As a nursing student, I stood by watching an autopsy. I was petrified. As a graduate nurse, I stood by watching a nurse continually defibrillate a dying man because he didn’t have a
DNR order. I was mortified. Those early experiences with death affected how I viewed death and dying. It was something to be feared, avoided, denied, and certainly not discussed.
Then my father dropped dead. Of course there would be no autopsy, as the images were fresh in my mind…open skull…raw brain. We would assume that he died from some kind of cardiovascular event, but we would never know. Now as I am raising my own children and looking at my own mortality, I believe that it would have been helpful to know if there was anything hereditary that could have caused his death. What I had experienced as student nurse, reflected the decisions I made in my own family, but they also affected how I viewed patients’ family members who requested autopsies. I would often be thinking “you don’t know what they do in an autopsy, you don’t want that for your loved one”.
My mother had a cardiac arrest suddenly after a cancer diagnosis. The time came for making a “code” decision. Of course there would be no defibrillation…the images flooded back to me…blistered skin…body twitching. We would never know if debrillation might have made a difference. But we couldn’t watch her suffer. After that, when I would see patients’ family members who could not make a DNR decision despite a hopeless prognosis, I would have to remind myself that my attitudes toward death and dying were reflected in my own experiences.
Every patient and every family member has a right to decide on code status, autopsy, and final arrangements. We must not let our own attitudes toward death cloud our objectivity in dealing with the dying patient. We, as nursing instructors and nursing students, need to examine our own beliefs. Only when we can confront and deal with our feelings about death, can we be helpful to those in need of our comfort.
From: Kathleen Wedin, RN, BSN
Associate Director of Nursing
Brooklyn Park Campus