The video, Facing Death, is relevant to my current career as a Home Hospice CNA. I haven’t worked for the Hospice unit very long however in the just the short time I have been there, many of the same issues and questions addressed in the video, have been raised. Due to my experience, I’m not easily surprised by choices that patient’s families make and I don’t believe that a nurse ever should be. It is not my job as a health care worker to interject my beliefs on the families or patients that I come into contact with daily. I believe it is the responsibility of the healthcare providers to deliver the best treatment and information while respecting the wishes of the patient as well as their families.
I too agree that your job as a Home Hospice CNA provides you with a very close insight into these kinds of issues. Some of the patients in the video finally opted to join hospice. In addition, I too believe that it is the nurse's responsibility to only inform the patient and their family to all the options that are available to them. I also agree that the nurse should respect the wishes of the patient and their family, because a nurse's role to give patient centered care and be there for the patient, not to insert their opinion and tell the patient what to do.
Demi, I have a lot of respect for you with wanting to pursue a career in Home Hospice. This would be something that I would have a very hard time dealing with. It definitely takes a special kind of person to be able to work with that all the time. I agree with you as well that it is not the nurses job to make a decision. It is easy sometimes to get wrapped up in wanting to make a decision. We have to take a step back and realize that it isn't our lives on the line at the time.
Demi, Home hospice would be a tough job, but i give you a lot of respect for going into that. It would be very difficult to see patents that are dying. I also agree that it is the nurses responsibility to inform the patient and their family about everything that is going on with the patient.
The most surprising thing about the video Facing Death was the fact that so many of the patients refused to give up, despite what the treatments were doing to them The one man was like on his third bone marrow transplant, and the effects of the treatments were quite evident. Despite the toll these were taking on his body, he refused to give up and truly believed he was going to get better. I think this is such a hard reality to face ad this video does a fantastic job of showing this perspective. I think that as a nurse this video has great significance. Nurses have to face these kinds of ethical dilemmas every day. Nurses see patients suffer and suffer and continue to suffer and refuse to give treatments, and sometimes it is very hard not to insert your opinion. However, it is not the nurse's place to insert their opinion. The nurse only needs to provide all the options available to the patient so that they can make an informed decision, and respect the decision that is made.
I also thought that the patients' resiliency was surprising. They just never wanted to give up, and I think that it's very admirable of them. I also agree with you that the video does a great job illustrating the hardship faced by many families. In your field, there is always a thin line to try not to cross regarding your personal beliefs, and I'm glad that you're aware of what the job entails, as far as your duties go.
While watching the movie I was thinking the same thing. Many of the patients were going through the toughest time of their lives and in so much pain they could hardly speak but they refused to give up. I believe this video did a great job showing how the doctors and nurses have to deal with this every day as their career. I couldn't imagine having to do that.
The video facing death had extremely bad timing for me. I found out this morning that my dog passed away and this video was unfortunate. This video showed how interesting technology is these days. Without all the technology, people would simply die and families would not be put through the tough decision of life support and tubes. It's a hard decision for many families. This video really showed how hard the decision is. I have had many people in my life pass away, so facing death isn't uncommon for me. I've seen my grandfather on life support and although my family knew his wishes, it was still very difficult.
Emily, I'm sorry to here that your dog passed away. I have a dog to and I can't imagine having my dog go to heaven. I agree with your with your statement above, it is crazy how technology has developed into what it is today. Technology has many good uses in the medical field but it is also a curse at the same time.
Emily, I am sorry of your loss of your dog and grandfather. I have never considered the idea that families would not have to make difficult decisions if the technology to prolong their life was not their. In some cases it would be easier without the prolonging life technologies but then it can also save lives which is great. It is hard in these circumstances to decide what is right and what is wrong which i hope to continue to explore throughout this class.
There is no black and white when looking at whether to take someone off life support or not and the gray area just seems to be a blur. I am so sorry to hear about your doggy, on July 4th this past summer we had to put my dog of 15 years down and it was one of the hardest things I had to do, they become like brothers and sisters. I believe if someone has never known the love of a dog (or another pet), they are missing out on a lot.
I watched this video last semester in Death and Dying Class. I remember how many families were caught in sticky situations as to how to proceed with medical treatment. I am surprised as to how many people don't know their parents wishes as far as life saving treatment and DNR. I breaks my heart that some patients have to suffer as a result of not getting treatment or even the dying process. I wish there was something that could be done to prevent the suffering that patients and families endure. I am aware of hospice and palliative care services that can help the transition from life to death and provide support for the families.
Lauren, It is very unfortunate that people suffer during death. This is where the positives of technology come in. They can do their best to keep them comfortable. However, also as said in the video often the underlying disease breaks out and continues to make the individual uncomfortable. Hospice is a great thing, but it is also very saddening for many families.
I agree with you. There seemed to be a lot of disconnect between the patients and their families as to what they were going to do as far as procedures. I think the decision making time should be spent more by spending time with your loved one for their last hours instead of spending it agonizing over what the decision should be.
I remember the first day of death and dying last semester when this video was shown how difficult and different each individual case is. Each have their own different issues and ethical questions asked within each case. This video and the death and dying class made me realize how important it is to understand certain situations such as choosing to stop care on a loved one. It also made me realize that the people close to me need to know and understand my wishes if i was in this situation so they would not have to make such a difficult decision. Overall, the video portrays multiple situations of what in the health care field we can face, it was informative to help me decide in what my wishes would be in a certain situation.
There were a couple surprising things about this video that really made me think. The first surprise was the cost of the procedures that were being undertaken. I wondered to myself during the video how commercial insurances went about helping the families in tough positions. The other surprise was the resiliency of most of the patients. I wondered how they could endure so much pain and, in my opinion, unfairness. Moreover, I have recently gone through a decision exactly like the ones being shown in class. I can personally relate to each case shown because my grandma, not even two years ago, was losing her fight with a rare form of inner abdominal wall lining cancer. This was very hard for my family to deal with, but eventually, a decision had to be made. Her children and husband decided to take her off of life support and keep her heavily sedated so she could slip away into God's hands peacefully. This is still a difficult thing for me to deal with even today, so I feel like my personal experience with having to be semi-involved in the choice gives me insight into why certain families would choose to quit fighting. Overall, the video really struck a chord with me, as you can imagine, and I can definitely see both sides of the story. I completely understand why one would want to fight, but I also see why it can sometimes be better to let nature take its path.
