Why I Practice Dying: A Nurse’s Perspective

author Diane SolomonI’ve been fascinated by death as long as I remember.

Just before I turned eight, my Grampa Lewis died. The event left a lasting impression on me. He had gone to the hospital, puffy and deteriorating from kidney disease, at age 56. I remember that Dad parked the station wagon with faux wood paneling in the hospital lot and we all got out and stood there in cold December sunlight. Strict visiting hours prevailed then, and no kids were allowed, period. Dad pointed up to Grampa’s window, where he waved down at us through the glaring glass as we waved back. The youngest of four children, I was too embarrassed to admit I couldn’t locate him in the anonymous grid of windows.

At the funeral, I grappled with whether or not to look into the casket. Both available options seemed horrible—be forever haunted by a vision of dead Grampa, or guilt-ridden because I hadn’t respected him enough to look.

As a parent, I know no child should feel alone with that type of decision. But this was the 60s, when feelings weren’t discussed. Although neither an open casket or an embalmed body are traditionally Jewish, Granny must have decided she wanted it this way. At the last minute, as […]

The Face of Burnout in Nursing: My Personal Story and Lessons Learned

Woman looking at ocean at sunset Photo by Artem Kovalev on Unsplash

Two-and-a-half years ago, I experienced severe burnout in my role as a night shift charge nurse in a cardiovascular ICU. This blog post shares my personal story, highlighting the common ingredients of burnout and the challenges I faced. Through this experience, I learned valuable lessons that can benefit both nurses and the health care industry as a whole.

Where it All Began

Transitioning from a clinical nurse educator to a night shift charge nurse in a new cardiovascular ICU was an exciting opportunity for me. However, it soon became overwhelming due to various factors. These included a surgeon I didn’t see eye-to-eye with, moral and ethical dilemmas in patient care, staffing challenges, and a hostile work environment created by lateral violence from coworkers.

Strained to the Breaking Point

As my anxiety grew, I struggled to meet expectations each night. While prioritizing patient care and my night shift team, I feared for our patients’ well-being. Frequently, we were overloaded with acute post-cardiothoracic surgery patients. Despite my efforts to manage admissions responsibly, I faced constant pressure. Doubts crept in, and I lost trust in myself and my ability to provide safe care.

The emotional toll […]

Comfort in the Midst of Grief: A Spiritual Care Journey

A mother’s grief.

Photo by Khamkéo Vilaysing on Unsplash

As a member of the spiritual care team, I received a request one morning to visit Ms. L, a patient who had just received devastating news: her son had unexpectedly died the previous night. Ms. L was recovering from a major surgery and in the process of being discharged from the hospital. The details surrounding her son’s death were unclear, but they only added to the profound sadness of the situation.

It was evident that the bond between Ms. L and her son was incredibly strong and loving. They had faced numerous physical challenges together, overcoming obstacles that strengthened their deep connection.

When I entered her room, there was a sense of familiarity about Ms. L, though I couldn’t quite place it. After I introduced myself, Ms. L turned to me, tears streaming down her face, and asked the agonizing questions that often arise in times of tragedy. “Why did this happen? Why were we subjected to so much pain? What had we done to deserve this punishment from God?” Ms. L, a devoted Catholic actively involved in her church, had always drawn strength from her religious beliefs for herself and her son.

In […]

In AJN’s July Issue, a Guest Editorial by Angelina Jolie and Other Essential Reading

The July issue of AJN is now live.

Among the highlights is a guest editorial by Angelina Jolie, “Addressing Health Inequities in Survivors of Domestic Violence,” which explains the importance of bruise detection technologies for patients with varying skin tones. Referencing her daughter, who is from Ethiopia, she writes:

“Even as my family has access to high-quality medical care, simple diagnoses are missed because of race and continued prioritization of white skin in medicine.”

On this topic in the same issue, see the Nurse Innovators column, “Improving Bruise Detection in Patients with Dark Skin Tone.

A useful read about getting patients up and moving again after surgery is a CE feature article, “Overcoming Movement-Evoked Pain to Facilitate Postoperative Recovery.” which emphasizes a multifaceted approach that includes timely evaluation and comprehensive care planning.

Improving Medication Safety in the ICU” is about a nurse-led initiative to reduce medication errors by increasing adherence to safety protocols, including compliance with barcode scanning before medication administration.

A Viewpoint addresses a possible solution to the thorny problem of how a hospital and its nurses handle patient access to medical cannabis.

See also the extensive health care news sections, the Journal […]

Honoring the Personhood of Brain-Dead Patients: A Delicate Approach

A dandelion alone in a field suggests the fragility of life. Photo by RIDVAN AYRIK/ Pexels

In the past month, we had a couple of patients in our pediatric ICU who had suffered tragic neurological injuries and were declared medically brain-dead. In the state of California as in most states, a pronouncement of brain death is equal to a legal pronouncement of death, and the medical team then possesses legal permission to remove mechanical support from the physical body that has remained under intensive care.

In both of these cases in our ICU, the parents struggled to accept the terminal implications of brain death and pushed back to varying degrees for more time to see if their children might still somehow find a way to recover. In these types of cases, the actual moment-by-moment practice of bedside nursing care becomes complicated. How do we honor the personhood of the patient as we provide intensive care for the body prior to removing mechanical support, and at the same time gently help the parents accept that their child has medically died?

The potential for misunderstanding nursing care

The interactions nurses have with family members as we care for their brain-dead child present many opportunities for […]

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