Death is often not spoken about in our communities and so when it hits home, we don’t know how to react. I have witnessed many deaths since the start of my nursing career and I really can’t say that it gets easier. Nurses whom I have worked with would say, you reacted as best as you could or that after so many deaths you just know how to deal with it.
I remember last year, I was looking after two dementia patients in a hospital setting and within a week they both died due to rapid deterioration. I grew fond of these two individuals and so I was deeply saddened when I heard the news of their death. Towards the end of their lives, both became distressed and would not keep their clothes on. One had to be sedated for long periods of time as she would be aggressive towards myself, the staff and other patients. I did not feel that these two had a dignified death and was sad to see them in such as state. No one spoke to me about how I felt or had any sort of discussion with me about the death of patients. I left to handle it on my own. During the next few weeks, I thought hard about death and attempted to handle it my way.
Moving on to my community placement. We visited a gentleman who has been battling cancer for some time now. He came to the end of his battle, where the doctors have said he has only a few days left. I had visited him four times during my placement and have seen him deteriorating. I was quite saddened by this case because I grew fond of him and his wife, they were a lovely young couple that loved travelling and had more things to to together. During his last days, we saw that he was growing more anxious, and could no longer get out of bed and was in a lot of pain. He told his wife not to call the ambulance and that he if it was time, he wants to pass away in his house listening to his favourite songs. He had made a playlist of his songs and his wife put the CD in. We came to visit as his pain was unbearable, we inserted a syringe driver to deliver pain relief slowly. And also to support his wife, letting them know what happens next. We made preparations for his death, the ambulance are not to be called. The palliative team in the community will be available for them.When we left, I was feeling sad. But what made the situation better was that this gentleman was happy as someone who as about to die can be. He was going to pass away in his home. With his wife beside him. Listening to his favourite music. I thought he was going to die with dignity, without pain and in his own bed. Of all the deaths I had encountered so far, I felt this was the most dignified.
What I learnt from these experiences was that communication was key in delivering the best care for a palliative patient. This results in them keeping their dignity and dying with comfort. In hospital I found this to be difficult as people seem to be busy and rushing. What I want you to take from my reflection: listen to what the patient wants when they are coming to the end of their lives, they still have a right to choose whether they should die in a hospital bed or in their home.