During my time on the ward I cared for Arthur who had four weeks to live as a result of a devastating cancer diagnosis. I became closely involved in Arthur’s care and developed a strong bond with him. Without any family or friends, his vulnerability saw him feel the need to develop a professional yet friendly relationship with the people who were caring for him.

”I knew it was my role to provide the comfort and support that Arthur needed but at the same time his condition made me feel utterly powerless and intensely frustrated”

My growing attachment to Arthur and his care meant I became increasingly aware of his regretfully shortened life. I watched him deteriorate in front of me shift after shift, losing the ability to care for himself. He could no longer prop himself up in bed, eat or drink and vomited constantly. I knew it was my role to provide the comfort and support that Arthur needed but at the same time his condition made me feel utterly powerless and intensely frustrated.

”I could sense the fear in his eyes and voice when he would persistently ask if the medications I was administering would make the illness go away”

The nature and role of the palliative ward soon struck a chord, especially when it came time to face the fact Arthur was unquestionably now in the end-of-life stages of his illness and palliative medications became a priority in his care. The last part of Arthur’s care was the most difficult as a nurse; I could sense the fear in his eyes and voice when he would persistently ask if the medications I was administering would make the illness go away.

A few days later when I wasn’t on shift, Arthur passed away peacefully surrounded by the familiar faces of the healthcare staff who had become fond of him.

The hardest part of caring for Arthur in the end stages of his life was that no matter how much you tried to explain, he could never understand why he had his illness or why it wouldn’t disappear. However, providing a listening ear, a hand to hold in the final weeks of life and a dignified death has made my progression into the nursing profession feel tangible.

These past eight weeks have taught me that caring for a patient isn’t something you can learn from words, only from experience.

Laura Gunn is a second-year adult nursing student, Keele University.

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Readers' comments (1)

  • We all find our way of dealing with this one. i am not prepared to behave as if i am powerless and will pull out all the stops to ensure the patients journey is as dignified and tranquil as possible with symptom control in place, close family involvement and a nice calm attitude.
    It is very difficult but i call it the art....even when they have passed over it is also very important to carry on after care as part of the journey and help the families morn and enable them with the mundane side of things as well as giving them time to say good bye to their loved ones.
    i am glad i trained as a nurse as i can make a difference and am aware some feel uncomfortable with this topic. i am interested in spirituality and it is a tetchy one of some. it is also inevitable we are all going to die and would like to see more open discussion-more training and communication in this topic.

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