DeHaan, Julie; Friesen, Pamela K.
Julie DeHaan and Pamela K. Friesen are affiliated with the Department of Nursing at Bethel University, St. Paul, Minnesota.
The authors declare no conflict of interest.
DEVOTIONAL: Caring For All
by Erika Hellstrom, a May 2014 graduate of Bethel University School of Nursing, St. Paul, Minnesota.
During a clinical rotation, I encountered a patient so fatigued by his failing health that talk of palliative care was discussed. My patient had recently suffered a traumatic experience when he coded. He had previously stated he was “DNR” (Do Not Resuscitate); however, his wife stated otherwise.
My patient was a kind soul. I got the impression he was at peace with his situation based on his smiles and jokes. But my interaction with his wife was striking—I don't think I'll ever forget her words.
Arriving, she introduced herself and stated her fears regarding her husband. After addressing her concerns as best I could, I asked her about their life together. She told me their story of getting married at 18 and then said, “I believe God gives us all a purpose and mine is taking care of him.”
Her words created an incredible “pause” moment for me, emphasizing that the palliative measures to be discussed were not just for my patient, but for his family as well. I understood in a new way that to have a successful care plan, everyone has to be on board.
At the end of the day, my patient was recovering from an EGD (esophagogastroduodenoscopy). I stopped to say goodbye to his wife. Sensing her appreciation for my caring reemphasized the importance of providing listening and care to all, not just the patient.
Galatians 6:10 states, “So let's not allow ourselves to get fatigued doing good. At the right time we will harvest a good crop if we don't give up, or quit. Right now, every time we get the chance, let us work for the benefit of all…” (The Message). We can become bogged down by the sheer number of patients and the level of care required. We may run from room to room answering call lights and forget to stop and pause. Rather than run, let's remind ourselves that nursing allows us to be the hands and feet of Christ. Daily we have opportunity to do good and show love. Remembering that we are called to love everyone is an opportunity we may miss. God calls us to love one another, not just the sick and poor, but all. This includes patients, coworkers, friends, and family. When we love and care, there is no limit to the good we are called to and capable of extending.
How can we encourage patients and family members to communicate their wishes for end of life? Five Wishes is one type of living will written in easily understood language. The document was developed by Aging with Dignity, a nonprofit organization.
The purpose of the Five Wishes:
* Allows families to have conversations together about the type of care a person wants when he/she is unable to make his/her own decisions
* Specifies the type of medical treatment a person does or does not want
* Designates what comfort measures a person wants
* Explains how a person wants others to treat him/her
Five Wishes is available in 26 languages and meets legal requirements for a living will in 42 U.S. states. It is available online. Anyone can designate his/her desires electronically and then print a copy for family members and healthcare providers. Find Five Wishes at http://www.agingwithdignity.org/five-wishes.php.
Practice Makes Permanent?
Nursing school can be stressful!
In the nursing lab, a student practiced repeatedly for her upcoming medication administration test. Using the bedside electronic medication administration scanning system and the mannequin “John Carlson,” she repeated the fives rights correctly the three required times and passed her exam without a hitch.
Excited and nervous, the student earned the privilege of passing medications in the acute care setting. As she stood at her patient's bedside, she took a deep breath and began her five rights/three checks. She looked at the patient, looked at the computer screen and stated, “John Carlson, John Carlson,” then abruptly stopped and looked at the patient with a bright red embarrassed face.
Her instructor smiled and noted, “You've obviously been practicing a lot!”
Never forget laughter is good medicine.