Reflection

My patient died at home
Peacefully with her pack of dogs and her daughter by her side
The way she had wanted to.
The Hospice at home team made it happen through talented design and planning
And initiatives such as the Cariad training scheme where lay carers are taught to administer medication subcutaneously and appropriately helped enormously
It was a multi disciplinary approach and as the newbie
I was very humbled to be present.
And when the daughter asked me what to do in those very last moments
I said quietly
" Just talk to her, and say what you want to" 
And as she did so with buckets of love , I stepped back quietly into the corner of the room 

69 comments:

  1. Only angels can do that job.

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    1. I have learnt a great deal from the community team

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  2. The work you do is such a blessing to your patients.

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  3. good on you, john. we should all be able to die with dignity at home (if we so choose).

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  4. It can be frightening to be with your loved one at such a time,feeling helpless and I believe your words would
    have helped them both John xxx

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    1. Flis this isn't about me it's about the new service that we offer...
      I saw it work ...well

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  5. Barbara Anne11:57 pm

    How kind and perfect your words were to the patient's daughter and they surely made this sad time a more positive one for her. You won't forget this experience nor will the patient's daughter.

    Peace be with us all.

    Hugs!

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  6. What a wonderful thing that she passed the way she wanted. I do know it's a big team effort as my stepfather died at two dear friends' farmhouse home, in my mother's arms, in 2011. I went out to Colorado to give what support I could. Did a lot of cooking and cleaning. I was shocked at the conflicts that occurred between my mother and his family, it was so intense.

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    1. Yes without the palliative care nurses who teach the carriad initiative the wishes of the patient would not have happened so seemlessly. Training carers to give vital sub cutainious injections means that waiting for meds in the community is drastically reduced

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  7. The moments of birth and of death are so similar. The doors open to...where? I don't know. But they open.

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    1. Anonymous11:11 am

      The birth doors open to awareness and life. The doors to death? None of us knows, whatever we believe. I believe it's to exactly the opposite. No life in the body - no awareness.

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  8. It takes strength and the right people to take this on.

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  9. Oh my...brings tears because I remember my dad. We used Hospice (USA) for 11 months for in home care. He was every ones superstar. He was not in pain much until the last three days and by then we had learned soooo much from Hospice that at the end my mom, my sisters and I looked at each other and said "we can do this" and we did. It was beautiful and I will always be grateful to Hospice for that. We called Hospice about an hour later and they came. I think it is a little more common here now and glad others are following.

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  10. You are a blessing John . . .

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  11. "Peacefully ….. The way she had wanted to."

    That says it all, John. Everyone should be so blessed.

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  12. This is why I have such huge respect for nurses and nursing.

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  13. I nursed my partner's at home when she was dying.
    I easily organized the nursing care from a pool of my colleagues and an occasional agency nurse.
    Our system was that there were always 2 people present-
    one family member and one nurse. Her local doctor made daily visits and came promptly after she died.
    It all went really well (we hired a few things to make life easier, and the hospital where I was working gave us a "slipper" pan as well).
    I firmly believe she died more peacefully with her loved ones there.
    So it makes me happy to read of your Hospice at home scheme, John.

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  15. I think Hospice at home do a fantastic job. My husband's Auntie was able to return home for her last two days, three months ago. She died surrounded by her loving husband and children. Huge respect for you John and all in your profession.

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    1. I am on a big learning curve as I've never nursed a dying patient at home with all of its challenges.
      It's very different that having someone as an inpatient

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  16. Anonymous6:16 am

    Peacefully with her pack of dogs by her side.
    That could not have happened in hospital and obviously the hospice couldn't accomodate a pack! If it would allow a visit from one (l am guessing this)
    Glad this innovation was in place for you to facilitate this lady's last wishes.
    Thanks to all who enabled this and was able to give the practical support needed as well.
    Tess xx

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  17. Would you not leave the room completely rather than stand in the corner?

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    1. Anonymous11:14 am

      I'm sure John knew exactly what to do and did it.