Vic, I am sorry for your loss. My uncle died almost three years ago from pancreatic cancer and my aunt kept him sedated so he wasn't in pain. My grandpa was the same way just two weeks earlier. This video is very controversial as far as the technology goes.I agree with you as to why people would want to fight but also seeing why it might be better to let nature take its course. I firmly believe everyone has a time to go and sometimes that can be very difficult.
Vic, I'm extremely sorry for you loss & even though it was less than two years ago, I know it still feels like it happened yesterday. We had to make the same decision for my grandfather two years ago, who was dying from colon cancer which had spread. I loved the words you chose, "slip away into God's hands peacefully" because I think that is more than perfect, We were both lucky, in a way, that we were able to say goodbye to our loved ones, instead of viewing their passing as negative.
After watching the Frontline program, it's hard not be a little bit frustrated watching the scenarios. At times, drastic treatments could be needed to help a patient survive; however, there comes a point where this seems hopeless. Watching doctors throw every possible high tech treatment at a patient who is obviously at the end of their life and in the process of dying is difficult. Just because treatment can be offered, doesn't mean it always should. If there is a chance at recovery, then yes be all means provide care. If it is clear death is inevitable, then it seems futile. This only provides false hope to a family that struggles to say "no" because they don't want to feel like they are giving up on their loved one. Care ought to move from recovery to comfort at this point. These issues could be resolved if living wills or plans of care would be set ahead if time; furthermore, this would relieve tension for families that are already in a difficult situation. However, the resiliency and determination of some of these patients is remarkable. I can easily see why they would want to continue treatment because they have families that they love and want to support.
Austin, I agree with what you said about how frustrating it is watching the video and how helpless some of the patients are. It doesn't help when family members have conflicting ideas on how to proceed with or without treatment.
Austin I have always questioned the motives of family members. Obviously I cannot generalize however do people continue these treatments for the right reasons? Or is it some primal need for control and to prevent the ending of life without regard for logic? I do believe that this confusion of patients wills along with personal agendas and the inability to let go is so convoluting that a bad situation is made worse.
This is in no way a criticism of those patients who chose to fight through their illness, but if I was a patient in a similar scenario I personally would be overwhelmed by guilt. I couldn't help but feel I required too much time and money from my family for so little reward. I would feel like I was mooching just to extend my misery. Again, these are my personal feelings, not a statement on what people should actually do.
If I was a family member and/or healthcare proxy, I would feel very differently. In this case I would feel a strong sense of obligation. I would be extremely hesitant to end treatment or life support. I would feel like it was not really my choice whether or not to stop delaying the inevitable. This would be especially strong if the patient in question was unable to weigh in on the matter and the choice then fell on me and other family members. There is always the slim chance for recovery. Yet the pitifully sad truth is that medical care requires a lot of money, and one's financial resources are often not enough to sustain this outside shot at recovery for very long. Even if the person was brain dead and unable to experience life again, I would still feel like I was guilty of selling them out. But there are circumstances in which that difficult decision must be made.
The video was an excellent introduction to biomedical ethics. It showed just how morally ambiguous and emotionally tempestuous this topic can be, and it did so by showing real people in real situations. It was a baptism by fire for the class, forcing us to face these difficult dilemmas from the first day of class.
I want to first send my condolences to everyone who has lost a loved one. It seems that, unfortunately, this class is not new to the idea of death. I too have lost a few family members, friends, and pets along the way. Just last week, a youth pastor that I was very close to passed away from cancer. He put up a good fight for several months, but decided to forgo treatment and let nature take its course. He trusted God through the entire process. It was inspiring to me that his spirit never faded.
Death is never an easy topic, but it has to be dealt with. As Dr. Cate said on Monday, it will benefit all of us to decide how we feel about the ethics of medical treatment, such as life support, before we are faced with them on a personal level. The most interesting thing to me about the video was that each family dealing with death handled it in such different ways. This goes to show the impact that culture, family, and personal values affect every aspect of life, including death.
Healthcare providers sit in a very tough spot. Everyone has their own ethical opinions, but it is not the place of a healthcare professional to force their beliefs on their patients and families. There is a thin line between giving rational, medically sound advice and telling your patient what you think they should do based off of personal morals or opinions. There is not always a clear cut answer for every patient situation, which is by-far the hardest part of healthcare.
Tori, You stated in your last paragraph about how each situation with a patient is different. This is something that is very hard for health care providers to understand along the way. There may be a patient that is willing to fight through whatever when another patient just wants to give up. We have to take a step back sometimes and understand that we can't always understand what everyone is going through.
Well said, Emily. Sometimes patients have been through a lot over the years and they are at a point in their lives where they are done fighting. It may not make sense to the physician or family members, but sometimes all that matters is that the patient is at peace with their decision. This is not to say that I condone things such as physician assisted suicide, but I see no harm in "pulling the plug" on a patient who is living only off of life support if everyone is aware and at peace with that decision.
Death, or the thought of death never gets easier. Unfortunately I know this previous statement to be true, based on personal experiences. My family has had to make some of these decisions for our loved ones. You watch someone lay in bed for months not being able to help themselves, and you wish you could do absolutely anything for them, you would even change them places to take away their pain but you can't and then the day comes where they close their eyes and never open them again and even though you knew for months that one day that tragic moment would come, you never thought it would happen to you and your family.
I have a friend whose niece has cancer and just when they think they finally beat it, the cancer comes back again and they have to start treatments over again. As you can see, I used the word "they", because even though this little girl is struggling to fight a battle all of its own, she has people fighting with her and praying for her everyday and that's what makes any illness or deadly disease even more difficult. You are not just losing (I say that lightly) an individual there is always a potential to be breaking up an entire family. People do not like change and death of a loved one is one of the biggest changes we face.
