Sitting here on a very quiet day thinking about my day at work. For some people its a day at the office with endless meetings and coffee breaks or for others it could be any number of unimaginable things but for me its caring for dying people.
I took some time out yesterday to talk to a patient ( yes, that’s right) our workload is so heavy if we stop for a chat in-between putting up intravenous antibiotics or giving out a veritable truck load of pills, making beds, lifting and pulling people in and out of showers we would never finish our days work on time. So, I stopped to talk to her, she is usually very quiet and basically apart from the occasional request says very little about her thoughts on dying. I took the time to initiate a conversation about her end of life pathway or if she had any thoughts about the end of her life. Beginning the conversation can be very difficult for some patents and nurses to initiate because to speak of dying is very awkward in our society and it is not an easy subject to approach in case just the very sound of the word ..dying upsets someone.
I was surprised to find out that she had planned to listen to music and that her iPod was ready loaded with her favourite song when her time at the end of her life is closer. I was really pleased to hear this, however my concern was that none of us who care for her new of her final wishes. In her final moments it will be us, the nurses who care for her who will need to ensure that her final wish is granted. She talked for some time and she seemed really grateful that someone cared enough to ask about her thoughts.
At the same time there was an old, old man gasping for breath purple in colour calling asking me with reassurance in his steely blue eyes, “I’ll be alright, won’t I ?” What do I say to him? No actually I give you a day to live at the most? Surely he knows on some level he just won’t be alright? Or do I say, No you’re dying, slowly without breath…and this is the way it will be you will struggle until you have no more breath or until I sedate you, which would you prefer? Well, I did the later…better for him I thought (and me…). It was unbearable listening to his struggle watching him trying to catch some air on the wind. What was the deepest meaning behind his question, I wondered. Could it mean its ok to die, or will I live, or will I die peacefully? I don’t know just because the dying word is so hard to say.
Yet it still seems so wrong that we can’t or won’t or are somehow afraid to speak openly and honestly about our end of life. Fear is powerful.