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STUDENT EDITOR BLOG

'People die alone and scared whilst in our care - and it is unacceptable'

Victoria Abrahams
  • 4 Comments

Now I’m in the middle of my third year I’m finding that I’m reflecting more on why I started a career in nursing

I think remembering why we’re doing it helps keep us focused during the darker days.

“As with many couples they’d rarely spent any time apart and despite us visiting daily she fell into loneliness”

My beloved Grandad died suddenly a few years ago and once he passed away my Gran was left somewhat alone. She’d broken her hip the year before and her mobility was reduced - as was her appetite for life.

As with many couples they’d rarely spent any time apart and despite us visiting daily she fell into loneliness. We got carers in to help with things she wouldn’t want us helping with. In all honesty the carers were dire. We changed companies so many times but the care was often worse. One day they didn’t visit her at all  because they were “busy”.

As my gran was a diabetic it was lucky that family dropped in each day and we found her still in bed. The company claimed it was a management decision not to inform us they weren’t visiting - charming! An older person living alone with no family near to fight their corner might not have been as lucky as my gran.

These incidents got the cogs working in my brain.

My gran deteriorated fairly fast.

In my heart I’ve always thought she wanted to die. She didn’t want to live without my grandad, trapped in the house, having to rely on others.

When she was admitted to hospital we hoped they’d help her and then perhaps we could move into a residential home. She improved and they told us to prepare for discharge. No support was provided and we had to find a place for her on our own.

“My gran had been calling out in distress for her family [and] was sedated to “settle” her”

The following day my dad received a call from my uncle who told him to get to the hospital as soon as possible. When he arrived he found my gran close to death. She had gone through the process of dying alone. When I arrived she was gone. The nursing staff hadn’t called the family. They had no excuse.

The ward was staffed by agency staff and they hadn’t acknowledge my gran had family that visited daily. Other patients told us my gran had been calling out in distress for her family most of the morning and that they were then told she was sedated to “settle” her.

”I am going to make it my life’s work to ensure that the people I care for get what they want at the end”

I’m still distressed to this day that my gran died alone and scared. You only get one chance to help someone have a comfortable death. You can’t take back what you do in those last few days and hours.

These thoughts are getting me through the final few months of the course. However you feel at the moment please remember why you’re doing nursing and what difference it is you will make.

I’ve now got a qualified role in a hospice and I am going to make it my life’s work to ensure that the people I care for get what they want at the end.

Vicki Abrahams is Student Nursing Times’ adult branch student editor

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  • 4 Comments

Readers' comments (4)

  • michael stone

    Hi Vicki,

    Some years ago, I did a bit of 'canvassing' to try and discover why some nurses choose to work in end-of-life care. I am fairly certain that the replies all went on Dignity in Care, but it was years ago and off-hand I can't point at exactly where.

    But I am fairly sure, that one nurse said she moved into end-of-life care, because she had been working in a hospital, where patients were dying alone - she had 'wanted to be able to [just] sit with these dying patients' but she wasn't able to do that.

    I'll see if I can find the DIC piece - not that links to DIC seem to post correctly here in NT !

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  • michael stone

    Hi again Vicki,

    I've tracked down my 'canvassing' on Dignity in Care.

    Links to DIC don't seem to post correctly here in NT, but if you go:

    http://www.dignityincare.org.uk

    Then click on 'Discuss'

    Then click on 'View the Dignity Champions forum'

    Then look (near the top of the list) for '3 Champions Searches about end-of-life issues' you will find the piece.

    I asked 3 questions, and the third of the questions was:

    3) Why do nurses and professional carers who choose to work with end-of-life patients, make that choice ? What motivates them ?

    One of the people who responded, said something very similar to your own story:

    Dear Mike,

    Firstly unfortunately I no longer work within the area of end of life care due to funding issues. Basically the funding ran out and sadly sometimes EOL is not always as important as other areas of healthcare.

    My particular interest came from working on the wards, during a very busy late shift we were short staffed as usual and a lady was dying in one of the bays. I managed to get 5 minutes to sit with this lady and hold her hand, she didn't have relatives but the majority of the shift I couldn't get to her and sadly she died alone behind a curtain. Now some
    people would say that she was semi conscious and not aware but I wanted to feel that I had made a difference to her death just by being there.

    Also I feel that eol and dying are just as important as birth and the memories left behind for the relatives is vital that a good death happened as this is the lasting memory.

    These are obviously my own reasons why I choose to work within this particular area of healthcare and hopefully there is the ideal position for me just around the corner.

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  • Thank you so much for your reply Michael. I'm sad that it happens. At the time I very much blamed the nurses. I was angry and I fought hard to get the ward she was on shut down - it was a 'temporary' overspill ward. I'm much more pragmatic now. Now (with hindsight and a clearer mind) I doubt the nurses did it on purpose and I'm sure now they went home feeling guilty and sorry. These things will continue to happen until we get clearly focused leadership. I feel we change tactics depending on the next whim of politicians that don't know what they're doing.

    Thank you again for your kind and informative reply. Vicki

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  • michael stone

    Thanks Victoria, the problem with hindsight, and it isn't what is applied at the time - quite how people, and especially 'systems', can usefully 'learn from hindsight' is an interesting issue.

    Can you tell me, did you find the piece on DIC ?

    I can recall, finding the replies I received very interesting, at the time.

    I'm usually involved in 'much more nerdy' debates, such as the one in the rapid responses to a recent BMJ article - the series of responses can be found at:

    http://www.bmj.com/content/353/bmj.i2452/rapid-responses

    By the way, I'm old, grumpy, and not really into 'social media'. But I recently joined Facebook, specifically to set up a Group page which I've titled 'A Discussion Group to try and improve End of Life care and Behaviour', which is at:

    https://www.facebook.com/groups/1722859091289711/

    If you or any other student nurses you know, would like to join the group and write in it about end-of-life issues, then I would be very pleased for that to happen. What I wrote for my group in the 'description' section (see below), does include my 'nerdy' legal thing - but, we need much more discussion, to really improve end-of-life behaviour:

    DESCRIPTION (for my EoL group)

    The intended purpose of this group, is to discuss the issues which dying patients and their family and friends encounter, when interacting with professionals such as doctors, nurses and 999 paramedics. I am aware that many professionals are interpreting the law [and the main law which affects dying patients in England is the Mental capacity Act] in a way which seems incorrect if you read the Act from the patient/relative perspective.

    I consider that discussion between all parties is necessary, if the behaviour and care for dying people is to be improved: not relatives talking to other relatives, and nurses talking to other nurses, but patients, relatives, GPs, nurses, 999 paramedics and everyone potentially involved in end-of-life, talking directly to each other - these 'perspective differences' can only be tackled, if first they are properly identified.

    I am not interested in discussing things such as the existence or otherwise of 'an afterlife', and neither am I interested here in discussing 'assisted dying' - I am interested in other issues (notably 'should family carers be trusted ?' and what exactly the MCA does say, about 'best interests' and Advance Decisions - and, whether the MCA really does promote 'advance statements' [the answer is 'no, it doesn't']).

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