It’s one of the toughest conversations a person can have in their life, but for nurses, it’s a conversation that happens more often than not.
Telling a patient or their family that their prognosis looks poor or that things have taken a turn for the worse is never easy. Even after three years of nursing training, I still find it hard and it still affects me. Although it is less than it once did.
I still come up short with things to say. I still get the fear that I sound rehearsed or robotic and I still worry that I’m going to say all the clichés in the world they don’t want to hear.
But I also know that I will be the first one to offer a hug or a shoulder to lean on if they need it. I’m also reassured by the fact that I know I’m in the best position to make such a difference to that patient’s last moments and to their family.
I know I will make sure I reposition them when they are uncomfortable, give them mouth care when their mouth is dry, I will give them pain relief when they are in pain among all the other basic essentials I can do for those at the end of their life. I will be there when they just need someone to be present with them.
If they are feeling anxious or stressed, I will simply let them talk while I listen and hold their hand. One of the community end-of-life clinical nurse specialists said it best when she stated that end-of-life care is just great basic nursing care and from my own experience, I’m inclined to agree.
Caring for those at the end of their lives is always a stark reminder that life is precious. It has confronted me – at 20 years of age – to ask myself what I would like whenever the time comes, whatever the situation may be. I’ve asked those I love the same.
”No one wants to think about these things”
What if I was involved in a car accident and it was discovered that I had permanent brain damage or if I was diagnosed with end-stage breast cancer – what would I like to do?
No one wants to think about these things but we also are not fortune tellers or clairvoyants. We simply just don’t know what can happen tomorrow.
It can be a really scary conversation to have and no one wants to tempt fate. But I’ve also experienced what the alternative is – having families squabble and argue about what a patient would have wanted instead of dedicating that time and energy on the person who is ill.
I recently attended an end-of-life conference in my trust where a speaker simply stated just how sensible it is to discuss what people want pre-emptively, and that as health professionals, we can lead by example.
Being confronted with the reality of what can happen if we don’t have these conversations or make these advanced directives has spooked me enough to do so.
What I really wanted to get across in this article is the simple fact that we’re all human. We’re all learning and we will all go through loss at some point in our lives. With staff shortages and time pressures, it’s harder than ever to provide the best we can for every single person we care for on every single shift.
But if we can let people pass away in the way they want to, in the circumstances they wanted with dignity and without stress or pain, then we can say we’ve done our best.
Have that discussion with your family members and confront your fears around dying, even if it seems like the hardest thing in the world.