When a patient is dying, whether it’s on a hospital ward or on a community visit, entering in to their environment can feel daunting. This feeling of apprehension can quickly be replaced by nerves and fear when asked to interact with and care for the patient.
“What do I say?” … “What if I say something wrong?” … “What if I get really upset?”
The potential fear of not knowing what to do, and how to care for someone who is dying, can be slowly replaced with confidence, through education and understanding. (And it is okay to get upset. Keep it professional when with the patient and/or their family, but it is so important to acknowledge and deal with being upset either through a debrief with your mentor or other support networks you have afterwards).
I have discussed end of life care with a lot of student nurses over the last couple of years, and, alongside fear of doing something wrong, a resounding thought is that “well, we can’t make much difference can we?”.
Well, actually, we absolutely can.
We have the ability to take time out of a busy ward schedule (of course, having asked & let our mentors know what we are doing) to sit with someone who needs it. I have sat with patients who are dying, because they had no family present or because the family needed to leave but did not want the person left alone. It is in these moments we can make a big difference, just by being present. I have shared this story before but caring for this patient was particularly pivotal in shaping my nursing training to date;
Whilst on a placement within the Older Persons Unit, I was privileged to be closely involved with a patient’s end of life care whilst on the ward. The patient had been admitted whilst acutely unwell and the decision on whether to commence an individualised care plan for last days of life had eventually been made. Having worked with the patient over a couple of shifts, his deterioration was obvious and his comfort of the upmost importance.
Despite his worsening symptoms, we had a long conversation about reading and I ensured I found a couple of his favourite type of books. Although not able to read by himself any longer, it was crucial for me to make sure the patient felt like an individual, and I read chapters of the books for him. Facing his bed towards the window (with a beautiful view over London) ensured that he was not staring at a blank white wall all day, especially as a side room can feel particularly isolated. Small actions, but of crucial importance.
I have found that although we have some exposure to end of life care teaching at university, this was not enough for me. I have researched and read widely on end of life care and I have contacted appropriate members of staff to clarify any questions I have. I did feel fearful as a student nurse, about what impact I could make, but I have since overcome that with self-education and learning from other’s experiences.
I’ve opened up the conversation about death and dying to many student nurses over the last couple of years, and will continue to strive for student nurse confidence in dealing with death. It is an emotional time and it can be scary, but we are in a very privileged position to be looking after someone who is dying. When I started my training, I had only experienced death within my family, not on a professional level. And, honestly, I thought it’d be really hard to deal with in practice. And it was. However, I have used all the support networks available to me and educated myself & I will strive to help any other student nurse who finds themselves in the same position I did.
I have included a few Twitter accounts at the bottom of this blog, with the hope that you may find some inspiration from them.
(Katy Sutherland – student nurse)