please respond to the discussions with reference

Discussion 1

I currently do not currently work in healthcare, but in the pastI worked in long term care and med/surg. In both of thesespecialties I worked with patients on hospice who died occasionally.My very first shift on my own as an RN I was called in to determineif a hospice patient at our long term care facility had died. I donot think I had even received report yet. I felt completelyinadequate and had no idea what the policy was at our facility.Meanwhile I had the family staring at me as I listened to her chest.I immediately realized the importance of my position and the impactI had on them. With all my hospice patients I considered it an honorthat the family would let me in on these final moments of theirloved ones. It is an important part of life that should berespected.

I did not have any patients die under my care who were not onhospice and expected to die. I have a lot of apprehension for whenthat happens. I think that would be a harder situation for me toaccept and I worry I will feel guilt about not providing the careneeded to help them.

Discussion 2

Accepting death has gotten easier for me. Many years ago, for myfirst job, I used to work in the hospital on a Med-Surg unit. I wasalmost afraid of the surprise and shock of death, I did not want to bethe one to find the person dead in bed. When I worked in ICU, Iremember at first not wanting to give patients morphine when they werein the dying process, because I did not want to hasten their death andfelt guilt. I became detached by watching the monitors instead of theperson and the technology became a barrier between the patient and me.When people had resuscitation attempted, it was so messy, traumatic,intense, etc. Sometimes I would be shaky afterwards from theadrenaline rush. I did not mind the “no-codes”. I likeddoing the comfort measures, the deep talks with people, therespectful, calm deaths. Most people and families in ICU, don’tdo superficial chit chat, but talk “real”, they speaktheir fears, sorrows, regrets, and joys. You can get to know patientsand families extremely quickly because they speak their raw emotionsand what is really important to them. Now I work in a special needsschool. We generally have 2 children die each year, but these have nothappened at school so far. Most of the time, parents find them deadwhen they go to get them up in the morning. Although each of thesedeaths is sad, and I mourn over the children, I cannot wish them back.I believe most of them are in a much better place and that they arewhole now, how they were meant to be. Whereas on earth they could nottalk, walk, communicate, and sometimes hardly move voluntarily, Ithink now they are running, jumping, and shouting for joy. Mystudents go up to age 26. Recently a Buddhist died. While there istalk that all children go to heaven, I am not sure about a 26-year-oldBuddhist. He is older physically than a child, but mentally was agedprobably about 9 months.

Discussion 3

Ihave been blessed in not experiencing many deaths in my three years onthe job. I am currently working on a cardiac unit and have only hadtwo patients that expire on my shift. One was expected as her vitalsigns were declining and her intestines were blocked from the cancerthat she had recently been diagnosed with. The first death wasunexpected at the time because I had not seen any signs except for achange in spirit. He was asking for a hug and kiss the day prior topassing away and I dodged his request on that day. When I came in thenext day at first passing and bed-side shift report he told me that Iowed him a kiss and hug. When bringing his medication to him he askedagain and yielded and gave a kiss on the cheek along with a hug, hedied about an hour later. He was a DNR so no heroic measures wereperformed. It was emotionally hard when the daughter stopped by on herway out of town and arrived just as he expired and yelled "Bringhim back."

Death is harder to deal with if it is totally unexpected such as in aMVA. This is a time when it is easy to ask, "Why God." Deathis never easy to receive for the families left behind. The patient isfree from pain, suffering, and worries. The family members must dealwith the separation of their loved one. Whether they believe thatthere will be a reunion after death is according to the worldview thatthe family holds as truth.

To everything there is a season, and a time to every purpose under theheaven: A time to be born, a time to die; (Ecclesiastes 3: 1.) In theCalled to Care page 223 the author held the viewpoint thatJesus struggled with death in the garden, but was it more the factthat he knew that God would have to turn his back on Jesus as he wason the cross? I feel that the threat of separation from God even forthat brief of a time deeply disturbed Jesus since he had a perfectrelationship with his father (God).

References

Shelley, J. &. (2006). Called to care: A Christian worldviewfor nursing. Downers Grove: IVP Academic.

Wellman, J. (2018). PHI-413 V Lecture 4.

