Meaningful Life and Death
Although we are aware of death and we know it will come to us all one day, the thought of it still brings a chill down my spine. To some people death is ridden with fear, while to others it brings strength and satisfaction of accomplishment.
For six weeks I have worked in the ICU unit of Tygerberg Hospital, and almost everyday I have experienced the death of a human being. That experience certainly brought a chill down my spine every time I had to face it. After just working with that specific person the previous day, next day they are just gone. Their lifeless body just laying there for hours, waiting to get taken away to the morgue. Family and friends saying their goodbyes, I could not help, but feel sad with them. I told myself I had to keep in mind that adhering to the highest standards of ethical and professional behaviour is essential, irrespective of the situation. My question is how do you as a professional/therapist keep yourself together in a situation like this?, what is your role in a situation like this?, how do you work through something like this? You have just built a very good patient- therapist relationship with this person and next thing he/she is not there anymore.
What is the ethically informed ways to participate in the rites of death and process of grief of the therapist? According to Breen and O’Connor (2007), there is a need for greater sensitivity to and recognition of the experiences and needs of the deceased, in order to provide appropriate and effective support services. To this effect Breen and O’Connor (2007) suggest that relevant grief education should be provided to all those involved in service provision to the deceased, including funeral directors, religious and spiritual leaders, general practitioners, psychologists, psychiatrists, counsellors , nurses and the wider community. A need for contextually relevant bereavement and grief literature appears to be imperative and necessary for all service providers to acquire. It is an imperative towards proper care and management of grief, so as to relief suffering and potential long term consequences of the loss or the passing of a patient (Breen and O’Connor, 2007).
Reference:
Breen, L., & O’Connor, M. (2007). The Fundamental Paradox in the Grief Literature: A Critical Reflection. OMEGA – Journal Of Death And Dying, 55(3), 199-218. doi: 10.2190/om.55.3.c
3 thoughts on “Meaningful life and death”
Hi Chanté,
I would firstly like to commend you on a very interesting writing piece. Personally, I cannot relate to the topic, as I had not experienced the death of patients to the extent you’re expressing in your writing piece. The fact that you are addressing the topic of death is commendable as it is a very touchy and unaddressed subject. Nonetheless, based on the curriculum we are taught, death is an untouched and often over- looked by subjects either leading up to death (effects of sedentary living, euthanasia and even critical care unit interventions). Connotations to these topics are often preventative measures to preventing detrimental complications or allowing progression of primary and secondary implications within a clinical setting. Though we are not really equip with a recipe indicating how to deal with experiences as such.
With this being said, I personally feel like death is a topic that you cannot be prepared for and deal with in a systematic manner, as you would with every other physiotherapy intervention. The reason for me saying this is that all individuals are dissimilar, in appearance, in our manner of perceiving and interpreting things, in addition to how we feel or address with certain life situations. Hereby, when confronted with a situation where the patient has passed on, it cannot be presumed that everyone will react in a desired manner. Therefore, one cannot adequately be prepared for such an instance. I agree and have to, identified a lack of literature within this field. Additionally I also feel that students would benefit students in dealing with experiences with death, because facets of how one has dealt with it might assist another. Though, I also strongly feel that every encounter will differ and individual reaction would to be dissimilar as it can be influenced by numerous variables.
Furthermore I encourage that that all students should be provided opportunities to either write about or counseled by an individual on their feelings and experience. Hereby the event (may it have been traumatic or not) does not remain an unaddressed mental burden, haunting the student. Williams, Wilson & Olsen (2005), states that a students’ first experience with death in clinical practice caused them considerable anxiety, and they reported feeling inadequately prepared for the reality of the situation.
In conclusion it should be considered that educationalists clinicians alike should introduce much more consideration to the fact, through finding certain teaching and learning methods that are appropriate to this challenging subject. The resultant effect hereof should be that students feel an increasing feeling of preparation for what they might encounter, though students should be open to varying responses to death, as it is a unpredictable encounter (Williams., et al, 2005).
References
Williams, C., Wilson, C., & Olsen, C. (2005). Dying, Death, and Medical Education: Student Voices. Journal Of Palliative Medicine, 8(2), 372-381. http://dx.doi.org/10.1089/jpm.2005.8.372
https://iepcourse.wordpress.com/2018/03/26/dealing-with-physiotherapy-students-coping-strategies-and-what-should-the-university-do-about-it/
Hi, Chante. Thank you for your post on the topic of meaningful life and death.
Death is something I am sure most of us would like to avoid. I also struggle to grasp the concept of death, even more so coping with it. In our profession, death is a concept which we will inevitably be faced with and it is our responsibility to “remain sane”, compose ourselves and try to cope.
I came across an article which highlights 2 main types of coping: problem-faced and emotion-faced. in problem-faced coping, the individual focuses on what her/she can do to change the undesirable circumstances whereas an emotion-faced individual will concern him/herself solely with managing the emotional distress. (Akuroma, Tasner & Aichetou, 2016)
Simply stated, problem focussed coping includes planful problem solving, confrontation, and social support. Emotion focussed coping includes distancing, escape or avoidance, self-control, positive reappraisal and accepting responsibilities. Social support generated by human interaction is usually sought from friends, family and co-workers and is seen as a separate component that facilitates coping.
Naturally, people are very different and will respond to and cope with death in a variety of ways. I hope that the points I discussed above might aid you in coping with this complex concept.
References:
Akuroma, R., Tasner, C. & Aichetou, E. (2016). Coping Strategies Used by Nurses in Dealing with patient death and dying. JAMK University of Applied Sciences. Retrieved from https://www.theseus.fi/bitstream/handle/10024/123887/Akuroma_Roseline.pdf?…1
Hi Chante,
Thanks for sharing your clinical experience with us.
Death is an emotional event and I think most students in their clinical block have experienced the loss of their patients or a patient in the ward they worked. Personally I have come to a realization that students frequently find themselves in this type of situation and are not equipped enough to know how to cope with it. I am currently doing my ethics proposal on this topic and from a few research conducted on this topic there seem to be very little evidence of existing education about coping strategies for students regarding patients loss. As students we are unfortunately not trained about grief of patients in current curriculum and this to me is an alarming situation because many students actually end up experiencing patients’ loss in clinical practice.
From what I have learned while doing research about this topic is that there are multiple factors that could impact a student’s emotional response to a patient’s loss. these include the amount of time spent treating the patient, the student’s exposure to previous similar event and the way in which the patient passed away.
Powell and Toms (2014) researched the coping strategies and the impact of a patient’s death on physiotherapists. According to these authors, a physiotherapist will grieve and select different coping strategies to deal with the death of a patient depending on the circumstances surrounding the patient’s death and the previous experiences of patient death. It is assumed that students are more likely to be impacted on a greater scale than health professionals with more experience with patient deaths who have developed coping strategies.
In conclusion I’d like to say that there is definitely a call for the university to do something about this. I think incorporating patients’ grief and coping strategies in the current curriculum will equip students for their first experience of a patient’s death in clinical practice.
Regards
Nathan Lunda
References
● Powell, S., & Toms, J. (2014). Passing Away: An Exploratory Study into Physiotherapy Students’ Experiences of Patient Death whilst on Clinical Placement. International Journal Of Practice-Based Learning In Health And Social Care, 2(1), 108-121. http://dx.doi.org/10.11120/pblh.2014.00026