Tag Archives: grief

Stepping Up

My apologies for being MIA this past week. I received my second Covid booster, and these never go well for me. I’m back in the land of the living, so I can provide a few updates. I’ve finished my End of Life Doula classes through INELDA. The final classes were bitter-sweet. Between the rich discussions, the role-playing activities, and journaling, you really bond with some of your classmates. I will miss the classes. So I am now a fully trained End of Life Doula. The certification process continues this summer, as they are revamping it for more mentoring and support.

The next step I took and completed today was to become certified by the Americans Clinicians Academy on Medical Aid in Dying. In Oregon, this is known as Death with Dignity. This is NOT assisted suicide, and it is actually illegal for insurance agencies to consider it as much. In Oregon, Death with Dignity is for terminal patients with less than six months to live. So these patients are already dying. This gives them control over the dying process and alleviates needless suffering. I’m very passionate about my support for this and will work to advocate for patients to have this right in any capacity I’m able to.

My last step will be to complete the therapeutic touch program. The first three foundational classes begin in September and run through November. Once those are completed, I’ll work through classes four and five, then certification. This is not only something I can do with the hospice patients I’ll be working with but as a stand-alone modality.

Marketing, business, rates, availability, etc, and all those details are being worked out. Once they are I’ll be sure to share all of that in a way that makes sense with my logo and some other details about what I’ll be doing. Thank you for following along with me here as I navigate this. I can’t wait to meet new people and help with the healing process in whatever capacity that may be.

Eastern Standard Time

Well, the class had an interesting start. When I say interesting, I mean a fail on my part to notice the time was eastern, not pacific standard. When I realized the time difference I practically fell over in a panic, running to the table to log into the Zoom session as fast as possible with my book ready to go. So I did miss a little of it. However, I read ahead to see what the material was and what exercise we’d be doing. So once I  logged in and was able to jump right into a breakout room on Zoom.

They paired us up with a partner. We’d take turns during our breakout time, one person being the Doula and the other being a client who just found out they had two months to live. So we role-played for quite some time. I loved every minute of the Doula role. For privacy reasons, I can’t share the contents of our conversation. The discussion was fruitful and very powerful. These are not easy conversations, nor is it easy to be deeply actively listening without “uh-huh” or “hmmm” inserts.

 I’m also a natural “fixer.” I want to fix and suggest. These practices are off-limits for a Doula. My place is to guide. I asked all open-ended questions to elicit more from the client and try to connect with them, draw out more emotion and really get to the heart of their concerns and wishes. This isn’t easy. It took complete presence and tuning out any distractions. There were tears with some. Considering your mortality is an emotional act, and when you get into the details, such as the family that may be left behind, kids, or areas that might need closure, it weighs heavily.

My next class is Saturday morning, so I’ll have more to update with, but I feel like I’m in my place so far. I love it.

Breathing

It happened within minutes. The first rapid response call quickly escalated to a code blue. One minute the patient is breathing and poking fun with me and the next they are quickly fading in front of my eyes. What came next was organized chaos.

My fellow nursing friends and I have all had several conversations making very clear our fears coming to fruition- a patient going unconscious, crashing or a code being called while we’re caring for them. We knew it was not a matter of “if”, but “when”. Apparently, it was my turn.

It’s not that we don’t know what to do- we’re all trained in CPR and have walked through the code process. The issue is how we would actually react at that moment and how it would feel. Would we panic and freeze up? Would we be able to think clearly and know what decisions to make in the very second that life comes to a screeching halt?

In my moment, an overwhelming sense of calm came over me. I can’t explain it or why I felt it, but that’s what happened. Everything stopped except what was happening in that room. As soon as the code was called, the room was flooded with various doctors, nurses, and other staff. CPR had already begun. When I say it was organized chaos, I mean it in every sense of the word. Every action had a specific purpose. Watching someone glide from life to death to life is surreal. It’s like the ebb and flow of breathing; you breathe your way in and exhale your way out. Out of respect for the patient, I won’t go into any more detail than that.

Later that same afternoon, I walked my patients’ room (a different one) and noticed them nodding off in their chair. I walked in to see if they wanted to get back into their bed. As I got closer, it was clear they were not nodding off but seemingly floating in and out of consciousness. I asked, “name here, are you OK?” When they responded, “No, I don’t feel well”, every hair on my arm stood up. I’ve heard seasoned nurses day they can sense when a patient is going downhill or may “crash”. They just know. They know how it looks. I never understood until that second. They just didn’t look right. After the nurse took a look at the vitals and the patient (again this was in seconds), I was told to call a rapid response. I learned later that the patient nearly had another called.

Yesterday was a day of many firsts. I also had my first post mortem care. It’s one of the most personal moments I’ve shared with a patient, second only to another this week (saved for a different post). You’re paying homage to the body that housed their soul and all the years of their life. It’s the CNA’s responsibility to assure the patient is presentable for family and respectfully prepared to go wherever they are headed next, whether that be the morgue, or what the patient or family has determined.

Everyone reacts differently to grief. I briefly worked in an ER and will never forget a young wife, openly weeping, “I want him back! I want him back!”. Or another family gathered around for hours to say their goodbyes peacefully. As with life, it’s just as important to guide and support patients and their families through death, through whatever manner it occurs.