Can You Let Go and Let Be
by Dragana NP Obradovic
Working as a Palliative NP , over the years I met many patients on heir death beds and desperate families next to them . Very often, patients are unresponsive and unable to communicate with the healthcare providers, due to extremely complex condition and even more complex aggressive interventions applied to support life. In those situations, family members were faced with decision on weather or not ” Let go and let be’. In my many years of experience, I have thought much about medical interventions on behalf of family members at the end of patient’s life. I have considered CPR, artificial feedings, IV therapy, hospitalization or even diagnostic work on dying patient. I always wondered why people chose those aggressive measures.
Perhaps the reason these treatments are pursued is that the family has not been able to let go . Very often, the Physician has also not been able to let go or has not informed the decision makers of the marginal benefit of such aggressive interventions .Sometimes it seems easier to aggressively treat patients , tan to help families confront the emotional and spiritual issues that are driving the treatment choices. Indeed, physicians are trained to order medical treatments.
Working with patients requires attending to the communicative needs of the family. The goal is to match family needs with resource and empower them through education and support ( MacPhee, 1955). Collaborating with the family requires ongoing structured communication that is aligned with preexisting family communication patterns and is sensitive to the family structure ( Leon &Knapp, 2008). The family is conduit to he patient , and family competency is important to the overall care experience (MacPhe,1955).
That is why is very important for nurses to communicate with family members who are responsible to serve as surrogate decision makers. Familiarity with the family enables the nurse to build relationship, develop trust and help them with reducing the stress. At the time of dying , family is under the stress at it is a worse time to make decision about ” letting go”. They turn to nurse to meet their communication needs. Recognizing that the family and impacted when a family member is seriously ill, can bring supportive communication to the family’s care experience.
After experiencing sometimes painful struggle, people go through letting go of someone at the end of life. A natural response to the possibility to losing someone, is to hold on tighter or to try to gain more control. ironically , this does not lead to life of freedom and joy, the very things we are pursuing. Most of us do learn to let go. We let go of our childhood and accept adults responsibilities. We let go of finding happiness in possessions or careers. To learn these lessons, we have to accept the fact that these things or people were gifts in the first place.
MacPhee,M. ( 1955). The family system approach and [pediatric nursing care. Pediatric Nursing, 21(5),417-423,437
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