Dealing with Death and Dying - Personal Statement Example

Reflective Essay The following is a reflective essay using the Gibbs cycle, exploring how I felt about the experience described in the and what I learnt from it. I have also explored what this patient was going through. Description: I was nursing Betty (name changed), a 78-year-old lady with ovarian cancer, admitted for palliative care. Betty had accepted that she was dying and her family and friends were supporting her as much as they could. On that morning, I went into her room to check her syringe driver and found her in tears. I sat beside her and held her hand whilst she cried. She told me that she had dreamt of her late husband and he had told her that he would see her in July (we were in December). She did not think that she would survive that long, and showed me a list of hymns she had chosen to be sung at her funeral and a verse from the bible she had chosen to be read. It was very sad. Feelings: I felt satisfied about the condition of the patient and the family before the incident occurred. This was because both the patient and the family had accepted the imminent death of Betty. Elisabeth Kubler-Ross (1969) in her book On Death and Dying has pointed that openly acknowledging the imminence of death and assisting the patient and family in addressing their issues of immediate concern would significantly improve the quality of the dying process. I had made efforts to ensure that rather than denying the situation the family could come together and support each other. I saw them expressing important emotional feelings for each other. I knew that this interaction was going a long way in helping Betty to resolve unresolved issues. I felt that she was being freed of emotional bondages so that the physical process could take its course peacefully. So when I saw Betty in tears I was taken aback and a little disappointed. I wondered whether there was any failure on my part. Evaluation: What was bad about the experience was the sight of a patient for whom I had worked hard in tears. I was reassured when I found that the reason for Betty's sadness was a dream rather than negligence on my part. I know that the emotional turmoil that goes on in a person who is dying is very intense. So I had taken every effort to address as many of these issues as possible and to be ready for all physical as well as emotional contingencies. When Betty shared with me about her dream I was a little unprepared. Especially as my personal belief is that dreams are a reflection of reality and was not inclined to accept that loved ones who have passed away could appear in dreams. However as a nurse giving palliative care I was aware that I needed to be sensitive to the beliefs of the patient. The UKs Nursing and midwifery council in it's 'code of professional conduct: standards for conduct, performance and ethics' (2002) in section 2.2 states: "You are personally accountable for ensuring that you promote and protect the interests and dignity of patients and clients, irrespective of gender, age, race, ability, sexuality, economic status, lifestyle, culture and religious or political beliefs." So I am glad that I respected her right to believe that her late husband actually visited her in the dream. This was the good part of the experience for me. I also affirmed her religious belief in the Bible as her religious book and empathized with her that the Bible verse and the hymns she had chosen for her funeral would have to wait for a little longer than she had expected to be used. I am also glad that I was able to communicate my empathy to her effectively. It was a situation where no words would have been appropriate. I knew that the key lay in my non-verbal affirmation of her emotional state. According to Hayes and Orrell (1993) the posture can communicate differently from the words and negative messages from the body are more likely to be believed than the positive words that are spoken. I knew I did the best thing I could by seating myself next to her and holding her hand. I was gratified that she felt safe with me to be able to cry and express her grief in that fashion. I realised that I had to live out what Tousley (2000) recommended: 'grief needs to be affirmed and the loss must be recognised as being worthy of grief.' I needed not only to validate Betty's grief but also help her accept that she had to endure the very real feelings of sorrow. Tousley (2000) also writes for the grieving person: 'It is important that you find an understanding, non-judgemental listener with whom you can openly acknowledge your feelings and experiences, express and work through your pain, and come to terms with your loss'. It was exactly this need of Betty's during the grieving process that I was fulfilling. Analysis I realized as I reflected on the incident that Betty had prepared herself mentally and emotionally for death. So I knew I had done a good job there ensuring that unlike many patients in her situation she did not fear death. Unfortunately she had become eager for death in the process and the prospect of its delay disappointed her. It was important for me to help her get over her disappointment even though it was perceived. I would also do well to encourage her to undertake a positive and wholesome approach to the remaining life that she had. Conclusion I found that while on the one hand I had done a good job in preparing the patient and the family for death, there was inadequate input given on living life to the fullest possible in the time between now and death. Betty had become so oriented towards death that she was unwilling to live longer. While palliative care assumes that death is a natural process which cannot be avoided I also needed to be aware of the fact that the time of death is not easily ascertained. Bris Bird who is a nurse having vast experience in caring for terminally ill patients quotes Ecclesiastes when she says that 'there is a time to be born and a time to die' (quoted by Leah Abramowitz, 2001). While Betty may have been prepared for death it was not necessary that death would come when she expected it to. So Betty should also have been prepared for life that happens before death. Action Rather than allow the patient to sink into depression like Betty seemed to be doing, I could have used her strong belief in Jesus and the Bible to enjoy life. It was necessary to allow Betty to come to terms with her disappointment but once that was done, there was much to celebrate in life especially for one who believed in Christ like Betty did. The apostle Paul says, "for me to live is Christ and to die is gain" (Phil 1:21 King James Version). Jesus himself said, "A thief is only there to steal and kill and destroy. I came so they can have real and eternal life, more and better life than they ever dreamed of" (John 10:10 The Message). As I reflect on these scripture even in the light of the disappointment and challenge that Betty faced I am more and more conscious of the complete victory that Christ offers us. It is joy in life as well as joy in death. With Christ life becomes beautiful as He gives us the enthusiasm to live and the resources to live it to the fullest - even just before our physical death. Yes indeed, I am convinced that promise of Jesus was not limited to healthy human beings like me but even sick ones on their deathbed like Betty. The 'better life' that He offered was an inner life not contained or limited by physical inability or discomfort. The hymns and verse that Betty had chosen could hardly have been reasons to grieve. They had the power to be her greatest strength and joy. I could have helped Betty to connect with God - to understand that His timing is perfect. Perhaps I could have encouraged her to use the time productively by praying not only for self but also for others. The satisfaction of answered prayers could have done wonders to the attitude of the patient towards the rest of life. It would also help in keeping the patient away from self pity and could substantially raise her sense of self worth. Maybe somewhere in all of this Betty could have enjoyed the full life that was within her grasp thanks to Christ and His promise. How much better than seeking a yet elusive death! Bibliography Abramowitz, Leah 2001, 'Dealing with death and dying', Wholefamily, [online] 15 Mar 2006, Code of professional conduct: standards for conduct, performance and ethics 2002, Nursing and Midwifery Council, 19 Mar 2006, < http://www.nmc-uk.org/aFramedisplay.aspxdocumentID=201> Hayes, Nicky and Sue Orrell 1993, Psychology: an introduction, UK: Longman group UK Ltd (2nd edn.) Kubler-Ross, Elisabeth 1969, On death and dying, Touchstone Tousley, Marty 2000, 'Understanding the grief process', Atimetogrieve, [online] 19 Mar 2006, The King James Bible, 1611 The Message Remix (Bible in Contemporary Language), Eugene H Peterson, Colorado Springs: Navpress, 2003 Read More