Finding peace in end-of-life care

Death is one of those topics that can make you feel a bit uncomfortable, unless you are a nurse. We are trained to inquire if a patient has an Advance Directive, often before doing a nursing assessment. Very few professionals speak so openly about death—it’s hard to imagine those in retail, banking or hospitality chatting about it at lunch over a Greek yogurt! Not so at the nurses’ station. We speak candidly among ourselves. In fact, some of our conversations are quite nonchalant. And it’s amazing the graphic details nurses and other health providers describe at the dinner table. Our own families are aghast at times!

One aspect of death that nurses struggle with, however, is helping patients who are close to the end of their lives find peace. These are the patients who carry heavy burdens and regret in their hearts. The ones with unfinished business: past mistakes or decisions that have cut them off from their families, or the loss of a child, or perhaps years of abuse and pain. One patient recently spoke of his children and that he doesn’t even know where they live. I can’t imagine the agony of such brokenness. Often I feel unable to help these patients accept circumstances that cannot be changed and to transition from this life in peace.

It’s difficult for me to wrap my mind around someone dying while leaving so much of his or her life incomplete. Forgiveness from others is necessary—we are incomplete without it. But we are even more so when we cannot forgive ourselves. Is it okay to talk of faith? Or spirituality? These are questions without absolute answers.

Sadly, there often is no resolution and no happy ending, and there we stand at the bedside of these most vulnerable human beings. We are their nurses and they are our patients. We want to help them find solace.

Sometimes it’s through our silence, our presence or just our touch that gives them space to be who they are. Perhaps that’s all we can do. Acceptance takes time, and time becomes elusive with a serious illness. But acceptance must come before peace.

As a nurse, I am powerless to change the circumstances, but remain willing to hold this space for my patients. This requires maintaining some emotional detachment. A delicate balance indeed. Paradoxically, through these patients I am indirectly taught the greatest lessons of all: the value of human life, the importance of family and that in each day there is a treasure—it only needs to be found.

Teri Blackadar has been practicing nursing, primarily in emergency rooms, for more than 20 years. Currently she is the Swing Bed Coordinator at Waldo County General Hospital in Belfast, Maine, as well as the Adult CNA Instructor for the Waldo County Technical Center. Her nursing background also includes training in sexual assault, forensic exams, cardiac rehab and a bit of home health and hospice. She believes wellness and nutrition education are critically important for healing. Blackadar is a 500-hour trained Kripalu yoga instructor and enjoys sharing yoga modalities for therapy.