Chapter Three
A Nurse's Approach to the Problem
by Claudia Hall, R.N.
Because of my personal beliefs about what happens at death, my guidance to the dying and their families is positive in approach. While I do not express my ideas to them in words, the ideas are my tools for dealing with the situation.
When I have been told that a patient is dying, I try to find out the beliefs of the patient and family, and then use those beliefs as a basis for imparting strength and acceptance.
For the patient, this is done by caring and empathizing. Nurses can help by relaying daily goings-on to ostensibly nonresponsive patients; by giving them messages from friends and family; by telling them that flowers have been sent, what's for dinner, what you are going to be doing to them in the next minute or two, or how nice their hair looks.
For the family, it's helping them accept the dying person's wishes. It is customary, believe it or not, for the medical profession to try to prolong death until the family can accept it. So my goal is to move the family as quickly as possible toward the patient's point of view. The patient's desires should, at all times, be the foremost consideration.
One of the most important things for patients is to be able to talk freely about dying. Many families deny them this right, and the dying person in turn feels as though he has to protect the family. Some families share the dying and become closer as a result. Sharing in this way, I believe, assists the grieving process and enhances greater acceptance, reducing the overpowering feeling of loss.
Families can help by reinforcing the positive aspects of relationships, such things as, for example, assuring the patient that overtures will be welcomed and accepted, secrets will be kept, loose ends will be tied and accepted -- whatever desires it is believed the patient may have.
While many patients respond to conventional religious approaches, others are helped by thinking of death as the entrance into a new state of living. All patients are helped by thinking of death as an absense of pain . . . of shedding the encumbrance of an unhealthy body . . . of peace.
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