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This site is for student nurses or nurses starting out. Letters to a Young Nurse are blog posts written like letters to help you find your way and make your journey as a nurse less difficult. 


DEATH Part 1

Updated: Jul 23, 2023

Let's talk about Death. We enter this career with the hope that we can do something, anything to prevent the death of our patients. Yesterday I read the history of a 90-year-old male patient who had Prostate Cancer. For over 10 years he was in and out of the hospital trying to outrun death. One surgery led to another and another and another. One hospitalization led to another and another. Chemotherapy weakened his immune system to such an extent that he could no longer fight off the weakest of viruses and bacteria. He had done everything the oncologists told him to do to stay alive. The day came when there was nothing left to do. In my job as a Hospice Nurse, I was there to tell him that Death caught up to him. I was there to help him in his transition from life into death.

Did you ever do the assignment in Psychology class where you write your obituary and design your headstone? If not, think about what you would say if you were writing your obituary. Do you want to be buried, cremated, or have your body sent to a medical school to be used as a cadaver? Do you want an open or closed casket if you are to be buried? Do you want your ashes to be scattered into the sea, or into a meadow with beautiful flowers? Do you want to donate your organs so someone else can benefit from them? And what do you want with all of your stuff that you leave behind?

There is an amazing show on Peacock called The Gentle Art of Swedish Death Cleaning. (There is also a book of the same name).A psychologist, a designer and an organizer go into people's homes and help them clear up and clear out. It is akin to what is done on the Hoarders show but with people who have a looming "expiration date". The person does not have to be actively dying but death is talked about. The problem I see in this country is we don't see death enough or sometimes never. When a patient dies a sheet is thrown over them until it is time to put them in a bag and take them to the morgue. 50 years ago, people were cared for at home and the coffin was placed in the sitting or living room. That is hardly ever done anymore. Everything is sterile and away from view. No wonder we are afraid to die.

By not talking about death and hiding it away from view we rob our patients and their families of conversations that need to be done before death is knocking at the door. As nurses we sometimes expect everyone else to have the “death talk” with patients and families. But we often spend the most amount of time with patients and their families and can have critical conversations BEFORE the patient ends up on a ventilator or worse.

In relation to death ask yourself the following questions:

Do you know the difference between a living will and an advance health care directive?

What is the difference between a living will and a Physician's Order for Life Sustaining Treatment (POLST)

If a patient has a POLST and 911 is called by someone in the residence do the paramedics/EMT have to honor the POLST?

Did you know that 70-80% of patients want to die at home but only 20% actually do?

If a person dies without a will, who gets all of their money and possessions?

Do you want someone else to clean out your home, apartment or place of residence when you die?

If you are tired of thinking about death, watch Elizabethtown, a 2005, quirky comedy written by Cameron Crowe about a man, Drew Baylor, played by Orlando Bloom, struggling with failure at work. Right before he attempts to kill himself, he gets a call from his sister that their dad died. Drew has to go to Kentucky to bring his father's body home to California. On the way he meets an airline stewardess, Claire, who helps Drew deal with the pain and gives him an assignment for the trip home. This movie and the above questions inspired me to get my affairs together and I have a list of all the places in the US that I want my ashes spread by my spouse (I always tell her I am going first!). I also have a list of songs I want played at my funeral (which will be a festive occasion and a party).

A funeral does not have to be sad. In fact, we can celebrate the great and grand life the person has lived with joy and laughter. I expect all of my former students will join my spirit at the bar and tell stories about how great a teacher I was!

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