The Irony Of It All….

This has been a turbulent week.

I was enrolled, by work, in a training session called “Respecting Patient Choices”. The training for it is this coming Monday, and prior to this I am supposed to complete 6 online training modules.

I made a start on these modules, only to discover that the training isn’t to do with dealing with patients and their treatment preferences in general, but with their preferences in regard to end-of-life decisions. Do they want CPR, intensive care admission, trial of ventilation, comfort care only? Who is their preferred medical “proxy”, EPOA, EPOG? What is most important to them as they die – being pain free, being aware, having somebody there, dying alone, being at home, being in hospital or hospice? In other words, Advance Care Planning.

So, for the last week, I have been studying the methodology behind producing an Advance Care Directive, and how to discuss the topic with patients – because, let’s face it, nurses seem to be the ones with the most exposure to patients and with the most “connection” to the patients, so we tend to be the people they are most comfortable discussing their death with.

So, with all of this revolving in my head, it seemed almost natural that I would suddenly be faced with the mortality of those around me.

My grandfather, who is in his 90s, was admitted to hospital with cellulitis. Not good for someone his age, as infection can quickly overwhelm the elderly. Every time I see my grandfather, he looks more frail than the time before. He is becoming unsteady on his feet, he is going deaf, and he seems to be shrinking in on himself and is no longer the strong, opinionated man I remember from my youth. I am very aware that our final goodbyes will not be far into the future.

And a close friend just informed me that her husband has been diagnosed with metastatic bowel cancer. It was only a few weeks ago that the two of us celebrated our 40th birthdays, and now she has to hold her family together during the months of her hubby’s chemo, radiotherapy, and surgeries, not to mention the possibility of his death. They have two young boys. She has had a hard enough life already, and deserves something to go in her favour for once. It’s so unfair!!

And thanks to this stupid training I have been doing, I keep wanting to ask “Have you thought about what is most important to you in your final stages of life?”.

Aaaarrrgggghhhh!!!!