I attended a dear friend’s viewing last week, a man who touched many lives as an educator, cultural community leader, and a spiritually jolly man who left us; suddenly after a short illness. Afterwards, a friend who has been through many caretaking challenges for about a decade; we headed to an Irish pub, where we enjoyed a pint and reminisced about our friend no longer with us. Then, she updated me on her trials of navigating the health care system and the challenges of obtaining answers from 10 years ago.
We in health care are different after the pandemic, whether we practiced or were being educated, but we definitely learned differently; what seemed impossible became reality with virtual meetings, consults, home visits. We need to remember we learn from our patients; they know their history and health status; it is presumptive to think that we in health care can suggest Do Not Resuscitate; a few minutes into a conversation to update a family member/spouse/partner, etc.
My friend is still grieving for her father, not that he died but how he was shunted aside to die anywhere but in the hospital. He had some significant health conditions, but he was clear he wanted everything done as God would determine when he would depart from this realm. He was admitted to his local hospital, and no doctor would speak about his condition other than his lack of a definitive DNR status. It was that he had a significant stroke, and his daughter was observant enough to question why the health team did not respond faster. Instead he missed the window for an anti-clotting agent to be used. The family was notified a long-term care setting would be best for his needs; they duly chose five facilities and were shocked when he was transferred the next day.
His condition was immediately flagged as beyond the capacity of the LTC facility (major factor no Hoyer lift in the home) and he was returned to the Emergency. This is one man’s vignette of being lost in the system; he did not receive his care with compassion but a system that lacked empathy, more to the point of identifying patients for transfers because the hospital had patients in the hallway. 2014, when such a concept was initiated. The author asked about whether anyone suggested an ethicist review the case, she had no idea such a service existed in the hospital.
As my friend goes through grief for her father, her mother has progressively required more support, and an aunt is now in the household with her own health challenges. My friend has taken a leave of absence to accommodate the many appointments and care requirements and trying to look after her own health needs. When I listened to her caregiver exhaustion was defined in her demeanour and her frustration that her parents paid into the health care system. Still, there is an empty space where community resources need to be to support her family. She did remark that improvements can be seen and experienced in the way her mother’s one doctor speaks to the family, though the Emergency doctor who pointedly commented a full DNR was in her mother’s best interests.
All the technology in the world with megabytes of data cannot replace the need for the necessary information from the healthcare team; to explain the situations they failed to provide adequate information to the author’s friend regarding her father’s stroke There has to be exquisite communication skills, compassion, and honesty. If a patient is dire say so, if they improve–good; if they die you gave the family the heads up that it could happen. No health care professional needs to remove all hope but when one of the first questions is what’s your DNR status? One cannot help but identify this approach as a lack of compassion.
For many patients that reduces their life to this moment not how they contributed throughout their life, their roles as spouse, parent, sibling, child, etc. It does not consider their religious status, nor what the family has discussed before that dire question is asked. Time is cited as a barrier, hogwash! For this level of care time has to be taken to explore who, what, and how they arrived to you on this day, my friend just wanted answers; she was left with doubts anyone on the health team cared. When a patient is having multiple admissions there is something wrong with the medical plan. Trust is built on communication, truth, even the certainty of “I don’t know” if you don’t love what you’re doing find something else. Namaste.
“Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual, and an intuitive sense of ethics, and of the appropriateness of action taken.” – Myrtle Aydelotte
Categories: Uncategorized
Paula M
Registered Nurse Storyteller, Healer, Scribe, Transformational Leader
Life of a Nurse 
Leave a comment