As part of the our series Voices from the Frontline, Nurses on Death and Dying, which premiered at the Dying Inspirationally session of Haelo Hosts ’16, documents front line nurses discussing the realities of palliative care.
Nurses from Salford Royal Foundation Trust opened up about their training, the beginnings of their careers, the importance of mentoring, first experiences of dealing with a death and going the extra mile.
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Download the full transcript here or see below.
When I first started my nursing career I was really quite scared of patients, and that sounds a really strange thing to say, but I did my first placement on a ward, on a medical ward and the sister. Sister Yardley, I’ve never forgotten that. She was quite a fierce Irish sister and she said to me one day, and they called you then, she called me “Student Nurse O’Donnal” She called me over and she said to me “Why are you so scared Cate? Why do you look so scared” and I said just, “I’m really nervous that I don’t, I don’t really know how to behave on the ward, that I don’t know what to say or how to talk to people sometimes” I was only very young, and she took me, and she took me down this Nightingale ward which is a long ward with many patients, and she sits me in front of a patient and she said “what do you see Cate?” and I said “I see a patient” she said no, “what do you see?” I looked around and said “I see oxygen, I see medicine” she said “no, look again what do you see?” and I said “I see a person” and she said “Yes, that’s what you see: a person, and if you keep that at the forefront of your nursing career you’ll never ever go wrong” and that’s what I’ve taken forward and I’ve never forgotten her saying that to me.
During my whole nurse training I hadn’t actually been part of actually dealing with a death, as in dealing with a dead body. This was quite a stress to me and I had a fantastic mentor and again I spoke to her about it and she said that she’d arrange for me to actually be involved with a person who died, with a patient who passed away, and I’ll never forget it because I was so nervous, and at the time i felt i didn’t know this person. I was going and being part of something that was, you know, so, so important to that person, but I couldn’t have asked for a better nurse to have been with that day, and what she told me on that day, was just… well, I’ve never forgotten it. Just the way her compassion, the way she treated the person who died and the things that surprised me, like, she was talking to that person and she obviously knew that person very well who died, and she was talking about the life that he had had, and she was washing him, she was really gentle with him, and she involved me in all those aspects, and I remember saying to her “It’s really cold in here” and there was a window open and said I’m, you know, she said “Don’t worry, he won’t be cold, we’re just letting his soul out of the window” and that, that really moved me because I’ve never.. obviously those things I’ve just never experienced but it was i was very fortunate and that, that was my first experience of dealing with a death and having somebody, you know, who died and I’ve never forgotten.
At the end of the day you you want to advocate for the patient at all costs, at all times, and sometimes, you know, to the detriment of yourself but you do it anyway because that’s your job. I think obviously personal care is important and making someone feel like an individual is really important, but the way that I help people the most, I think, is by helping them feel more in control of what’s going on so even taking the time, saying to somebody “Okay so I’m leaving this room now but you’re not on your own, I’m outside and this is what I’m doing for you” This person is feeling vulnerable at this point and I have to help them, I have to do what I can to make this better for my patient and their family and make this as much of a positive experience as possible.
If somebody wants to lie on the bed, if they want to have the dog in the bed with them, or if they want to have lots of family around them, then that’s absolutely fine, that’s their wishes and preferences. It’s about making sure that they have comfy bedding, their own pillow and pictures around them, favourite smells. Making it more personalised, making it individualised to them to make sure that they’ve got what they need. It’s such a difficult time, making the families as comfortable as possible. Let families be involved, it’s you know it’s the last thing that they could possibly do for their loved ones so let them get involved, washing, dressing, is there something particularly they’d like to wear? Is there a particular perfume or aftershave, making sure that the hair is the way that they wanted it.
Throwing birthday parties for people who are dying, bringing pets in, putting them closer to a window. Decorating a room and open visiting. I think open visiting is just the most incredible thing, because if you’ve ever had anyone die your family or ever had a relative in the hospital, being able to come in at 3am and just sit there and watch them sleep because this might be… it might be one of the last times that you can see them do that. Being able to take pictures with them, get hand-prints made with them, you can have locks of their hair. You can just be there and have really intimate moments with people before you say goodbye.
It’s hard to convey to people just what an amazing job nursing is. I think I’m just so fortunate to do a job that i absolutely love and am passionate about it, and make a difference. The positives have always been the patients, the families and the relatives, those have always remained and if you’ve got that passion for that then your nursing career… you’ll just love it because that is your main focus.
Palliative and end-of-life care when I was a community nurse became my passion because I was so privileged to be part of this special moment for those families. To make sure that we make sure that those last final days are as perfect as it can be. Making sure that there’s no crisis, making sure that they feel supported, giving them the final moments that are memories, good memories just to share with each other, and being part of that is that, it’s a privilege, you know, it’s a really lovely experience and so if we can make things that little bit easier and support that family, it makes your job worthwhile.
You probably spend more time with patients than you do with your own family and friends and you probably know more about patients and are with them for more intimate moments of their life than 99.9 percent of the people that you know. You can’t lie and say that you never take work home with you. I think people describe advanced nursing skills as skills like advanced life support goals or whatever, but I think that a really advanced nursing skill is being able to, kind of, detach and reattach at an appropriate time. Just because you have to be well to look after all the people and make sure they’re well. It’s not always as easy as it sounds.