I agree with you. Many people do not like change, and the death of a loved one is probably the biggest and most difficult change that an individual, and a family, could go through. I experienced a situation like this with my aunt, and it was very difficult for my family. However, I do believe that it makes a family stronger, because every family member knows what the other is going through.
Amanda, I like how you point out that the battle is not just the patient fighting to survive, but also the family struggling to make decisions that they think are right and then being in constant fear that it's not the right thing, or that there's still a chance that the patient might wake up or the treatments might finally take and they will get better.
The most surprising thing to me about this video is how long these individuals, and their families, fought to keep them alive for as long as possible. I understand that you don't want a loved to be gone from your life, but at the same time, are they really living? Some of the patients were just laying in the bed on a ventilator, not able to talk or interact with anyone. I guess my point is, when is enough, enough? I had an aunt that went through a similar situation as what we saw in the video, and she eventually decided that enough was enough. It was hard for not only her, but our whole family.
Jillian, I completely agree with you. Sometimes enough is enough and patients need to be let go. I feel that if a person is living solely off of a ventilator or similar machine, then they really have no quality in their life. They are being kept alive for the sake of the family. I would understand keeping the patient alive for just a few days so that family members who live far away could fly in to say goodbye, but an extended amount of time is not good for anyone.
To me, the most surprising thing about this video was the way many of the families handled these terrible situations. There were many cases where the families chose to keep their loved ones on the ventilators for a long amount of time. To me I think it would be harder to watch my loved one suffer if they aren't able to function as they wish they could. I can relate this to my own life by thinking about my grandpa. He was very sick and my family had to choose whether or not to keep him on the ventilator or not. The biggest thing my family had to think about was what would he want us to do? After a lot of thinking my family decided to let him go. It was hard for us but we knew that is what he would want.
I'm so sorry about your loss. I agree about how well the families handled such hard times. I also think it would be hard for me to watch a loved one suffer if they are not able to function as they wish they could.
This is the second time that I have seen this video. Even the second time seeing it was hard to watch. Death is something that never will be easy. You can never prepare yourself for death when it arrives. I think the hardest thing for me to watch wasn't the reactions from the family but the reactions of the patients that were dying. Coming to cope with the reality that you are dying is a hard concept to grasp. It scares me now to even think about it. I lost my grandmother a couple years ago. My grandmother seemed invincible to me. I knew that she wasn't but even when the time came for her passing it was still hard. We grow up sometimes thinking that we will never die. I always pictured myself dying at a old age. Some of the people in this video weren't very old. This was a hard part for me to grasp as well.
I agree that dying is a very hard concept to grasp and it is scary for me as well. We had a classmate who passed away my junior year of high school in a car accident. It made me realize that not every day is guaranteed, and death can happen at any age.
While watching facing death, I felt for the patient's family, but mostly for the patient. In some of the situations while being intubated, the patient's family would have to make the decisions for them. As a loved one, it would be hard to let the patient go with it being your final decision to take them off the life sustaining equipment, hoping for the best. My opinion is that the family should not have to make this kind of decision because in every case they just don't want to lose them. I think that since the patient is the one that is actually going through this, they should have the final say. Whether it's them signing the DNR, deciding that they will do all that they can to stay alive, or resorting to comfort measures until the time comes. All the healthcare team can do is to education the patient and provide them with honest answers and options for the planning of the next step of care. I have worked as a CNA on the MICU (Medical Intensive Care Unit) multiple times and cared for patients in the same situations that were shown in the video. Actually seeing these situations and reading up on some of their history raises the questions on whether the treatment is worth putting the patient through and if they could even lead a life that they would think is worth living if they were eventually able to be weened off of the equipment.
Death is never an easy thing to deal with because there is more people than just the patient that has to deal with the consequences (good or bad) of the choices made along the way. Nobody wants to live or watch someone else live their life in pain or go through frequent treatments and at the same time nobody wants to die or watch someone else die. After watching the video and trying to understand those cases it almost looks like a casino. The choices they had to make seemed like a gamble, but instead of gambling money they were gambling life. I have had a couple friends my own age die as well as my grandpas death many years ago. None of those deaths were in a hospital like the patients in the movie but death is still death and is a reminder to me personally that there is only 86,400 seconds in a day and to live each one to the fullest. To quote the movie Braveheart, "every man dies, not every man really lives." As I was watching the video I couldn't help but think about the goals each patient had for their life and if they achieved them or not. Death is hard but as my momma told me, as a believer in a god if life was lived with the way god had intended it to be lived, death should be a celebration rather than a hard time because even though the persons life is over on earth, they continue to a perfect life in heaven.
I agree with what you said about nobody wants to live through or watch a loved one go through pain and suffer, as well as no one wants to die or watch a loved one die. I agree with what your mom has told you, I think God has a time that He calls everyone to be with Him, but at the same time I think some go sooner than expected.
Danny, As an athlete, I appreciate the reference to Braveheart, ( one of my all time favorite movies) I was raised in a southern Baptist church with parents who were deacons. In doing so, respectfully, our family attended several funerals of member of the congregation. I too believe in a better life for those who have lived according to the Word. The correlation made to the video and gambling gave insight I had not though of before. Those patients and their families are taking chances and risk, hoping for a desirable outcome.
While I was watching the movie, Facing Death, I realized how blessed I am to have family that is in good health, and has not had to go through any situations similar to the ones shown in the film. Making the decision on whether or not to allow someone to stay on a life supporter or whether or not to get them out of their pain and suffering would be such a hard decision. the story that really hit home to me was the man who was diagnosed with cancer, and had three young kids at home. I could not imagine seeing my father go through that. I have not had any situations similar to the ones shown in the film, but I could not imagine what was going through their minds. I enjoyed the film, I thought that it really opened my eyes to difficult health situations.
