From left to right: Carrie wheeler, Andrea Burkley, Mackenzie Martin (me), and Lyndsey O'Rourke For the past two months, I have been interning at St. Anthony Hospital (SAH) in Lakewood, Colorado. Working in a level 1 trauma hospital has been a wonderful and rewarding learning experience, despite some of the challenges it has presented.
My second day here I attended rounds in the medical ICU where we had a patient who was transitioning to comfort care later that day. I briefly understood what that meant, but it became all the more real when the patient passed away the very same day. She was young with many health problems and two daughters who were the same age as myself. I remember thinking that no amount of schooling could prepare me for being a part of someone’s last moments of life.
I enlisted the help of some experts, the fabulous RDs here at SAH, to better prepare you for some of the more difficult situations you may encounter during end-of-life care in the clinical setting:
My second day here I attended rounds in the medical ICU where we had a patient who was transitioning to comfort care later that day. I briefly understood what that meant, but it became all the more real when the patient passed away the very same day. She was young with many health problems and two daughters who were the same age as myself. I remember thinking that no amount of schooling could prepare me for being a part of someone’s last moments of life.
I enlisted the help of some experts, the fabulous RDs here at SAH, to better prepare you for some of the more difficult situations you may encounter during end-of-life care in the clinical setting:
- Understand that your opinion has no place in comfort care or hospice. Patients/family members already have wishes in place regardless of suggestions you may want to make. Also remember that some patients do not want feeding tubes or TPN, and that’s ok.
- Be empathetic and make it known that you are there to support the patient’s and their family’s wishes. Assure them that you are there for support..
- Sometimes in an end-of-life setting, docs may need a gentle reminder to discontinue certain procedures and medications like blood glucose testing, statins, PPIs (Proton Pump Inhibitors), etc. Advocate for the patient and help the team carry out the patient’s wishes.
- Some hospitals have comfort care amenities available. They may have carts of food and beverages available for the patient, the family members, or both.
- Lastly, a little coping strategy. Don’t bring these experiences from the hospital home with you. It is difficult at first, but eventually you understand what you have to do for your own well-being. We tend to draw parallels to our own lives and the hospital situations we encounter, and it will get easier. By honoring a patient’s last wishes, you are being the very best intern/RD you can be.
