In the End we all die alone.

1)    Having been a patient on Hospice I learned very quickly that the people caring for you find it easy to speak to you as a client/ patient and not a dying human being. They talk around you, through you, but not with you...I do not want to appear callous towards those care givers because they do an important and difficult job, what I am saying is being on this side of death, perspective becomes well, selfish, fearful, and lonely.
    What I know now, that I wish I knew then, is, that a dying persons process is their own, it is their journey and no one alive knows what it is like to reach the end of this journey...their death is real, their dying is real and no matter how strong they may appear, they are afraid...
   And did I treat patients in this manner? Was I distant, was I superfluous, did I try to actually place myself in the patients shoes?  I do not think I did...who wants to confront death, and now that I have had to, I feel alienated, alone, and cast aside like no one really cared. Now I know how my patients felt, because that's how I felt.
    Yes I did my best to keep them comfortable and yes I tried to keep the families aware and educated to the death process but I seem to have forgotten that this is the patients moment, their,trail and tribulation with the inevitable, and who am I to cast my views, ideas, the myriad  treatment modalities, when most of the time  the patient just wanted you to know they were frightened and just needed someone to allay their fears and ease their pain and curiosity of the impending death.

2)  the pervasive use of indwelling intravenous catheters, eg. Groshongs, Hickman's,and Picc lines etc. This prevents multiple needle sticks and allows the patient more comfort and less anxiety.. A nurse as well as a trained family member can access this to give pain meds and anti emetics. No one I know enjoys suppositories and most anti emetics are in this form... The reason most patients do not have this comfort measure is the fear of infection and the fear of an air embolism but as with anything in health care, if you do as policy and procedure dictate, their is nothing to fear..
 A)  The  great injustice dying patients are faced with now, not then is the lack of proper analgesic treatment. Now that the Feds are prosecuting doctors for improper pain management, eg. Pain clinics, patients abusing narcotics, nation wide addiction, etc. The trickle down effect has reached the physicians who treat dying patients...
  Before the narcotic situation, most doctors gave carte Blanche to analgesics. Whatever it took to make the patient comfortable was okay. Now I have the unenviable task and witness to patients being allowed to languish in excruciating pain all because the physician fears repercussions from the Feds. There are on going law suits now because of this sad phenomenon. And patients are still dying in Horrible pain...

B) I was witness to this with one of my patients last year when the patient kept requesting increases in his liquid morphine and when addressed this and  I asked the doctor, his answer was, " No,  I'm not giving him another damn thing, he's just a a GD addict"!  My retort was, " but doctor he's dying of liver cancer that has metastasized to the bones, so he is in valid excruciating hip and back pain"! The doctor looked at me and said, " the answer is no, if he's in that much pain send him to the ED"!
    I knew there was no way I could help the patient, so I went to the patients house and did the best I could to comfort him, and finally did have to call an ambulance and have him transferred to the hospital, therefore incurring further costs to an already overtaxed system, and all the physician had to do was write a simple script for an increase and or different narcotic...

3) I suppose the biggest surprise that people see when a loved one dies is, that no matter how prepared you are for their impending death, no matter how much counseling you've received, no matter how strong your faith, nothing can prepare you for that moment when your loved one breathes their last...
    I have watched family members jump in the bed with their loved ones, scream, cry, yell, any emotion you choose, all the while begging the love one not to go, " please come back, don't leave us"! It can be gut- wrenching...
    So no matter how "ready" they say they are...they really are not.no one wants to loose loved ones.

4)  having seen countless patients die it makes living easier because it makes you realize that death is the great equalizer, it comes to us all, and there ain't a dang thing you can do to stop it. Yes you can slow it down and yes even sometimes evade it, but when your day, your hour, your minute, your second comes, well, vaya con Dios!
   Being in the health field as long as I have you would think we, nurses, become use to death  maybe even apathetic, but that is far from the truth, I can see every face I've covered with a sheet, every body I've transferred to the morgue, every patient I've performed CPR on, and I believe I will see them until death comes to me, then I will be at peace. You see when people in the professions that see death on a regular basis, they become haunted by the incidence and faces of the dead...it doesn't happen every day but as I age and since my recent bout with near death, they come to me more... And it is unsettling.

5) if there were any words I could say to comfort people on the journey of life is that please, believe me when I say, it is short, fragile, and we take it too much for granted. Research death,  talk about it, to your family and your children, ( this society steers away from it because we fear it so, most other cultures embrace death, celebrate it by memorializing their lives), understand that this body is just a shell of who we really are and that we will all be together again in the vast dust clouds of stellar nurseries. From star dust we are born to star dust we return...death is just part of life.

And when you witness a loved one die and we all do and will...hold them, give them a kiss and let them go because what they were is already gone. I know, I watched my daughter die and I thought I would die right along with her...

When I was younger and one of my tasks preparing dead bodies was to give them a bath and clean up any mess that may be present...sometimes I found myself looking in the eyes of the deceased and asked them, " where are you, where do we go, and what's it like"? I have yet to receive an answer. Humans search their entire lives for all the unanswered questions to the enigmas of life and yet we still do not know what happens when we die.

But we all will someday...



I hope this enlightens as well as informs. I can expand or detract any and all of what I have submitted. Sometimes I can get a little "wordy" as you can see!!

My name is Michael R. Ivy
I am a RN by profession and work part time as a nurse consultant now.
I also own Ivy Leaf Film Productions Inc.
www.ivyleaffilm.com
My blog post address is
  http://miguel-ivy-marquez.blogspot.com/
I am enjoy writing as a side line and great keeping me out of therapy...
I have written five novels, a myriad of articles, short stories, screenplays and scripts.
We are in production for two projects at this time and
We are proud to announce promoting the first horror film festival in this area, to be held Oct. 31,2014. At the Frank theaters in Murrells Inlet SC...press release to be sent out this Monday.
I am also an accomplished musician and write and compose all the music scores for our films, weddings, commercials, and music videos,
My band opened up for Charlie Daniel's and Nantucket way back in 1989,
And we toured the east coast...
I have two grown boys, one is president of my company and he is chief editor for a local television station.
My other son is in the military and served two tours in Iraq during "Enduring Iraqi Freedom".
My politics are to the left of center
I am a human secularist

I will attach a photo for you. I am honored that you chose me to talk with you and will be honored to write for,you in the future since I know so much about the medical field...

Some subjects that are eye opening
nurses and doctors carry MRSA in their nares
Nurse and doctors continue not to follow hand washing and glove policies
Mistakes made by nurses are hidden by incident reports and most patients never know about them.
I have a lot of info for the asking.

Sincerely,

Mr. Ivy