Jon, I’d like to comment on the position of the Physician as he/she delivers the life arresting news…if at all possible, don’t be in a position higher than the one you are talking to…if they are sitting then kneel down if possible so you are at eye level.
Also, in regard to offering compassion, choosing words carefully is always best.
Gently, respectfully touching or holding a hand does more for the person than all the words you could ever use in that sacred space…and can be long remembered.
The only thing I would add is a place for a human touch! Hand on a shoulder, grasp of a hand or gently touching the loved one’s body! Health touch speaks volumes!
Ah, Michele. Thanks for this. I’m cautious about touch. And, at times, before walking out of the room where a son is at the bedside of his father who has just died, I’ve offered and then given a hug. And, as I write this, I’m remembering even a handshake can offer that support. I will pass this on. (And I’m guessing that Matt did this, too.)
Michele - I love your heart in this. I'd just like to add a caveat - a fleshing out of the "caution" that Jon mentioned. As a newly diagnosed Autistic, I can say via personal experience that when I'm overwhelmed, being touched adds an additional layer to the overstimulation of the situation. Possibly - someone I trust very deeply could touch me; but a stranger, not a chance - no matter how good the heart/intention.
That said, I'm not against the practice as a whole, I'm just suggesting being perceptive. If someone flinches or leans away when you start to lean in - not the right time and place for that.
I know that being touched can help others to feel loved and even can ground them in the present moment, so please love in the way you clearly naturally do, just keep an eye out for those who aren't in the space for that.
Rarely does someone die in the hospital without touching the lives of others. What I am saying is, if possible have some key team members familiar with the pt who worked with the patient. For examples, have a nurse, social worker, and/or chaplain present to offer their support.
Have group huddles before the death notification so everyone is in the same page. And after the death notification for check in’s or feed back.
Thanks for this reminder that there isn't a standard death in a hospital. I am around deaths in the Emergency Department where there has been little connection. And I'm around deaths in supportive care where there has been a team of people providing care. And I'm around deaths in Intensive Care where there is often little conversation with the patient, but lots of conversation with family. And I'm around deaths in other places where the death is sudden or is expected. And you, Benjamin, have had the range of experience, too.
You are speaking well to the idea that in many of those situations, the physician knows most about the cause of death, but least about the context of the death. And, because we are addressing the ongoing impact of this death on a network of relationships, drawing on the people who know that context is huge.
For example, if this is the third death in six months for this family, that's meaningful context for care.
And yet, in some research among internal medicine residents at in one med school, when making death notifications by phone, none of them involved nurses, social workers, or chaplains. I will be mentioning that today.
The other thing you are pointing to, is that those team members who are familiar with the patient and family will be affected by this death, too. Just this week, I read a post from Hui-Wen Sato, a PICU nurse, who talks about "professional grief" which is "the natural human emotion we feel over losses we witness and/or experience in people that we have built connections with in the context of a professional relationship." It's a thoughtful read.
Thanks for the recommendation. I read the article and sent it to my director, she is a nurse, she loved it and sent it to the hospice team. And a couple of the nurses shared stories how it touched them. Professional grief is big in hospice.
I like your simplified list. My capacity to receive info when overwhelmed is minimal. More words do not equal a better outcome for me in this kind of experience. My ability to comprehend and respond to anything/anyone in that moment will be at best limited - possibly non-existent. Please don't tell me anything vital - that I need to remember or do. My brain shuts down with my love one being dead. Give me space to begin to integrate that reality.
And yes, I remember about the funeral home decision needing to be made promptly - but hopefully other things can be done with a little more grace to breathe while entering a completely new reality that I'm unprepared for whether this was "expected" or not; whether the person was 8, 80, or 108.
One of the reasons I'm exploring these questions is because I'm not satisfied with what we (in healthcare, as friends, as cultures) do to offer space and grace in these moments. There's no best answer, of course, but we can do better. Thank you for talking here.
