18 Apr Dying Patient
It takes someone special to thrive as a certified nursing assistant (CNA) and this job comes with its fair share of hardships one of which is dealing with a dying patient or resident which is one of the areas that will be covered in a CNA training class. While you may learn what to do in a classroom, actually dealing with this situation is quite another matter. One way that a CNA can deal constructively with the death of a patient or resident is to do your job and properly care for the resident or patient during this time.
Dealing with Dying Patients or Residents
CNAs will usually cater to patients or residents every need many of which are taught in a CNA training class and in the course of providing this care, nursing aides will encounter all sort of patients or residents. Some of these patients will make the job easier while others will make it harder.
In the course of providing this care, there will be patients or residents who spend weeks, months or even years at a care facility and the CNA may grow attached to some of these patients. Some of these patients or residents may have to deal with dying while under the care of the CNA. This can be a difficult experience for not only the resident or patient to go through but for the patient’s family as well as for the CNA to go through.
When death and dying comes into the picture, the aide may have a tough time due to getting attached to the patient or resident or just have a tough time due to the general nature of dealing with dying and death. Counseling services are usually offered by the employer to help the CNA cope with this aspect of the job which the CNA should take advantage of even when they feel that this is unnecessary.
Caring for a Dying Resident or Patient
• The first area that is covered in a CNA training class is to ensure that the patient remains as pain free as possible. If he or she complains of pain, ensure that you notify the nurse in charge so that the patient can be properly medicated.
• Keep the resident or patient as comfortable as possible. For an immobile patient or resident, ensure that he or she is turned every two hours.
• Keep him or her as clean as possible, through bathing if necessary, oral care, etc.
• Ensure that the patient or resident’s family remains close at hand.
• Allow him or her to eat what they desire.
• While providing basic care, you may also be required to provide emotional support for both the patient and resident as well as his or her family.
• Be aware that hearing is the last sense to fade even when he or she appears to be comatose.
Signs of Impending Death
While taking a patient or residents vital signs is not usually required with a dying patient, it is important to watch out for various signs when death in imminent which will also be covered in a CNA training class. You should watch out for the following signs and inform the nurse in charge when noted;
• A slowing or irregular heart rate
• Shallow respiratory rhythm
• Rattling quality to the breathing (the death rattle)
• Decreased blood pressure
• Decreased temperature
• Not being able to arouse a patient or resident
• When blood pressure is lost, the patient usually dies
While death is difficult for everyone involved, knowing how to properly perform your duties is important and is covered greatly in a CNA training class as well as by your employer. Making the transition from one stage of life to another for a patient or resident and their family as smooth as possible will help you cope effectively with the death. You will know that you did everything you could which will be a great source of comfort for yourself even when you want to break down after the loss.
For certified nurse assistants (aides) there comes a time when we will witness the passing of a resident in some form or another. Most of the time this loss is not known until we come in to work to find an empty bed. A familiar face is gone from the unit, the lunchroom, or it may be one of our residents that we care for on a regular basis.
Dealing with the Loss
No matter how much you try to distance yourself from the “job”, eventually you are going to become emotionally invested in a resident. If you work at any facility long enough, the resident will more than likely pass away. That is a fact of life – all people die at some point. Our job, as aides, is to make their elder years more comfortable. Often we are the only family that a resident has, their own families are gone or too far away to visit on a regular basis. That bond is a strong one, even to aides that appear to be resolute and sometimes, unemotional.
This job can leave you feeling jaded if you allow it. Or, for others they feel emotionally exhausted by losing so many residents that they care for. Either way, you will need to learn how to deal with the grief that can come with losing residents that you care for everyday.
One thing that many aides do is suppress their sadness. It is okay to cry. If the passing of a resident, you know dies, it is fine to take a few moments to cry. If it is close to your break time, you can spend the time alone, cry, and then stop in the restroom to wash your face before caring for your other charges. After work, take some time to reflect on the resident if you wish. Suppressing thoughts of the resident can cause you to have feelings of regret, later on.
Once in a while an aide will find that a resident they did not care for has passed away and find that they feel guilty for the feelings of dislike they had towards that resident. This is normal. Crying is just as acceptable in this situation. You are not required to like every resident you care for, only to treat them with respect and dignity while giving them the care they need. Unless you have done something to deserve feeling guilty for – personality conflict is not a crime. You cannot adore every person you come across in life, that includes residents.
Sometimes it helps to talk with other aides or the family of the resident when they come to collect his or her belongings. Long time aides, that you work with, may be able to help you through a difficult time in your career and help you learn how to cope in your own way. Many facilities offer grief counselors for nurses and aide, check with your employer to find out if this is offered in your facility.