palliative Archives - Shania Lynn

“Life is pleasant; Death is peaceful. It’s the transition that is troublesome”- Isaac Asimov

Palliative care is a field of medicine that focuses on an individual’s and family’s quality of life as they suffer from a chronic illness. It involves ensuring the individual is knowledgeable about their disease process, has all of the resources they need to succeed, and can ultimately end with Hospice care.

Palliative care candidates are those who suffer from chronic illness such as heart failure, COPD, multiple sclerosis, cancer, etc. Hospice is a subset of the umbrella of palliative care, but not all palliative services involve hospice.

Palliative care enables individuals to have the best quality of life for their illness. With the knowledge they need to succeed, individuals with palliative care often live longer, go to the hospital less, and have a higher life satisfaction.

The team involves MDs, RNs, social workers, case managers, and more. They all work together to provide an extra layer of support and listening ears. The team may assist with arranging resources, pain control relating to the illness, advanced care planning, end of life wishes, among many others things.

Today, I got the opportunity to witness a beautiful conversation between a palliative care nurse and a wife of her very ill husband at the bedside in the ICU. The RN opened the conversation to the wife and the wife had unrealistic beliefs regarding her husband’s medical condition. The RN was able to answer questions regarding his diagnosis/prognosis, provide options, pray, and truly listen to the wife’s concerns. Here are a few questions/concerns the wife had that were answered:

What will happen if we turn off the machines?
Will the doctor say, ‘I told you so’?
Will he gasp for air?
How will I live without him?
I never lost hope in God. This just isn’t in his plan and that is so hard.
How do I tell my 3.5 year old granddaughter that papa is not coming home?
How do I call and start this conversation with my family?
He isn’t getting any better, but my heart hurts so much.
I know he wouldn’t want to be on life support, but how do I know when to stop it?

The Palliative Care team gives families and individuals the opportunity to discuss their concerns in a safe environment and the support when they may not even realize they need it. It is a heartbreaking field to be in, but it is truly a calling and the opportunity to witness this interaction was such a blessing.

Do you have any patients or family members that may benefit from palliative care?

Until next shift,

Shania

“What matters is not the meaning of life in general, but rather the specific meaning of a person’s life at a given moment” – Man’s Search for Meaning by Viktor Frankl

Working with many hospice families on the medical floor, there are so many stories that cannot be explained by science, alone. Each death is different, surprising, and often, beautiful. Supporting a grieving family as they wait and watch their loved one take their last breath brings me to the core of nursing care. No computer, no doctor, no book, and no prayer can comfort like the personal touch of the nurse.

I have seen oxygen saturations in the 70s jump to 100% as a family member walks in to say goodbye. I have seen patients who hang on until they find their last bit of closure whatever that may be before crossing over. I have seen obtunded patients open their eyes and use all of their remaining energy to say a few last words to their family members before closing their eyes for eternity. Death is and can be beautiful.

The first death I experienced was when I was still on orientation. It was a man who battled many years of cancer. He was literally skin on bones. His daughters and wife were at bedside, and it is the family that breaks your heart the most. They sat around his bed and talked about all of the memories that they shared together. They showed me a picture of him, a healthy 180lb man, now a 60lb man laying in the bed. Those are images you can’t forget.

Caring for Hospice patients and families is some of my favorite cases because of how real and genuine the emotions are. At the bedside, nothing else matters except the love and belonging the family has left.

Some families grieve with anger, some with prayer, some with thankfulness, and some with silence. Some patients wait for families to step out of the room before passing, some wait for a bath, some wait for a blessing, and some go suddenly.

It is crucial to maintain the compassion for each of these families. It is easy to appear too busy or even to become insensitive to these life events. The most important thing for palliative care and hospice is to simply be present. Sit down and listen to the family wishes and hopes. It is okay to cry with them, I often do. Cry, and then carry on. Focus on each patent encounter individually. One room at a time.

Death is a beautiful thing.

Until next shift,

Shania

Palliative Care: A Day in the Life

Death: You cannot doubt God

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