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The Importance of Creating a Good Death

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Most of us have seen it. Some of us have even felt it. That moment. It’s the moment where a person leaves their body. Where their face goes slack, their breath ceases, the electricity goes out of the air, and they are finally at peace. Death in nursing, particularly in critical care, is an inevitability. We can fight it, keep it at bay for a while, but eventually there is nothing else to do.

As nurses, we have a special role in caring for the dying patient and their families. It goes so much beyond providing privacy, sandwiches and hot coffee. Those things merely get people through a terrible day. Our role, whether we know it or not, is to aid in the creation of a good and comfortable death. If you work in a population where you see death frequently, it’s easy to forget how it feels to be the one losing someone. To have your last moments with your loved one be among strangers, in a cold place with everyone watching. Until very recently, I had forgotten.

I have always had very strong feelings about how death should be handled. I make sure to remember that they’re not simply dying, but their life is ending. The life that we never saw. The life filled with joys and sorrows, failures and victories, that is all ending. We may not be able to see it, but nevertheless we must revere it. We need to remember their person-hood, and allow their loved ones to mourn it’s loss. That is the lens I’ve always seen the dying and their families through. That lens humanizes the dying process.

Creating a good death is more than simply making the dying comfortable. It is making the loss palatable to the family, while gently guiding everyone toward the inevitable end. Having dealt with the loss of someone very dear to me recently, it reopened my eyes to the necessity of a curated death experience. While the term curated may sound too crafted, I think it is exactly what we must do.

This past Saturday, my Grandmother passed on just a few months shy of 101 years old. She was in the home she had lived in since 1940, surrounded by her daughters and a grandson when she left this world. She was calm, peaceful, and most of all she was ready. In terms of a clinical death, it was perfect. But that clinical perfection doesn’t change the sadness we feel. It doesn’t replace the depth of loss felt in our hearts. Clinical perfection does however, facilitate the grieving process. It allows family to see her leave, and know that she was at peace.

Losing someone is always going to be difficult. It’s our responsibility to not add to that difficulty by leaving the memory of a difficult death in the family’s mind. In situations with dying patients, our work is often more with the family than the patient. We must take the time to hear them. We must listen to them, through their sadness and fear, to see what it is they truly need. Nurses have a unique role, along with the ability to shape an entire family’s memory of loss. Their experience with us during the dying process, has the ability to shape and aid in processing their grief. As hard as it is, it’s the least we can do.

 

I’d like to dedicate this post to my Grandma T. Thank you for the rooftop tea parties, for showing me why snapdragons are the best flowers, for always meeting me on my horse with a butterscotch chip cookie, and for always believing in me no matter how much I was screwing up. I loved you deeply, and I’m so grateful to you for waiting on me so I could say goodbye.

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