Dying to Be There is for the 75% who qualify for hospice but do not get admitted because they, their families or their doctors don't know or understand what hospice is or does.
This is part 2 of chapter 2 of the 21 Life Lessons From Those at the End of Theirs.The Spirit Of Man: What Is It?
Another interesting realization from my discussion with Donna, the hospice social worker, is that in addition to being social beings, humans have a unique quality that animals do not possess. It is the quality of spirituality. It is a human quality and is not always referring to something religious.
She said, "So tomorrow you will meet with Sam. He is one of our spiritual caregivers. He wanted me to ask you this question before you left for the day." Donna handed me an index card.
Turning it over, looking at it, there were these words...
"What would you say?" Donna asked. "―What would your family say? What would friends or people at your job say? What would the next several people you meet say? Please take some time to do your own survey."
Handing me a manila envelope, Donna said, "Here is some reading for you for tonight. Promise me you will not read it until you ask several people the question about 'what spirituality means to them' and summarize the responses."
With that, I left day one of my introduction to my new job in hospice. My head was spinning. Never have I experienced such an interview and received such an education at the same time. This unique view of what hospice is has allowed me to see what an extraordinary thing it can be for terminally ill patients.
As I left and read the paper inside the envelope, it became obvious here was yet another lesson in life. While not from someone who died, it was from someone who was near death and was in a condition where death could have easily been the outcome.
Dear reader, before you go on, please call a few of your friends and ask them what comes to their mind when they hear the word ‘spirituality.’ Or ask a coworker or someone else with whom you come in contact. Make a phone call and connect to a friend. Reach out to a colleague. See what others in your circle have to say in answer to the question…,
"What comes to mind when you hear the word 'spirituality?'" Please let them know you have reading and thinking about (through these pages), different aspects of the end of life care that are available should they ever be needed, which are:
Providing palliative end-of-life care, not curative care.
Maintaining dignity during the end of life.
Maintaining the maximum quality of life.
Being there for them and with them through the end of life.
To be able to provide this type of care, the patient's spirituality plays a role. Thus hospice employs spiritual caregivers like Sam who would start off the second day of my interview. After you have collected some comments from people, please read the following information that was in the envelope Donna gave me to read that night.
It was titled, 'Why Do Some Patients Refuse to Die?' It might sound familiar to many.
Turn the page to see what was inside and what it said. It provides the clue to the next life lesson.
Some Patients Just Refuse To Die, This I Believe.
It has to do with the spirit. The spirit of man, rather than being some ethereal possession, is the life force within us, and this I believe.
As a scientist, I believe it's the force that actuates our mind and body and all the hundreds of trillions of cells that interact in the symphonic harmony we call life. Like the burning of a match, as long as there is fuel and oxygen there is fire, so with us, as long as there is spirit sustained by breathing, we are alive. Like a match running out of fuel into the mere glow of the final flicker of a flame, the spirit or life force comes to an end. Helping people understand and even use this power to keep their personal flame burning affirms my belief.
One evening at the end of my shift, a patient I had cared for six months earlier was again in the hospital, requesting me to visit her. She spoke of her impending death. Starting an assessment, I assured her she wasn't dying. Yet she seemed to have an awareness of her life force slowly slipping away. She somehow knew that it was starting to become that flicker that was soon to go out. She was dying. At least, this she believed.
On completing her assessment, this I too believed. I called the 'Code Blue.'
In a flurry, the night shift nurses worked on filling her physiological needs. Her blood pressure was 83 over, well, there was no bottom number. It was 84 over palp, down from the 88 I was able to feel but not hear just two minutes earlier. The supervisor squeezed a liter of saline into her veins to keep her kidneys from shutting down. Each of the other nurses quickly and precisely provided various aspects of care she needed while at the same time, the bed was being moved toward the operating room.
Me, I cared for her spiritual need. Not her religious or needs of her faith, rather a scientifically proven psychological need, the empowerment of that life force.
"Is there anything you have to do before you die?" I asked." "Is there any job to be done, anything to live for?" Her reply, the words came in almost a whisper, "Yes...my granddaughter's graduation."
Encouraging her to tap into that powerful force, I suggested, "See yourself alive, see yourself there."
The doors to the surgical sweet closed with me outside before I could say another word. I tried to provide the fuel to keep that flame from going out. The mantra to keep her going. Would it be enough? Emergency surgery and a re-operation would seal her fate.
The next evening the surgeon approached me and shared his thoughts on what happened and what went so wrong. Shaking my hand, he thanked me for saving her life. Later, the daughter, a bedside witness, came up hugging, crying, and thanking me for saving her mom's life. Had I not gone to visit her after clocking out, she might have not survived the interim of the change of shift before her nurses would have seen her on their rounds.
Yet who really saved her? Was it the nurses acting with the precision of a pro sports team, or the skilled surgical staff, who against the odds preformed a difficult re-operation?
Or was it my LPN nursing school orthopedic instructor from Wilkes-Barre Voc-Tech, Mrs. Sereno? She said if we forgot everything else she taught, remember this unusual, difficult to recognize syndrome that presented in this patient. A silent and invisible killer that I caught mere moments before it took another life, a condition called compartment syndrome which was the tell-tale sign of her bleeding out, only from within.
What about the patient, or rather her spirit? What kept the flame burning just long enough for the emergency surgery to permit her continued existence?
Clinically speaking, her body entered a condition that was not compatible with life, yet she lived. This experience, in spite of scientific data suggesting otherwise, tells me that there is a power in life. This unseen force is the spirit of man, one of life's most precious possessions, the force that actuates our mind – and our ability to be. It can keep us alive against all odds and it can be let go of in the span of a single breath.
And this I believe.
The Introduction: How I Came to This Place Called Hospice
Chapter 1 My Introduction to Hospice .....or
Why would anyone ask the job interview question, "How do you want to die?
Chapter 2: Hospice Social Workers
Chapter 2-B: The Spirit of Man
Pen. Pencil and Ink
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