As I watched this video the thing that was most surprising to me was the patients refusing to give up. There was always something that they wanted to try. It really surprised me that one of the men was going through his third bone marrow transplant and still hadn’t given up on believing one of the transplants would finally be successful. The part that really hit home to me was the fact that was stated during the movie where it say around 95% of patients in the ICU can’t communicate. Two summers ago my mom got really sick out of no where and she isn’t one to get sick at all. She’d been having headaches for a week or so but thought it was just sinus headaches, it wasn’t until one night she started getting sick that we took her to the ER. They found a blood clot in her brain; she was transferred to the ICU and was lucky enough that it was caught in time. She was only there for a week, but she was a part of the 5% of the patients in ICU able to communicate. Death is something that will never be an easy event to get through, no matter how much time you have to be ready for it.
I have always considered myself a sensitive person, which is why when people who are close to me find out I am a nursing student, in some ways they act surprised. I attribute this mostly to the fact that at times I can be overly emotional. I am curious to see how I handle death and dying on a professional level. While working as a CNA I was charged with starting CPR on a patient who had just coded. The patients family were escorted out of the room as the attending came to intubate. As I compressed the patients chest, I felt her rib crack. Finally the attending pronounced the patient dead and then went out to speak with the family. The scary part for me was the fact that I had never broken anyone else's bones, and furthermore that the patient had passed away. Luckily for me, the other aids that day were more familiar with death, as I needed a moment to compose myself. The Frontline video really showed a side of the dying process that most have never seen. I personally don't think myself or members of my family would feel comfortable enough to let rolling cameras film a process such as that. The tough medical decisions made, at least in my family, would have required more time for consideration. I am not sure if that were the case as seen, or maybe through editing, the decision process was shortened. Nevertheless, I feel that when faced with making difficult decisions, each person can say how they would react or what they would do, but not until a person is faced with such a situation, can one actually determine how they react. At some point I will be in the same situation. I plan on having some many advanced directives that my last days are smooth, clear and as easy on my family as possible.
Being directly involved with a patient death for your first clinical experience with death is backwards to most studying nurses, it must have been tough to deal with. While working as a CNA, even though it has only been for 6 months, I have had multiple patients pass away, but have not witnessed their last breath. In regards to having your advanced directives set, I completely agree! In the situations in "Facing Death" the patients and families were having to deal with these decisions as they go. I too plan on having everything ironed out before being in the situation rather than waiting and making it more stressful than it needs to be.
As a CNA, I imagine having to do CPR on a patient would be terrifying. I worked as a CNA in a nursing home and on my first night of third shift, a patient started to fall on me. I had eased him to the ground and noticed he was having difficulty breathing and called the nurse in. Fortunately for me, he began to breath better on his own and did not die. It was a situation that i never wanted to happen, but also a great learning experience.
This video even though previously viewed always causes one to reflect on their own personal beliefs regarding supportive care. There is no denying the significance of the topic for it affects many. The video gave many examples on how medicine much like many topics are not black and white rather "grey". This abstract grey causes much debate for it places peoples personal opinions against one another. This video did a great job of showing how those different opinions cause way to many issues which shouldn't be occurring. It is important to respect this topic for it has many implications. Obviously the personal experience is most likely similar for all of us meaning it was a very difficult time in our lives. I have personally seen it in hospice volunteering, but also within my family like most others. This video has always interested me because I seem to distance it because I have never been in this actual situation, however, I know how quick things can hit the fan and I have known others in this predicament. Overall this video forces me at least to think of the possibility of an end of life decision which I may not be ready for
The most surprising part of the video, to me, was the fact that so much conflict arose among the families of those who were involved in making the tough decisions. I can't remember the name of the man who's girlfriend said that he did not want to be resuscitated in the event that he should quit breathing, however when he spoke to the doctors and his sister, he stated that he wanted them to do everything they could to keep him alive in that exact scenario. The girlfriend seemed very upset that what she believed he wanted wasn't actually what he wanted.
A similar situation that I have experienced was when my grandfather was diagnosed with prostate cancer. At the point he was diagnosed, the cancer was already too advanced for treatment or even hope for him to go into remission and he was told that he only had about 6 months to live, but that there were certain things that could be done to increase his odds of living past the expected time frame. My grandfather did these things not because he had any hope of a miracle occurring and that he would suddenly be cured, but because he knew his family needed more time to say goodbye, even if it meant he had to suffer a little longer.
My family was very upset and emotional, which is understandable, however my grandfather made it very clear what he wanted. I couldn't imagine being placed in a situation where not only were you facing the possibility of a loved one dying, but also unsure what that person would want in that situation and said person being unable to communicate what they would want.
To me, the most surprising part of the video was not only how pretty much all of those who were suffering refused to give up, but also how some of spouses and family members sort of wanted their loved ones to stop fighting. I understand that they did not want their loved ones to die, they just wanted them to not suffer and be in a better place. The man who had been in the hospital for months, was finally able to go home, and then he came right back refused to give in. I remember his wife saying that the condition he was in was no way to live but he replied that he would rather be like that than die.
Fortunately I have not really had to deal with issues in my family with facing death, at least not that I recall. One of my grandfathers died of a heart attack when i was months old and one of grandmothers had mild Alzheimer's, but other than that she was in good health. She passed away in her sleep so my parents never had to make that difficult decision. However, over Christmas break, i noticed my 15 year old Chihuahua was having difficulty breathing and moving on a Sunday night. I was going to take her to the vet the next day, but she died in her sleep that night. I loved my dog to death and if the vet had told me the next day that i should truly think about euthanasia, i would have done so, but i am extremely grateful that i did not have to experience that and that my dog decided that she was ready on her own.
The video, Facing Death, is relevant to my current career as a Home Hospice CNA. I haven’t worked for the Hospice unit very long however in the just the short time I have been there, many of the same issues and questions addressed in the video, have been raised. Due to my experience, I’m not easily surprised by choices that patient’s families make and I don’t believe that a nurse ever should be. It is not my job as a health care worker to interject my beliefs on the families or patients that I come into contact with daily. I believe it is the responsibility of the healthcare providers to deliver the best treatment and information while respecting the wishes of the patient as well as their families.
