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End of life decisions

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Life is fleeting. We all know this. We only get one chance at it. I think it’s safe to say that most individuals are very familiar with father time. As we get older, father time ‘visits’ our life and all those around it quite often. No beating around the bush on this one – sooner or later we all die. Sorry if this is news to you.

Most of the time death is not something we ‘plan’ for, yet we all know it’s coming (sooner or later). Maybe we all keep convincing ourselves it will happen much ‘later’?

Time passes on, old friends and family also pass on. Yet, the majority of the public still don’t ‘prepare’ for death. And as a nurse, you’ve likely seen this firsthand, maybe far to many times.

Why does this happen? Is it because some think recognizing it will happen is ‘putting one foot in the grave’?? I don’t know. What I do know is most individuals have the forward thinking to purchase life insurance and can even have a final will drawn up, but still don’t plan for the actual process of death. The one question everyone needs to ask themselves and their patients is , “How do you want to die?”

Once again, it’s not a death sentence. It’s not a way of ‘asking’ for trouble. It only allows you and those you love to understand your wants and needs for when that ‘time’ comes. Death is feared by everyone, and horribly misunderstood. As a nurse working in critical care I’ve seen my fair share of deaths, both planned, unplanned. I’ve seen life being taken when the time is right, and taken too soon. They all shared one commonality – misunderstanding and confusion. A conflict of interest and communication between patient and family.

Everyone still thinks that Hollywood is the medical standard by which all sickness and healing is measured. If it happens on TV it should happen to me (and my family / friends / loved one). Life saving measure always lead to revival and a return to normal right?? One of life’s harshest lessons comes right at the very end. Death is not like Hollywood.

Here are some ideas to ponder and share with your patients when considering end of life care for you or those you love.

What if you can’t speak for yourself during the time of crisis?

Who can and will speak for you, truthfully, honestly and without reservation. Who will think of your needs above all else. The majority of the time the patients’ loved ones think the decisions they are making are in the best interest of the patient, but in reality all they want is to not lose their loved one. So they want everything fixed.

What do you want done in an emergency?

It’s a hard one to think about, but what happens when your body can’t function without the assistance of machinery. Do you want that? There are of course a million scenarios we could discuss, but the final decision has to be yours and yours alone. Do not base your decision on someone else’s ability to survive or not survive. Just because it did/did not work for so-and-so does not guarantee your body will do the same.

When is enough enough?

This is another hard pill to swallow. At what point do you finally let nature and physiology take it’s course. Forget religion and belief, there really is a limit the human body can take. It’s been proven time and time again. Just because the procedure or intervention can be performed, does not need it should be done. There IS a difference between quantity of life and quality of life.

These are all very general questions and points to ponder. You are never to young or too old to start thinking about death. There is nothing wrong with death, other than the obvious, death is as natural as birth. Be sure you approach it with an open mind, and open heart and listen more than you speak. Being prepared for death is the most honorable thing you can do for yourself and your loved ones.

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Sean Dent

Sean Dent is a second-degree nurse who has worked in telemetry, orthopedics, surgical services, oncology and at times as a travel nurse. He is a CCRN certified critical care nurse where he's worked in cardiac, surgical as well as trauma intensive care nursing. After five years practicing as an RN, Sean pursued and attained his Masters of Science in Nursing. Sean currently practices as a Board Certified Acute Care Nurse Practitioner (ACNP-BC) in a Shock Trauma urban teaching hospital. He has been in healthcare for almost 20 years. He originally received a bachelor's degree in Exercise and Sport Science where he worked as a Certified Athletic Trainer (ATC).
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2 Responses to End of life decisions

  1. Yvette

    My name is Yvette and I am an LPN. I work for Hospice and am finding out that death is one of those things that our society is not comfortable with. I am beginning to understand more the longer I work here the difference between quality and quantity of life. Allowing someone to die in their own home may seem weird to many people but it is the way so many people wish to go, in their own home around their loved ones. It is hard switching from “keeping someone alive” in the hospital to “keeping someone comfortable until they pass” in their home.
    I love this job but I have had some major things to change as far as my thinking goes. It can be very difficult watching a person decline while their family stands by their side grieving.
    Even though I am still working through my own personal fears of death, I love this job and feel that this is where I’m supposed to be. I do my best for my patients until they move on and feel great afterwards knowing that they are in a better place pain free.

  2. Sean Dent Scrubs Blogger

    @Yvette Thank you for sharing your story and your personal view. Very well said. Keep up the good work!