The Words We Use to Talk About the Act of Suicide

    marie + alistair knock/flickr creative commons

Suicide. A dear friend of mine died this way almost 40 years ago, leaving behind a beautiful six-month-old boy and a beloved and loving husband. I have never given any thought to the way we friends and family refer to her death. Then last week, I came across a 2015 blog post by the sister of a man who died in the same way.

In the post on a website that shares experiences of disability and mental illness, former hospice social worker Kyle Freeman argues that this term suggests criminality. She points to laws in the U.S. that, until a little more than 50 years ago, defined suicide as a criminal act. Kyle feels this history has perpetuated a sense of shame and embarrassment in survivors.

“…the residue of shame associated with the committal of a genuine crime remains attached to suicide. My brother did not commit a crime. He resorted to suicide, which he perceived, in his unwell mind, to be the only possible solution to his tremendous suffering.”

Kyle believes that the common use of the phrase “committed suicide” is not only inaccurate but can add to the suffering of those who have lost friends or family in this way. She prefers the term dying by suicide. […]

Please Nurse: Needing to Feel Human Again in the ICU  

Ruby Vogel circa 1970. Courtesy of Shannon Perry.

The patient perspective below was written by Ruby Vogel in 1976, shortly after she was discharged from the hospital following a cholecystectomy and colon surgery. Her daughter Shannon Perry, PhD, RN, FAAN, professor emerita at San Francisco State University, recently received the document from her sister, also a nurse and former nursing educator, to whom their mother had originally given it.

According to Perry’s sister, who found the document while cleaning out some files, Vogel had thought her daughter could use the information to help her students understand the experiences of patients in the ICU. Some things were different back then—for example, says Perry, a cholecystectomy and colon surgery were major surgeries with several days in the hospital for recovery. But some things stay the same, and this vivid account highlights how patient-centered care—a touch, a hand on the brow—can make the difference. Ruby Vogel died in 1985.

Intensive care put me in a different world—of noises, silly ideas, and feelings. I seemed apart from people. They came and went but I wasn’t people, just that big sore place. I could hear and I could see. People didn’t seem to speak to me nor stay around long enough for my eyes to focus or my lips to form words. In and out. Checking! Checking! Checking! I could see and hear. Family, nurses came in, took a look and left. I was still there.

That awful machine next […]

2017-09-11T10:45:55+00:00 September 11th, 2017|patient experience, Patients|0 Comments

How Long Should Routine Health Screening Continue in Older Adults?

Photo by Johner Images / Alamy Stock Photo

Communicating to older patients that routine screening tests are no longer recommended can prove difficult. Recent research, however, offers guidance on how nurses and other clinicians should approach such conversations.

As we report in a September news article, a study focused on cancer screening found that older adults unlikely to benefit from certain tests were receptive to recommendations to stop screening, with a caveat: they preferred that life expectancy not be a part of the conversation.

The study’s accompanying editorial notes that broaching the topic of life expectancy can turn a discussion about maintaining health into an unexpected discussion about the end of life, which “may be a shock in the primary care setting at a routine visit.” The authors of the study recommend changing the language used in these conversations—for example, saying “This test would not help you live longer” instead of referring to “life expectancy.” […]

2017-09-06T09:21:09+00:00 September 6th, 2017|Nursing, patient engagement|1 Comment

Intimate Strangers: A Pediatric Intensive Care Nurse Reflects

By Lisa Dietrich for AJN.

“How do I talk about these things with a stranger unless I know how to be intimate?” asks pediatric intensive care nurse Hui-wen (Alina) Sato, the author of “Intimate Strangers,” the Reflections essay in AJN’s August issue.

Sato writes about “walking intimately . . . through the most devastating hours of her life” with a woman she’s only just met—even as her role as a nurse involves ending the life-sustaining treatments of this mother’s child.

Nurses will tell you such experiences can be common in their profession. But essays like this remind us that such experiences are also remarkable. Sato is the type of nurse who ponders her role, who stops after the fact to wonder what it means to be a participant at such moments in others’ lives. […]

2017-08-04T10:51:54+00:00 August 4th, 2017|Nursing, nursing stories, patient engagement|0 Comments

Connecting Emotional Intelligence, Team Communication, and Patient Safety

An Early-Career Nursing Memory

Photo by Barry Diomede/Albany Stock Photo.

Many years ago, fresh out of nursing school, I was in charge one night, with no other RNs on the unit. We had an “active GI bleeder” who needed hourly boluses of either ice water or iced milk through an NG tube. (Yes, the standard treatment at that time was gruesomely uncomfortable for the patient, and in later years determined to be counterproductive.) I had more than a dozen other patients to care for, but everyone got their meds and, miraculously, the bleeding man made it through the night.

When my supervisor made rounds at the end of the shift, I reported that all was well and that my critical patient had survived. Her only response: “Mrs. Todd! There is blood on your shoes!”

This senior nurse, standing there in her starched whites and impeccable shoes, didn’t recognize that I had feared I would be inadequate to the task, or even acknowledge my pride as a brand-new nurse in actually saving someone’s life. In retrospect, I can’t help wondering if her choice to focus on a superficial fact, irrelevant to the crisis, could be interpreted as an indication that she lacked a certain acuteness of emotional […]

2017-07-17T16:49:20+00:00 July 17th, 2017|Nursing, patient safety|1 Comment