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Over the past two years, I?ve had the priv?i?lege of par?tic?i?pat?ing in a?nurs?ing ethics fel?low?ship with six under?grad?u?ate nurs?ing stu?dents. We?ve dis?cussed, ques?tioned, researched, stud?ied, and dis?cussed and ques?tioned again how nurs?ing ethics per?me?ate each of our var?i?ous focus areas of study. My focus is on how cul?tural and soci?etal atti?tudes play a?role in how peo?ple talk about death and dying. It isn?t as lofty as it sounds. We all are prod?ucts of our tra?di?tions, cul?tures, soci?etal influ?ences, fam?ily envi?ron?ments, and past expe?ri?ences. These fac?tors influ?ence the choices we make, our views and opin?ions, and who we ulti?mately turn out to be. To put it another way, one person?s nor?mal is another person?s weird.
This becomes very impor?tant when dis?cussing death and dying. It is one half of the book?end of each of our lives (birth being the other), and hence, there aren?t any do-??overs or sec?ond chances. Sud?denly, tra?di?tions, cul?tural prac?tices, fam?ily roles, and spiritual/?religious pref?er?ences become very important?sometimes even more so than the clin?i?cal?piece.
I?ve spent my time in this fel?low?ship think?ing about how indi?vid?u?als per?ceive death and dying. As a?health?care pro?fes?sional, it?s some?thing I?con?front every day. For a?patient, it?s a?whole dif?fer?ent story. Chances are, they?ve never had can?cer before?they?ve prob?a?bly never had a?rea?son to think about death and dying, cer?tainly not in such an inti?mate way. There?s a?def?i?nite lan?guage about death and dying?it has a?jar?gon all its own. For patients who are fac?ing this for the first time, it can be hard to find the right way to express them?selves and their wishes to their friends and?family.
As oncol?ogy nurses, we can?not afford to be squea?mish or uncom?fort?able dis?cussing death and dying with our patients. We do our patients a?dis?ser?vice with our silence. They look to us for guid?ance and sup?port. We have unique tools and skills to help them artic?u?late their thoughts, fears, and feel?ings in a?way that can encour?age and sup?port mean?ing?ful dia?logue. All to often I?have seen patients and their fam?i?lies later regret not talk?ing frankly about death and dying with their loved one, either because they were too afraid or didn?t know how to begin that con?ver?sa?tion. Our patients and their fam?i?lies deserve bet?ter than this. I?encour?age you to take the extra time to speak to your patients about their ideas con?cern?ing the end of their life. What is impor?tant to them? What are their wishes? What are their tra?di?tions and cul?tural prac?tices? Do they have any spiritual/?religious pref?er?ences? End-??of-??life care is so much more than clin?i?cal practices?it?s a?mean?ing?ful and impor?tant time of tran?si?tion for the patient and his or her fam?ily. Oncol?ogy nurses have the chal?leng?ing and reward?ing oppor?tu?nity to help this time be one of mean?ing and celebration?a time to be cher?ished by patients and fam?i?lies?alike.
Want to go?deeper?
Dance, Laugh, Drink. Save the Date: It?s a?Ghana?ian?Funeral
Dead Join the Liv?ing in a?Fam?ily Celebration
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Megan Kilpatrick, RN, BSN, OCN?, CHPN, is an infusion nurse at the MultiCare Regional Cancer Center in Tacoma, WA. She is also a Butterfield Ethics Fellow at Seattle Pacific University, where she is working on her MSN degree. Her professional interests include adult oncology, palliative care, the caregiver experience, and evidence-based practice. Outside of nursing, she's a self-professed news junkie who likes traveling off (and on) the beaten path, having random adventures with her fantastic husband, and is at her happiest whipping up culinary masterpieces in her tiny kitchen while listening to her collection of vintage records. Read more articles by Megan Kilpatrick
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