Discussion 4

Currently, I work at long care term facility and most of thepopulation are elderly residents whose needs cannot be met if theywould live in the community. Most of them need different degree ofhelp with activities of daily living as well as specialized nursingcare. During my 6 months of working there unfortunately, I witnesseddeath a few times. My view of death was shaped long ago when me beinga kid questioned my parents what death was. Being Christians, theytaught me that death is final only for the body, but soul continues toand goes either to heaven or to hell depending on our deeds during thelife. In the end, there will be resurrection and no more death.Surely, there is much more to death, dying and afterlife. Myexperience of death was redefined as I started facing death of thepeople I knew and took care of. First the most conscious and mostpainful experience was the death of grandmother who passed awayafter long battle with disease and whom I love cordially. My feelingof loss was tremendous. At the same time, I understood that hersuffering was finally over, and she was in better place now.When I was thinking of her death from position of Christian, Iknew it was God’s will and her death was just end of her life onearth and she was with Lord now. The experience of death of residentswas a little bit different. First of all, those people were notrelatives who you know all your life, but nevertheless, seeing themdeteriorating and suffering was still hard. I understand that fromChristian point of view God is with them in their suffering. We asnursing personnel tried to ease their suffering by maximizing care andmake them as comfortable as possible. Situation with dying in healthcare facilities are often shaped by presence or absence of DNR, DNI,and DNH orders. Recently, we had to announce code blue on one residentwho although was expected to pass away, the family still want him tobe resuscitated. It was painful to feel his ribs got broken undercompression during CPR, and, honestly, all staff thought our effortsto revive him was hopeless. Then 911 came and took over CPR and littlelater he was transferred to the hospital still alive. Sadly, he diesfew days later in the hospital. This situation made me thinkmore about moral dilemma around the death, whether or not to keepresidents full code or DNR and whose decision it should be. I cannotanswer that if it easier or harder for me to accept fact of deathafter what I experienced because every time it’s differentpeople with different stories. One thing I can say for sure, I feelrelieved when their suffering ends.

Discussion 5

At the hospital where I work, in myunit med-surg, we began having hospice patients six months ago.I’ve cared for many patients at the end of life, but itwasn’t until two weeks ago that one of my patients passedduring my shift. It was a really strange feeling when I had to checkfor the absence of pulse; although it was obvious he had alreadypassed. He didn't have much family and there was no one at thebedside at the time he expired which made it seem less emotional.I’ve cared for many hospice patients who have families at thebeside 24/7, and I have gotten to know their families well. In thisway there is more emotional attachment. It is also a strange and sadfeeling when you come on to your shift to find that that aparticular patient has passed. Even though it is expected thathospice patients die, it is still difficult. Though I haven’tyet had a med-surg patient die unexpectedly.

Although this is all a new experiencefor me, it hasn’t changed my view of death. It is sad everytime I know someone is leaving the earth too soon (it seems theyare usually in their 50’s) and their families are feelingthis tremendous loss. In this situation we are not only caring forthe patient, but also their family. I feel we need to show a lotof respect towards the families, as this is an extremely difficulttime. We have patients of various forms of Christianity(Jehovah’s Witness, Catholic), but all tend to show theirfaith in God by having a cross at the bedside, or visit from apastor or priest. This sense of faith helps me know they arepassing peacefully to a better place.

Discussion 6

Workingin both transitional care and IR, while I don’t experiencedeath daily, I have been the one to pronounce, several times, on theTCU. In witnessing someone actively dying it humbled and brought meto tears. I wondered what they were thinking or feeling. I reflectedon my children and myself, my life. Asked “will my husband beable to care for them adequately? I placed myself there in thatperson’s state of condition and felt saddened. I visualized mytime of demise and it deeply saddened me. I don’t care that Ihave a happy, fulfilled life. I love it and want to stay. Idon’t consider myself obsessed with death, but I think of itevery day. Am I prepared, not just on paper but spiritually? Iquestion whether my behavior is pleasing to my Lord. I fear dyingespecially tragically but no one knows when that time will be or how- until it is. While some may fall ill and think that they Know fromwhat they’ll perish, sometimes death comes so unexpectedly andit doesn’t have anything to do with the terminal ailment.Being a nurse, it is realized very quickly that death is imminentand sits upon all of our doorsteps. Modern technology, biochemistry,biogenetics, whatever the scientific pleasure, cannot cure death.Accepting death is difficult for me but I acknowledge that I ampromised this phase in my existence from God and it will be done.