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DQ: How often do you engage with or witness death in your work?

DQ: How often do you engage with or witness death in your work?

PHI 413 Topic 4 DQ 1

In discussions surrounding suicide and euthanasia this week, one meaningful aspect is the emphasis on the ethical principle of autonomy. Advocates argue that individuals have the right to make decisions about their own lives, including the choice to end their suffering through euthanasia or assisted suicide. This perspective underscores the importance of respecting personal agency and the right to die with dignity, especially in cases of severe and incurable illnesses where the quality of life is significantly compromised. On the other hand, one of the most controversial aspects involves the potential slippery slope and the risk of abuse in implementing euthanasia or assisted suicide. Critics express concerns that legalizing these practices may lead to involuntary or non-voluntary euthanasia, where vulnerable individuals might feel coerced or pressured into ending their lives. The ethical dilemma also extends to questions about the criteria for eligibility and the potential for discriminatory practices, particularly concerning individuals with mental health conditions. Balancing the respect for autonomy with the duty to safeguard against potential harm poses a challenging moral quandary that fuels ongoing debates on the ethics and legality of suicide and euthanasia. (Billings, 2019).

In exploring the course materials on suicide and euthanasia, a pivotal and contentious focus emerges in the discourse surrounding physician-assisted suicide (PAS) from a Christian perspective. Found in Chapter 4, the text advocates for a nuanced approach termed “just assisted suicide,” challenging the conventional belief that PAS is universally wrong. The arguments presented include the absence of explicit scriptural prohibitions, a consensus based on reason among physicians, and the alignment of a natural-law defense with Christian reasoning. This chapter prompts essential inquiries about Christian responsibilities in the face of medical suffering and delves into the intricate intersection of faith, rationality, and ethical considerations. It introduces the proposition that assisting in suicide can be consistent with Christian values, emphasizing compassion, care, and the obligation to alleviate suffering. These dynamic challenges traditional views on the sanctity of life and introduces a nuanced perspective within the realm of medical ethics. (Billings, 2019).

In response to the passage, it stimulates critical reflection on the interplay between religious convictions, rationality, and compassionate responses to human suffering. The contested notion that PAS may align with Christian values urges a reevaluation of ethical stances, inviting readers to navigate the complex landscape of faith-based perspectives on end-of-life decisions.

Reference:

Billings, J. A. (2019). A Review of Physician-Assisted Suicide: Where do you Stand? Journal of Holistic Nursing, 14(3), 206-222. doi:10.1177/089801019601400304

Replies

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.

What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?

 

Before we can try to explain a person’s own worldview, we must first understand what a worldview is. According to Bogue 2020 worldview is the point of view for understanding one’s personal experiences and the events of societies and the history. This can be an underlying assumption about reality that a person holds. Spirituality is a dynamic and intrinsic aspect of humanity through which persons seek ultimate meaning, purpose, and transcendence, and experience relationship to self, family, others, community, society, nature, and to the significant or sacred (Bogue, et al., 2020). For me, I always knew I wanted to be a nurse since I was a little kid. When I was about 11 years old, my mom had to have a surgical procedure that required home health to come out and help clean the incision. The home health nurse taught me how to do a wet to dry dressing change, from that moment I knew what I was destined to do. I work in an OB/GYN, it is not always rainbows and sunshine. I see patients that have miscarriages almost every day. This never gets easier as the years go by, from the miscarriages to the babies born with complications.

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

Thank you for your heartfelt post to this weeks discussion question. I am so sorry for the loss of your friends and the deaths of your patients in the ED recently. I would love to work in the ED but I knew my heart could not take the death that a nurse would encounter there so I have worked in OB/GYN & PACU my entire nursing career. Your comment about transformation from a physical form into a spiritual one that is similar to a caterpillar turning into a butterfly really moved me. I liked that a lot. It also was wonderful to read that you hold the hand of you dying patient.