ReplyDeleteDemi,
DeleteI too agree that your job as a Home Hospice CNA provides you with a very close insight into these kinds of issues. Some of the patients in the video finally opted to join hospice. In addition, I too believe that it is the nurse's responsibility to only inform the patient and their family to all the options that are available to them. I also agree that the nurse should respect the wishes of the patient and their family, because a nurse's role to give patient centered care and be there for the patient, not to insert their opinion and tell the patient what to do.
Demi,
DeleteI have a lot of respect for you with wanting to pursue a career in Home Hospice. This would be something that I would have a very hard time dealing with. It definitely takes a special kind of person to be able to work with that all the time. I agree with you as well that it is not the nurses job to make a decision. It is easy sometimes to get wrapped up in wanting to make a decision. We have to take a step back and realize that it isn't our lives on the line at the time.
Demi,
DeleteHome hospice would be a tough job, but i give you a lot of respect for going into that. It would be very difficult to see patents that are dying. I also agree that it is the nurses responsibility to inform the patient and their family about everything that is going on with the patient.
The most surprising thing about the video Facing Death was the fact that so many of the patients refused to give up, despite what the treatments were doing to them The one man was like on his third bone marrow transplant, and the effects of the treatments were quite evident. Despite the toll these were taking on his body, he refused to give up and truly believed he was going to get better. I think this is such a hard reality to face ad this video does a fantastic job of showing this perspective. I think that as a nurse this video has great significance. Nurses have to face these kinds of ethical dilemmas every day. Nurses see patients suffer and suffer and continue to suffer and refuse to give treatments, and sometimes it is very hard not to insert your opinion. However, it is not the nurse's place to insert their opinion. The nurse only needs to provide all the options available to the patient so that they can make an informed decision, and respect the decision that is made.
ReplyDeleteTony,
DeleteI also thought that the patients' resiliency was surprising. They just never wanted to give up, and I think that it's very admirable of them. I also agree with you that the video does a great job illustrating the hardship faced by many families. In your field, there is always a thin line to try not to cross regarding your personal beliefs, and I'm glad that you're aware of what the job entails, as far as your duties go.
Tonya,
DeleteWhile watching the movie I was thinking the same thing. Many of the patients were going through the toughest time of their lives and in so much pain they could hardly speak but they refused to give up. I believe this video did a great job showing how the doctors and nurses have to deal with this every day as their career. I couldn't imagine having to do that.
The video facing death had extremely bad timing for me. I found out this morning that my dog passed away and this video was unfortunate. This video showed how interesting technology is these days. Without all the technology, people would simply die and families would not be put through the tough decision of life support and tubes. It's a hard decision for many families. This video really showed how hard the decision is.
ReplyDeleteI have had many people in my life pass away, so facing death isn't uncommon for me. I've seen my grandfather on life support and although my family knew his wishes, it was still very difficult.
Emily,
DeleteI'm sorry to here that your dog passed away. I have a dog to and I can't imagine having my dog go to heaven. I agree with your with your statement above, it is crazy how technology has developed into what it is today. Technology has many good uses in the medical field but it is also a curse at the same time.
Emily, I am sorry of your loss of your dog and grandfather. I have never considered the idea that families would not have to make difficult decisions if the technology to prolong their life was not their. In some cases it would be easier without the prolonging life technologies but then it can also save lives which is great. It is hard in these circumstances to decide what is right and what is wrong which i hope to continue to explore throughout this class.
DeleteThere is no black and white when looking at whether to take someone off life support or not and the gray area just seems to be a blur.
DeleteI am so sorry to hear about your doggy, on July 4th this past summer we had to put my dog of 15 years down and it was one of the hardest things I had to do, they become like brothers and sisters. I believe if someone has never known the love of a dog (or another pet), they are missing out on a lot.
I watched this video last semester in Death and Dying Class. I remember how many families were caught in sticky situations as to how to proceed with medical treatment. I am surprised as to how many people don't know their parents wishes as far as life saving treatment and DNR. I breaks my heart that some patients have to suffer as a result of not getting treatment or even the dying process. I wish there was something that could be done to prevent the suffering that patients and families endure. I am aware of hospice and palliative care services that can help the transition from life to death and provide support for the families.
ReplyDeleteLauren,
DeleteIt is very unfortunate that people suffer during death. This is where the positives of technology come in. They can do their best to keep them comfortable. However, also as said in the video often the underlying disease breaks out and continues to make the individual uncomfortable. Hospice is a great thing, but it is also very saddening for many families.
I agree with you. There seemed to be a lot of disconnect between the patients and their families as to what they were going to do as far as procedures. I think the decision making time should be spent more by spending time with your loved one for their last hours instead of spending it agonizing over what the decision should be.
DeleteI remember the first day of death and dying last semester when this video was shown how difficult and different each individual case is. Each have their own different issues and ethical questions asked within each case. This video and the death and dying class made me realize how important it is to understand certain situations such as choosing to stop care on a loved one. It also made me realize that the people close to me need to know and understand my wishes if i was in this situation so they would not have to make such a difficult decision. Overall, the video portrays multiple situations of what in the health care field we can face, it was informative to help me decide in what my wishes would be in a certain situation.
ReplyDeleteThere were a couple surprising things about this video that really made me think. The first surprise was the cost of the procedures that were being undertaken. I wondered to myself during the video how commercial insurances went about helping the families in tough positions. The other surprise was the resiliency of most of the patients. I wondered how they could endure so much pain and, in my opinion, unfairness. Moreover, I have recently gone through a decision exactly like the ones being shown in class. I can personally relate to each case shown because my grandma, not even two years ago, was losing her fight with a rare form of inner abdominal wall lining cancer. This was very hard for my family to deal with, but eventually, a decision had to be made. Her children and husband decided to take her off of life support and keep her heavily sedated so she could slip away into God's hands peacefully. This is still a difficult thing for me to deal with even today, so I feel like my personal experience with having to be semi-involved in the choice gives me insight into why certain families would choose to quit fighting. Overall, the video really struck a chord with me, as you can imagine, and I can definitely see both sides of the story. I completely understand why one would want to fight, but I also see why it can sometimes be better to let nature take its path.
