Thursday 4 August 2016

Metal Nurse Spaketh: Dying Matters

"But on the most basic levels a Nurse has 2 roles
They impact people in positive ways not limited to and as far as  saving someone's life in the very literal sense
And comforting someone as their candle light flickers out."
I've worked in healthcare for a long time. Nearly 16 years now. And I have seen a lot of people dying. I've been there when the last light flickers out. I have been present when patients families are surrounding there loved one, saying goodbye one by one. I have performed more last offices than I've been able to keep count off. And here's the kicker. It never gets any easier. My experiences as a nurse aren't unique. We all go through this. Every time it happens when I'm on shift, my mind invariably turns to mortality. Mine, my children's, my loved ones, my family, my parents. We all know that life is finite, that it will end at some  point. But it never feels right, it never feels like it should happen. But it does and it will.

Thinking about how I would like to end my life. I am sure I would not want it to end in a hospital or a nursing home.



Currently we have a document called "Do Not Resuscitate". This is often done by the elderly since their chances of surviving a heart attack is so very very slim and resuscitation is brutal on the human body. There is this misconception that DNR also means that no treatment will be given for various illnesses, this is not true. DNR is only in case the patient has a cardiac and/or respiratory arrest from which they are unlikely to survive.

But what a lot of older people are also taking out alongside it is something called "Advanced Directive" or "Living Will". These can be about where they'd like to be cared for at the end of life. Or it could be about not wanting to go to hospital for treatment. Not because they think they will get bad care. But more because they feel like that they've seen enough of life and their end is coming then it should be spent in familiar surroundings.

But far too often those Living Wills are not adhered to. Family members beg for their relatives to be saved. To be cured. They put the doctors and nurses into position they shouldn't be pushed into. Because they cannot bear to be without their relatives, which is understandable. But if your relative has made their wishes known, then you should go by those wishes. I cannot think of a worse death than dying where you don't want to be. Surrounded by people in uniforms. They might be caring, but they are also prolonging the inevitable. 

I would rather die at my preferred place than at a hospital. I like most of the people I work with, but not enough to spend my dying moments with them. Far too many people die in hospital rather then their  preferred place of care. Those dying moments should, realistically, be shared by those who you love and care for. Those last moments are important, because those are the moments that stay with those who have been left behind.