Jon, I’d like to comment on the position of the Physician as he/she delivers the life arresting news…if at all possible, don’t be in a position higher than the one you are talking to…if they are sitting then kneel down if possible so you are at eye level.
Also, in regard to offering compassion, choosing words carefully is always best.
Gently, respectfully touching or holding a hand does more for the person than all the words you could ever use in that sacred space…and can be long remembered.
Thanks for sharing Jon!
The only thing I would add is a place for a human touch! Hand on a shoulder, grasp of a hand or gently touching the loved one’s body! Health touch speaks volumes!
Ah, Michele. Thanks for this. I’m cautious about touch. And, at times, before walking out of the room where a son is at the bedside of his father who has just died, I’ve offered and then given a hug. And, as I write this, I’m remembering even a handshake can offer that support. I will pass this on. (And I’m guessing that Matt did this, too.)
Michele - I love your heart in this. I'd just like to add a caveat - a fleshing out of the "caution" that Jon mentioned. As a newly diagnosed Autistic, I can say via personal experience that when I'm overwhelmed, being touched adds an additional layer to the overstimulation of the situation. Possibly - someone I trust very deeply could touch me; but a stranger, not a chance - no matter how good the heart/intention.
That said, I'm not against the practice as a whole, I'm just suggesting being perceptive. If someone flinches or leans away when you start to lean in - not the right time and place for that.
I know that being touched can help others to feel loved and even can ground them in the present moment, so please love in the way you clearly naturally do, just keep an eye out for those who aren't in the space for that.
Rarely does someone die in the hospital without touching the lives of others. What I am saying is, if possible have some key team members familiar with the pt who worked with the patient. For examples, have a nurse, social worker, and/or chaplain present to offer their support.
Have group huddles before the death notification so everyone is in the same page. And after the death notification for check in’s or feed back.
Thanks for this reminder that there isn't a standard death in a hospital. I am around deaths in the Emergency Department where there has been little connection. And I'm around deaths in supportive care where there has been a team of people providing care. And I'm around deaths in Intensive Care where there is often little conversation with the patient, but lots of conversation with family. And I'm around deaths in other places where the death is sudden or is expected. And you, Benjamin, have had the range of experience, too.
You are speaking well to the idea that in many of those situations, the physician knows most about the cause of death, but least about the context of the death. And, because we are addressing the ongoing impact of this death on a network of relationships, drawing on the people who know that context is huge.
For example, if this is the third death in six months for this family, that's meaningful context for care.
And yet, in some research among internal medicine residents at in one med school, when making death notifications by phone, none of them involved nurses, social workers, or chaplains. I will be mentioning that today.
The other thing you are pointing to, is that those team members who are familiar with the patient and family will be affected by this death, too. Just this week, I read a post from Hui-Wen Sato, a PICU nurse, who talks about "professional grief" which is "the natural human emotion we feel over losses we witness and/or experience in people that we have built connections with in the context of a professional relationship." It's a thoughtful read.
https://heartofnursing.blog/2024/08/05/what-is-professional-grief/
Thanks. Jon
Thanks for the recommendation. I read the article and sent it to my director, she is a nurse, she loved it and sent it to the hospice team. And a couple of the nurses shared stories how it touched them. Professional grief is big in hospice.
I like your simplified list. My capacity to receive info when overwhelmed is minimal. More words do not equal a better outcome for me in this kind of experience. My ability to comprehend and respond to anything/anyone in that moment will be at best limited - possibly non-existent. Please don't tell me anything vital - that I need to remember or do. My brain shuts down with my love one being dead. Give me space to begin to integrate that reality.
And yes, I remember about the funeral home decision needing to be made promptly - but hopefully other things can be done with a little more grace to breathe while entering a completely new reality that I'm unprepared for whether this was "expected" or not; whether the person was 8, 80, or 108.
Lauren, thank you for this reflection.
One of the reasons I'm exploring these questions is because I'm not satisfied with what we (in healthcare, as friends, as cultures) do to offer space and grace in these moments. There's no best answer, of course, but we can do better. Thank you for talking here.