ReplyDeleteVic,
DeleteI am sorry for your loss. My uncle died almost three years ago from pancreatic cancer and my aunt kept him sedated so he wasn't in pain. My grandpa was the same way just two weeks earlier. This video is very controversial as far as the technology goes.I agree with you as to why people would want to fight but also seeing why it might be better to let nature take its course. I firmly believe everyone has a time to go and sometimes that can be very difficult.
Vic,
ReplyDeleteI'm extremely sorry for you loss & even though it was less than two years ago, I know it still feels like it happened yesterday. We had to make the same decision for my grandfather two years ago, who was dying from colon cancer which had spread. I loved the words you chose, "slip away into God's hands peacefully" because I think that is more than perfect, We were both lucky, in a way, that we were able to say goodbye to our loved ones, instead of viewing their passing as negative.
After watching the Frontline program, it's hard not be a little bit frustrated watching the scenarios. At times, drastic treatments could be needed to help a patient survive; however, there comes a point where this seems hopeless. Watching doctors throw every possible high tech treatment at a patient who is obviously at the end of their life and in the process of dying is difficult. Just because treatment can be offered, doesn't mean it always should. If there is a chance at recovery, then yes be all means provide care. If it is clear death is inevitable, then it seems futile. This only provides false hope to a family that struggles to say "no" because they don't want to feel like they are giving up on their loved one. Care ought to move from recovery to comfort at this point. These issues could be resolved if living wills or plans of care would be set ahead if time; furthermore, this would relieve tension for families that are already in a difficult situation.
ReplyDeleteHowever, the resiliency and determination of some of these patients is remarkable. I can easily see why they would want to continue treatment because they have families that they love and want to support.
Austin,
DeleteI agree with what you said about how frustrating it is watching the video and how helpless some of the patients are. It doesn't help when family members have conflicting ideas on how to proceed with or without treatment.
Austin I have always questioned the motives of family members. Obviously I cannot generalize however do people continue these treatments for the right reasons? Or is it some primal need for control and to prevent the ending of life without regard for logic? I do believe that this confusion of patients wills along with personal agendas and the inability to let go is so convoluting that a bad situation is made worse.
DeleteThis is in no way a criticism of those patients who chose to fight through their illness, but if I was a patient in a similar scenario I personally would be overwhelmed by guilt. I couldn't help but feel I required too much time and money from my family for so little reward. I would feel like I was mooching just to extend my misery. Again, these are my personal feelings, not a statement on what people should actually do.
ReplyDeleteIf I was a family member and/or healthcare proxy, I would feel very differently. In this case I would feel a strong sense of obligation. I would be extremely hesitant to end treatment or life support. I would feel like it was not really my choice whether or not to stop delaying the inevitable. This would be especially strong if the patient in question was unable to weigh in on the matter and the choice then fell on me and other family members. There is always the slim chance for recovery. Yet the pitifully sad truth is that medical care requires a lot of money, and one's financial resources are often not enough to sustain this outside shot at recovery for very long. Even if the person was brain dead and unable to experience life again, I would still feel like I was guilty of selling them out. But there are circumstances in which that difficult decision must be made.
The video was an excellent introduction to biomedical ethics. It showed just how morally ambiguous and emotionally tempestuous this topic can be, and it did so by showing real people in real situations. It was a baptism by fire for the class, forcing us to face these difficult dilemmas from the first day of class.
I want to first send my condolences to everyone who has lost a loved one. It seems that, unfortunately, this class is not new to the idea of death. I too have lost a few family members, friends, and pets along the way. Just last week, a youth pastor that I was very close to passed away from cancer. He put up a good fight for several months, but decided to forgo treatment and let nature take its course. He trusted God through the entire process. It was inspiring to me that his spirit never faded.
ReplyDeleteDeath is never an easy topic, but it has to be dealt with. As Dr. Cate said on Monday, it will benefit all of us to decide how we feel about the ethics of medical treatment, such as life support, before we are faced with them on a personal level. The most interesting thing to me about the video was that each family dealing with death handled it in such different ways. This goes to show the impact that culture, family, and personal values affect every aspect of life, including death.
Healthcare providers sit in a very tough spot. Everyone has their own ethical opinions, but it is not the place of a healthcare professional to force their beliefs on their patients and families. There is a thin line between giving rational, medically sound advice and telling your patient what you think they should do based off of personal morals or opinions. There is not always a clear cut answer for every patient situation, which is by-far the hardest part of healthcare.
Tori,
DeleteYou stated in your last paragraph about how each situation with a patient is different. This is something that is very hard for health care providers to understand along the way. There may be a patient that is willing to fight through whatever when another patient just wants to give up. We have to take a step back sometimes and understand that we can't always understand what everyone is going through.
Well said, Emily. Sometimes patients have been through a lot over the years and they are at a point in their lives where they are done fighting. It may not make sense to the physician or family members, but sometimes all that matters is that the patient is at peace with their decision. This is not to say that I condone things such as physician assisted suicide, but I see no harm in "pulling the plug" on a patient who is living only off of life support if everyone is aware and at peace with that decision.
DeleteDeath, or the thought of death never gets easier. Unfortunately I know this previous statement to be true, based on personal experiences. My family has had to make some of these decisions for our loved ones. You watch someone lay in bed for months not being able to help themselves, and you wish you could do absolutely anything for them, you would even change them places to take away their pain but you can't and then the day comes where they close their eyes and never open them again and even though you knew for months that one day that tragic moment would come, you never thought it would happen to you and your family.
ReplyDeleteI have a friend whose niece has cancer and just when they think they finally beat it, the cancer comes back again and they have to start treatments over again. As you can see, I used the word "they", because even though this little girl is struggling to fight a battle all of its own, she has people fighting with her and praying for her everyday and that's what makes any illness or deadly disease even more difficult. You are not just losing (I say that lightly) an individual there is always a potential to be breaking up an entire family.
