Thursday, August 20, 2009

What do you do when you know your patient is going to die?

What do you do when you know your patient is going to die?
What do you feel inside?

Death is a hard thing for us to face. In the field of healthcare and spiritual care, death is a prominent player. While part of our work is to provide support and comfort for patients, family and staff involved in a death, it doesn’t seem to get easier. And when you have spent years investing your care and energy into the life’s story of a person, it is not easy to walk away unscathed.

I did not plan to get into this line of work. I did not aspire to be a “midwife for the dying”. I started my ministry career at the age of 23. I love stories. I am fascinated by books and movies. That is why I do this work. I get to hear stories from my patients and to be a part of their story. I am sure that others in this field will agree that some stories are hard to hear, while others are hard to watch. So after meeting the person and journeying with them, it is hard to not be untouched by their life. It is often said at funerals that whether we knew the deceased well, or whether we knew the deceased in passing, the fact that they are gone from this earth will have an impact on us. What that is I do not know. I think that some deaths are harder to deal with than others, for the attachments that come from the relationships. While we maintain the professionalism and boundaries, I think that there are some lives and deaths that impact us more than others. So when you have invested time and energy, and the story has taken its hold, how do you feel when you know that your patient is going to die? What do you do?

I have given this some more thought. The question of "what do you do/feel when you know that your patient is going to die?" A lot of people find it interesting that I refer to them as "MY" patients and commented on this. I realize that I am not a doctor nor am I the primary caregiver who influences the success of their treatment, but considering the area of expertise and the time that I have invested in the relationship, I will think of the individual as "my patient". So hence I suppose that the attachment that one feels to the person who is dying is of consideration in the matter what one thinks or feels when you know that they are dying.

The relationship of caregiving is very intimate. In pastoral/spiritual care, people will bear their souls to another who is virtually a stranger. Hence the depth of the relationship and the content can have influence to the emotions of the care provider when the patient's condition deteriorates. I have had various patients that I have known for numerous years. It is a different reaction for one to die versus another, and I think that it is dependent on the type of relationship that has been cultivated and whether or not the death was anticipated.

So I pose the question to my fellow chaplains/spiritual care providers, what is your reaction when YOUR patient dies? What do you do? What do you feel?

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