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    2. Anonymous11:17 am

      Rachel - read the comment from A Smaller Life below.

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    3. No need for you to but in Anonymous. John and I have already discussed it. I have no idea why you think you can do this here on John's blog everyday. Keep your nose out of my business with John. Why not have the nerve to use your name, have a blog and write yourself. I can read and do not need you pointing me in other directions.

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    4. And as ever, John is perfectly able to defend himself.

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    5. And please from now on all anonymous comments without a name will be deleted xxx

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  18. Thank you, John. It's the anniversary of my dad's passing today. We were at his bedside. xx

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  19. Oh John, what a peaceful way to go.

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  20. That is a good death John .
    It seems to me that birth is violent with a huge rush of energy coming into the world, where as death is or should be a gradual gentle slipping away.
    Kathy xxx

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    1. Babies sometimes rush into the world all fast and slippery and with the danger of being dropped but it need not be violent. Sometimes though, they sit half in the world and half not here yet, they just wait and look around, wisely waiting until the next surge pushes them the rest of the way.

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    2. I meant violent in the sense of great rush of energy.
      Kathy x

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  21. Most people want to die at home but almost nobody does. This is a great initiative. Was it a more enjoyable way to nurse?

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  22. This is a wonderful initiative. It must feel, as you say humbling, but also very honoured to be present with the patient you have nursed and their special loved ones right at the end.

    Stepping back, but being there as support is the perfect way to do it. It can be so scary in those first couple of moments when your loved one has passed, and knowing there is someone there for you that knows what's going on is so reassuring.

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  23. Where would we be without you and your colleagues...... we are all so lucky to have you all in our time of great need. Thank you. XXXX

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  24. Thank you for being there, for helping the person remain comfortable, for helping the family know what to do, for coordinating that the person wanted. Family, dogs, home. Both of my parents died at home, with care from hospice, the way they wanted to.

    ReplyDelete
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  25. Having had the experience of both, I believe NICU and Hospice nurses are angels in disguise. Both of my parents died at home, but here in the states they cannot administer pain meds, those are given by the family. My two siblings and I set our clocks to wake up every hour to give my Dad his morphine. It was scary, but knowing he wanted to die at home, this was our last gift to him. He, of course, had to do it his way and managed to leave us while we were all napping sometime between 5:30 and 6:30 in the morning. Anyway, you and your work are appreciated. Steph

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    1. We can give meds and we change the syringe drivers as the district nurses do but it's vital for carers to give other meds promptly if they can

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  26. I've been thinking about life and death a lot lately; reading this was helpful. Thank you, John.

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  28. Treasured last memories I am sure John - so important.

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  29. Hard to watch a loved one pass away.

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  30. Hospice is a great program. My 99 year old Uncle chose hospice and home care. He lived for almost 6 months. Hospice nurses were outstanding. Very supportive and ensured he was comfortable and very much pain free. Death is a process including lots of emotions. John can you write a book about this?
    I learned so much from hospice nurses.

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  31. Bless all of you!
    Joyce

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  32. Heidi3:11 pm

    Hello John, I don't comment as often as I used to do as I don't always have the time or I'm too tired (carer for husband) but as things decline here I just wanted to let you know that I've found your posts about Hospice care very comforting. I don't know how long before we get to that stage and there may be a care home before then. After vowing over the years to keep him at home I find my own health isn't good now and I'm not as capable as I was. Not having experience of Hospice care for any others in the family I've found your words to be informative and a big comfort. Just wanted to let you know it's appreciated.

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    1. Thank you
      If you would like. My helpnanytime please
      Email me
      jgsheffield@hotmail.com

      Anytime x

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    2. Heidi5:29 pm

      Thank you for your kindness.

      Delete
  33. I love you, John Gray! You make a difference! My heart goes out to her family.

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  34. Happy your patient's wishes were able to be followed through.

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  35. What a lovely way to leave the world. I am glad you were there to help.

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