People do not like change and death of a loved one is one of the biggest changes we face.
Amanda,
DeleteI agree with you. Many people do not like change, and the death of a loved one is probably the biggest and most difficult change that an individual, and a family, could go through. I experienced a situation like this with my aunt, and it was very difficult for my family. However, I do believe that it makes a family stronger, because every family member knows what the other is going through.
Amanda,
DeleteI like how you point out that the battle is not just the patient fighting to survive, but also the family struggling to make decisions that they think are right and then being in constant fear that it's not the right thing, or that there's still a chance that the patient might wake up or the treatments might finally take and they will get better.
The most surprising thing to me about this video is how long these individuals, and their families, fought to keep them alive for as long as possible. I understand that you don't want a loved to be gone from your life, but at the same time, are they really living? Some of the patients were just laying in the bed on a ventilator, not able to talk or interact with anyone. I guess my point is, when is enough, enough? I had an aunt that went through a similar situation as what we saw in the video, and she eventually decided that enough was enough. It was hard for not only her, but our whole family.
ReplyDeleteJillian, I completely agree with you. Sometimes enough is enough and patients need to be let go. I feel that if a person is living solely off of a ventilator or similar machine, then they really have no quality in their life. They are being kept alive for the sake of the family. I would understand keeping the patient alive for just a few days so that family members who live far away could fly in to say goodbye, but an extended amount of time is not good for anyone.
DeleteTo me, the most surprising thing about this video was the way many of the families handled these terrible situations. There were many cases where the families chose to keep their loved ones on the ventilators for a long amount of time. To me I think it would be harder to watch my loved one suffer if they aren't able to function as they wish they could. I can relate this to my own life by thinking about my grandpa. He was very sick and my family had to choose whether or not to keep him on the ventilator or not. The biggest thing my family had to think about was what would he want us to do? After a lot of thinking my family decided to let him go. It was hard for us but we knew that is what he would want.
ReplyDeleteKrista,
DeleteI'm so sorry about your loss. I agree about how well the families handled such hard times. I also think it would be hard for me to watch a loved one suffer if they are not able to function as they wish they could.
This is the second time that I have seen this video. Even the second time seeing it was hard to watch. Death is something that never will be easy. You can never prepare yourself for death when it arrives. I think the hardest thing for me to watch wasn't the reactions from the family but the reactions of the patients that were dying. Coming to cope with the reality that you are dying is a hard concept to grasp. It scares me now to even think about it. I lost my grandmother a couple years ago. My grandmother seemed invincible to me. I knew that she wasn't but even when the time came for her passing it was still hard. We grow up sometimes thinking that we will never die. I always pictured myself dying at a old age. Some of the people in this video weren't very old. This was a hard part for me to grasp as well.
ReplyDeleteEmily,
DeleteI agree that dying is a very hard concept to grasp and it is scary for me as well. We had a classmate who passed away my junior year of high school in a car accident. It made me realize that not every day is guaranteed, and death can happen at any age.
While watching facing death, I felt for the patient's family, but mostly for the patient. In some of the situations while being intubated, the patient's family would have to make the decisions for them. As a loved one, it would be hard to let the patient go with it being your final decision to take them off the life sustaining equipment, hoping for the best. My opinion is that the family should not have to make this kind of decision because in every case they just don't want to lose them. I think that since the patient is the one that is actually going through this, they should have the final say. Whether it's them signing the DNR, deciding that they will do all that they can to stay alive, or resorting to comfort measures until the time comes. All the healthcare team can do is to education the patient and provide them with honest answers and options for the planning of the next step of care. I have worked as a CNA on the MICU (Medical Intensive Care Unit) multiple times and cared for patients in the same situations that were shown in the video. Actually seeing these situations and reading up on some of their history raises the questions on whether the treatment is worth putting the patient through and if they could even lead a life that they would think is worth living if they were eventually able to be weened off of the equipment.
ReplyDeleteDeath is never an easy thing to deal with because there is more people than just the patient that has to deal with the consequences (good or bad) of the choices made along the way. Nobody wants to live or watch someone else live their life in pain or go through frequent treatments and at the same time nobody wants to die or watch someone else die. After watching the video and trying to understand those cases it almost looks like a casino. The choices they had to make seemed like a gamble, but instead of gambling money they were gambling life. I have had a couple friends my own age die as well as my grandpas death many years ago. None of those deaths were in a hospital like the patients in the movie but death is still death and is a reminder to me personally that there is only 86,400 seconds in a day and to live each one to the fullest. To quote the movie Braveheart, "every man dies, not every man really lives." As I was watching the video I couldn't help but think about the goals each patient had for their life and if they achieved them or not. Death is hard but as my momma told me, as a believer in a god if life was lived with the way god had intended it to be lived, death should be a celebration rather than a hard time because even though the persons life is over on earth, they continue to a perfect life in heaven.
ReplyDeleteDanny,
DeleteI agree with what you said about nobody wants to live through or watch a loved one go through pain and suffer, as well as no one wants to die or watch a loved one die. I agree with what your mom has told you, I think God has a time that He calls everyone to be with Him, but at the same time I think some go sooner than expected.
Danny,
DeleteAs an athlete, I appreciate the reference to Braveheart, ( one of my all time favorite movies) I was raised in a southern Baptist church with parents who were deacons. In doing so, respectfully, our family attended several funerals of member of the congregation. I too believe in a better life for those who have lived according to the Word. The correlation made to the video and gambling gave insight I had not though of before. Those patients and their families are taking chances and risk, hoping for a desirable outcome.
While I was watching the movie, Facing Death, I realized how blessed I am to have family that is in good health, and has not had to go through any situations similar to the ones shown in the film. Making the decision on whether or not to allow someone to stay on a life supporter or whether or not to get them out of their pain and suffering would be such a hard decision. the story that really hit home to me was the man who was diagnosed with cancer, and had three young kids at home. I could not imagine seeing my father go through that. I have not had any situations similar to the ones shown in the film, but I could not imagine what was going through their minds. I enjoyed the film, I thought that it really opened my eyes to difficult health situations.