I too believe that it was divine intervention for me to take this class at this period of time. My mother died in August unexpectedly and I have been struggling with having sad days as I grieve for her. This class has caused me to looked deep within myself and ask myself what my beliefs are and what they mean to me. I have come to realize that my religious beliefs really do mean more to me than I thought at the start of this class. I feel like I am going through my own little metamorphosis. I will keep you in my prayers and hope that you are able to have better days ahead.

Thank you. I am so sorry for the loss of your mom. Unexpected death is just so hard to process at times, even more during a pandemic.

Our class has been a blessing for me in helping me through the emotional roller coaster that I have been and will continue to experience for some time. As healthcare workers, we all are one big team taking care of patients at different times in their life. Working in the ED was more of a continuation of patient care after working as an EMT-P in the field. The ability to care for many patients in a day and work with colleagues as a team to prolong life (not save it) is where I feel I do the most good for patients as a health care provider. The wonderful gift about our profession is that it provides us with the opportunity to change patient care venues—something I am pondering.

I am very sorry to hear that you have had so many deaths of loved ones and patients recently. I think that is a very beautiful way to think about death, a caterpillar turning into a butterfly. I hope you can find comfort in God during these tough times. I myself also use to work in a level one emergency department and now work in a critical access hospital. Unfortunately, no matter what ER you work in, there are deaths, and having this comfort in God can make these deaths easier to cope with.

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Thanks a lot for sharing with us your topic 4 DQ 1 discussion post where you managed to give a very eloquent account of your experiences with death while working in a level 1 trauma center emergency department as well as at a personal level. I can only imagine how difficult it must be for you and your colleagues having to witness all those deaths in the ER department. Also, accept my sincere condolences for the loss of your girlfriend and friends. May God comfort you during this trying time and may He give you infinite peace and strength to help you through this difficult time.

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.

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)

I believe that witnessing death as a healthcare professional is one of the most devastating encounters. When death happens and you were caring for the patient, one starts to wonder and even blame themselves for not helping the patient stay alive. On many occasions, I have witnessed nurses and physicians that cry uncontrollably because a patient they were caring for has dried. It is even hard for nurses to disclose the news to family members that their patient has died. As a matter of fact, I feel more disturbed when disclosing to a family that their loved one has passed on. During the covid 19 pandemic, my hospital has been experiencing deaths so often that we were used to death. I believe that we also need to embrace coping mechanisms that will assist healthcare professionals to live well and avoid post-traumatic stress disorder. During my first years as a nurse, I was so scared even to walk in the wards to avoid meeting a dead or dying person. today, I am encouraged to never give up and I offer treatment including the end of life support to patients despite their condition.

“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.

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.

How often do you engage with or witness death in your work? How has this experience or the lack of it shaped your view of death? Has it gotten easier or harder for you to accept the fact of death? As you explain, include your clinical specialty.

I encounter death almost daily or every other day. The form of death that I encounter in my line of work is heart very heart breaking, not that death in general is heart breaking. I work in OB/GYN, and have been in this field for over 7 years now, first as a medical assistant and now a nurse. When I first started 7 years ago and I had my first patient that just recently found out that she had a fetal demise it was challenging to accept that I would be dealing with women who are having a miscarriage. As they years have gone on, it is easier to deal with the fetal demises and the knowledge on how to properly comfort and educate the patients. To me the first trimester losses are the easiest for me to deal with, the second and third trimester losses are very difficult. There are a few patients that I remember and their cries as they find out their baby has passed at 36 weeks along.

I had a patient that I formed a bond with, as I was her medical assistant her entire pregnancy, she was having twins. Both babies were born very healthy, a year passes and she comes back in for a consult. As I am talking with her about the reason of her visit, she informed me that one of the boys crawled their way to the family pool and drowned on accident. While in the room with the patient I could not help but just cry with her. That was one of the hardest deaths in the medical career. I had another lady find out around 17 weeks that she had a demise. While I was down at the other end of the building, you could just hear her wail and cry. While the death I deal with is not due to old age, injuries, medical illness, or with humans outside of the womb, it is very difficult to deal with at times.