PHI 413 How often do you engage with or witness death in your work?

PHI 413 How often do you engage with or witness death in your work?

PHI 413 How often do you engage with or witness death in your work?

Working in a Level 1 Trauma Center emergency department, I have cared for many patients who have died. Unfortunately, the death of patients while in the emergency department often happens multiple times a month, week, or within a day. Death, to me, is the transformation from a physical form into a spiritual one, similar to a caterpillar turning into a butterfly. Whereby “the souls or spirits of the deceased exist after death and before the resurrection” (Hoehner, 2020, para. 38). Two of my patients passed during one of my shifts last week, one from a heart attack and the other from a motor vehicle accident. Before the attending physician announces the time of death, two questions are asked of the health team members working on the patient: Does anyone have any other ideas we can try? (Pharmacology and/or medical interventions), and Does anyone object to calling the death of this patient? When there is no objection voiced, I hold the patient’s hand when the time of death is called. Holding someone’s hand can be comforting. As I hold the patient’s hand in the physical world, I envision passing relatives and friends meeting the patient and extending their hands in the spiritual world, which helps me shape a more optimistic view of death.

Recent events have affected my heart, mind, and emotional stability around death. I attended my girlfriend’s memorial two weeks ago and experienced the unexpected loss of my friend and my ED director three days later. Two days before my ED director’s passing, we discussed the new procedures we planned to implement in the front-end triage process. Part of me is still in denial. I have been struggling this past week, trying to sort through all of my emotions, from the loss of both of my friends and witnessing two other patients’ deaths though I cannot help but think that this class’s timing may have been divine intervention. 

Reference Hoehner, P. J. (2020). Death, dying and grief. In Practicing dignity: An introduction to Christian values and decision making in health care. Grand Canyon University. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/4

At the moment, I do not work as a nurse. In my current job as a dorm Resident Assistant, we don’t deal with death at all, and the only time death is even talked about is in the context of suicide or medical emergencies, which we are trained to deal with. I do deal with it a little bit when I go to clinicals for my RN courses, since so far we have done most of our clinical hours at a nursing home. We do not get enough time caring for those residents to get attached and be terribly affected by their deaths, but we see the aftermath from both the nursing staff’s perspective and from the families’ perspective. For me it has affected my view of death in interesting ways. I feel like seeing it as an outsider looking in has made me a bit jaded, I still care for the person and their family but it doesn’t affect me much emotionally. I already am fairly accepting of death, especially if I know the person shares my beliefs about salvation, since I believe that if you are saved then death is not the end of your spiritual life, but you get to go to heaven and spend eternity there. It is a little harder for me when I don’t know for sure what they believed or I know they didn’t share my beliefs, because I don’t know if they’ll go to heaven, and sometimes when it’s someone I am fairly close to I feel like I could have introduced them to Jesus.

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I have only experienced death at work from a distance. I am a 4th semester Associates degree nursing student. I’ve been in the hospital when patients have coded and passed away but none have been under my care when it happened. I have assisted with postmortem care once during my 2nd semester. I had no interaction with the patient before he passed was just asked to assist after death with the postmortem care. The few times I have been at the hospital when a patient passed away I asked if it was expected. One patient had terminal cancer and the other just got transferred from ICU to the floor and was considered stable. Personally I have only lost a few family members in my lifetime and only one who I was close to. It was hard when my uncle passed of a sudden heart attack. I have no clue how I will feel when I lose a patient under my care. All I hope is that I can have done everything in my power to prevent their death. Paul Hoehner explains death perfectly when he states, “Despite the great strides to alleviate pain and prolong life in even the most serious of illnesses, the death of the body remains one of the central, universal, and inevitable outcomes of life” (Hoehner, P. 2020).

Hoehner, P. (2020). Foundational Issues in Christian Spirituality and Ethics. In

                   Practicing Dignity: An Introduction to Christian Values & Decision Making in                

                  Health Care (1st ed.).  Retrieved from:

Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care (gcumedia.com)

“The biblical perspective on suffering, death, and hope in an eternal resurrected life molds a Christian believer’s outlook on life, gives meaning and value to their trials and ordeals in life, and transforms the way they make decisions about many end-of-life issues” (Hoehner, 2020). I have a very empathetic personality and I find that I really connect with patients. This is a blessing and a curse because it allows me to provide incredible care to patients but it also makes it hard to accept difficult information about sick patients. During my clinical rotations in nursing school I was on the surgical trauma floor for a semester, this is where I became most familiar with declining patients. I had one patient, an older man, that came in with a stomach ache, he was very positive and so kind. He kept saying that his wife was just waiting to come pick him up and he wondered how long he would be in the hospital. Each week that I went back for clinical I kept getting assigned to this same patient. He was still there week after week, not getting better, not getting worse. The third week the doctor came in, while I was in the room, sat down and told the man that they found a complication with his diverticulitis and ultimately there was a cancerous mass in his intestines. Needless to say, the man did not go home. I had a very hard time with that conversation and left the room, I immediately ran into my primary nurse and burst into tears. It was that moment that I knew hospital nursing was not for me.

PHI 413 How often do you engage with or witness death in your work
PHI 413 How often do you engage with or witness death in your work

I now work for an incredible plastic surgeon, I love the company, I love my boss, I love the hours, and I love that the patients (99% of the time) are there for elective reasons and very happy and excited. I have dealt with a lot of personal loss and while I do understand that God has a plan, and I believe that this physical life is not the end and he protects us, it doesn’t (unfortunately) make me miss loved ones any less. In a professional environment I do think I would eventually be able to process the information in a healthy way and be able to care for patients with terminal illness but with the personal loss that I’ve experienced I do ultimately find it difficult not to fall apart when I see the family members that are left behind. 

Hoehner, P. J. (2020). Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/3.

Working as a medical-surgical nurse means witnessing death several times during my career, which makes me accept death as a rite of passage. As a medical-surgical nurse, I have witnessed these deaths and helped process them, which made the experiences shape my view of death.  The multiple experiences with death shaped my views when I see death as a rite of passage, and it held an inevitable nature. Considering every act of a man gets defined as an act by the whole man (Hoehner, 2020), death presents a time when the person experiences a halt such that they could not work on the worldly perspective. In this regard, I view death as something that will happen to everyone regardless of age. The uncontrollable nature of death leads me to see that human beings possess the minimal authority to overlook its scope.

 The very first time I witnessed death was a cancer patient that was in a lot of pain, and his medical condition was critical; I still remember his words, “I am tired, and in pain, the Lord may call me tonight to free me from this pain I want to be closer to my Lord” He passed away that night. His face was peaceful. Every human being needs to consider that death could mean the end of pain in the physical sense (Wells et al., 2013). Going by the notion, I accept death as I perceive it as the end of suffering for my patients, and I accept it over time when it signifies the end of suffering.

References

Hoehner, P. J. (2020). Death, Dying and Grief. In Grand Canyon University (Ed.), Practicing dignity: An introduction to Christian values and decision making in health care (Chapter 4). https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/4

Wells, Fray, & Cataldo. (2013). Euthanasia. https://lopes.idm.oclc.org/login?url=https://search.credoreference.com/content/entry/galegnaah/euthanasia/0?institutionId=5865