ReplyDeleteAs I watched this video the thing that was most surprising to me was the patients refusing to give up. There was always something that they wanted to try. It really surprised me that one of the men was going through his third bone marrow transplant and still hadn’t given up on believing one of the transplants would finally be successful. The part that really hit home to me was the fact that was stated during the movie where it say around 95% of patients in the ICU can’t communicate. Two summers ago my mom got really sick out of no where and she isn’t one to get sick at all. She’d been having headaches for a week or so but thought it was just sinus headaches, it wasn’t until one night she started getting sick that we took her to the ER. They found a blood clot in her brain; she was transferred to the ICU and was lucky enough that it was caught in time. She was only there for a week, but she was a part of the 5% of the patients in ICU able to communicate. Death is something that will never be an easy event to get through, no matter how much time you have to be ready for it.
ReplyDeleteI have always considered myself a sensitive person, which is why when people who are close to me find out I am a nursing student, in some ways they act surprised. I attribute this mostly to the fact that at times I can be overly emotional. I am curious to see how I handle death and dying on a professional level. While working as a CNA I was charged with starting CPR on a patient who had just coded. The patients family were escorted out of the room as the attending came to intubate. As I compressed the patients chest, I felt her rib crack. Finally the attending pronounced the patient dead and then went out to speak with the family. The scary part for me was the fact that I had never broken anyone else's bones, and furthermore that the patient had passed away. Luckily for me, the other aids that day were more familiar with death, as I needed a moment to compose myself. The Frontline video really showed a side of the dying process that most have never seen. I personally don't think myself or members of my family would feel comfortable enough to let rolling cameras film a process such as that. The tough medical decisions made, at least in my family, would have required more time for consideration. I am not sure if that were the case as seen, or maybe through editing, the decision process was shortened. Nevertheless, I feel that when faced with making difficult decisions, each person can say how they would react or what they would do, but not until a person is faced with such a situation, can one actually determine how they react. At some point I will be in the same situation. I plan on having some many advanced directives that my last days are smooth, clear and as easy on my family as possible.
ReplyDeletePaul,
DeleteBeing directly involved with a patient death for your first clinical experience with death is backwards to most studying nurses, it must have been tough to deal with. While working as a CNA, even though it has only been for 6 months, I have had multiple patients pass away, but have not witnessed their last breath. In regards to having your advanced directives set, I completely agree! In the situations in "Facing Death" the patients and families were having to deal with these decisions as they go. I too plan on having everything ironed out before being in the situation rather than waiting and making it more stressful than it needs to be.
Paul,
DeleteAs a CNA, I imagine having to do CPR on a patient would be terrifying. I worked as a CNA in a nursing home and on my first night of third shift, a patient started to fall on me. I had eased him to the ground and noticed he was having difficulty breathing and called the nurse in. Fortunately for me, he began to breath better on his own and did not die. It was a situation that i never wanted to happen, but also a great learning experience.
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ReplyDeleteThis video even though previously viewed always causes one to reflect on their own personal beliefs regarding supportive care. There is no denying the significance of the topic for it affects many. The video gave many examples on how medicine much like many topics are not black and white rather "grey". This abstract grey causes much debate for it places peoples personal opinions against one another. This video did a great job of showing how those different opinions cause way to many issues which shouldn't be occurring. It is important to respect this topic for it has many implications. Obviously the personal experience is most likely similar for all of us meaning it was a very difficult time in our lives. I have personally seen it in hospice volunteering, but also within my family like most others. This video has always interested me because I seem to distance it because I have never been in this actual situation, however, I know how quick things can hit the fan and I have known others in this predicament. Overall this video forces me at least to think of the possibility of an end of life decision which I may not be ready for
ReplyDeleteThe most surprising part of the video, to me, was the fact that so much conflict arose among the families of those who were involved in making the tough decisions. I can't remember the name of the man who's girlfriend said that he did not want to be resuscitated in the event that he should quit breathing, however when he spoke to the doctors and his sister, he stated that he wanted them to do everything they could to keep him alive in that exact scenario. The girlfriend seemed very upset that what she believed he wanted wasn't actually what he wanted.
ReplyDeleteA similar situation that I have experienced was when my grandfather was diagnosed with prostate cancer. At the point he was diagnosed, the cancer was already too advanced for treatment or even hope for him to go into remission and he was told that he only had about 6 months to live, but that there were certain things that could be done to increase his odds of living past the expected time frame. My grandfather did these things not because he had any hope of a miracle occurring and that he would suddenly be cured, but because he knew his family needed more time to say goodbye, even if it meant he had to suffer a little longer.
My family was very upset and emotional, which is understandable, however my grandfather made it very clear what he wanted. I couldn't imagine being placed in a situation where not only were you facing the possibility of a loved one dying, but also unsure what that person would want in that situation and said person being unable to communicate what they would want.
To me, the most surprising part of the video was not only how pretty much all of those who were suffering refused to give up, but also how some of spouses and family members sort of wanted their loved ones to stop fighting. I understand that they did not want their loved ones to die, they just wanted them to not suffer and be in a better place. The man who had been in the hospital for months, was finally able to go home, and then he came right back refused to give in. I remember his wife saying that the condition he was in was no way to live but he replied that he would rather be like that than die.
ReplyDeleteFortunately I have not really had to deal with issues in my family with facing death, at least not that I recall. One of my grandfathers died of a heart attack when i was months old and one of grandmothers had mild Alzheimer's, but other than that she was in good health. She passed away in her sleep so my parents never had to make that difficult decision. However, over Christmas break, i noticed my 15 year old Chihuahua was having difficulty breathing and moving on a Sunday night. I was going to take her to the vet the next day, but she died in her sleep that night. I loved my dog to death and if the vet had told me the next day that i should truly think about euthanasia, i would have done so, but i am extremely grateful that i did not have to experience that and that my dog decided that she was ready on her own.