Thursday, December 4, 2008

death/dying and the nursing student

Finally, a new post!!

I've had a lot of good things to write about, but I seem to be more prolific when I've got an axe to grind, sorrow to nurse or just general blahs hanging over my head.

I've got an axe to grind.

Every class has a know-it-all don't they? The perennial teacher's pet who will polish every apple, dislocate her shoulder raising her hand repeatedly and elucidates neckbreaking eyerolls when she threatens another anecdote. My cohort's know-it-all is about ten of these biznatches rolled into one grating package. Ordinarily, I ignore her save for my sarcastic comments under breath (because, hey, my powers of restraint are only so much). We actually used to be friends, but above know-it-allness (this is tiring; now known as KIA) combined with a deep need to cut others off at the knees with horrible rumormongering just left a bad taste in my mouth, so I separated from her with a clean break shortly before the term started. As exasperating as she is, there's really not much I can do about her. I try to ignore her when she speaks to me, but am civil when necessary. I don't like her in the least, but we can get along for the next year, right?

Not so much.

The scene: clinicals last week. I have a resident with Alzheimer's that I have worked extensively with. I really enjoy her and am currently working on a careplan about her. She's been under hospice care for close to 2 years now and from all appearances will most likely die soon. I've gotten attached to her, but used to work with hospice patients, and have learned how to deal with death in a way that I actually consider healthy while at the same time preserving my own self. Not to mention that as nurses, quality of life is important, no? How much quality of life can a person with Alzheimer's so severe have that they cannot communicate basic things like being in pain, hungry or just wanting to watch TV? If I think too hard about it, yes, it will make me horribly saddened. But, as people like me like to so enigmatically say, it is what it is.

Here is where Kia comes in. At our postconference in clinicals, she had the sweetness and light in her to say that I was cold and unfeeling toward my patient.

Let's pause, for a minute and think about that. I've spent a lot of hours with this patient, do any small interventions that I can. And to have someone tell me that I'm cold because I don't dissolve over the possibility that my patient's death is imminent? Oh hell nah.

We all handle this grief and heavy burden differently. Even though my stating that I dislike her is lightyears away from my actual disdain, I didn't crack a sarcastic joke as per my usual way when her patient that she'd only spent 1 hour with died suddenly between clinical days. I know she doesn't have much medical experience and it would hit her hard.

What is the point of this, you ask? I don't know. A little kvetching maybe. Or, to kind of set the record straight on death and how we each accept it in a different manner. There is no wrong way and it doesn't make someone cold and uncaring to understand the nature of life in a way different than your own.

We can have petty differences that we commonly snark one another about - this doesn't have to be a part of that.


undergrad RN said...

God, I love your writing. I wanted to high five you within the first 5 sentences. :)

As for the death thing, I have a fairly controversial POV. I just don't think death is the worst thing that can happen to someone. Sometimes I think it's the best thing, especially for my great-aunt who died of Alzheimers complications and at the end was completely helpless. I don't call that living, I call that shit purgatory. So I was (glad? relieved?) when she died because I knew her quality of life sucked ass.

Mind you I haven't been in a hospice situation or faced with death much in my life so I don't know how I'd react.

Anyway, my rambling point - I don't think it's callous at all to accept that someone's going to omg-die. Personally I think it's a weird perspective to think that living-no-matter-what is the only good thing for people.

I don't know if this comment made any sense. Summary: I hear ya :)

Somnambulant Student Nurse said...

*high five*!

And wow, thank you for the awesome compliment. My first degree is in English, so that makes me delighted. :)

And your comment not only made sense, but rang so true to me! You and I definitely have a similar approach to the whole death-dying part of nursing (and life, really). I realize that there are likely going to be times that I will be there for a patient as they die. While I'm not going to say I'm 100% comfortable with it yet, I'm more there than a lot of my classmates.

I'm totally with you on the point that where there is no quality of life, there is little to mourn. No one wants another human being to cease life as they know it. But, if they haven't really known or experienced living in awhile, there's a sense of bittersweet relief involved in assisting them peacefully to whatever they believe is waiting, be it eternity or nothing at all. And without my feelings coming into play.

I knew coming into my program that I would likely be unpopular at times like these - a stance I'm okay with because in the end, it's all about her and not my re-damn-diculous classmate's opinion.

She really is a megabitch though. ;)

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