Effective communication is a key element in providing culturally sensitive care to patients and their families. The College of Nurse of Ontario (2018) state that as a nurse, “you are accountable to listen to, understand, and respect patients’ values, opinions, needs, and ethno-cultural beliefs.”
Communication is very important during end-of-life care no matter what the situation may be. Understanding the patient and their cultures, beliefs, values etc allow the healthcare team to better the patient and their last days. When a patient chooses medical assistance in dying, it is important to respect those wishes and understand that it is their choice, even if you may not agree with them.
What is medical assistance in dying? Check out my blog post here!
What are the nursing roles during MAID? Check out my blog post here!
How can you support the patient and their families? Check out my blog post here!
Reflection
During this course, I was able to sit in on MAID with one of my patients. It was important to me to be there for the patient even though I wouldn’t be the one assisting the doctor with the process. I found that the entire process consisted of effective communication, from originally seeing if the patient qualified for MAID to making sure the patient was comfortable right up until they passed. The patient wanted his family present, he wanted visitors up until the day, he wanted to be comfortable and to have his family see that he was comfortable as well. He was surrounded by some of his favourite things and people and you could see that those were his wishes and needs at this time in his life. Understanding culturally sensitivity from taking this course allowed me to be present with this patient, and to ask questions I would not have thought too much about asking before. I wanted to make sure there was no other cultural considerations that he wanted to carry out, I asked if he had plans for after his passing including a funeral etc and if his family knows about his wishes. Those are conversations I would have felt uncomfortable with in the past, but, was able to do, as I was more knowledgable on the subject.
my peerwise question
You are an RN caring for a palliative patient who speaks with you about their upcoming MAID. The patient asks if you would be the nurse to assist the patient in completing the process. You explain to the patient that you would be:
A – Willing to administer the medication for the patient as you two have formed a trusting relationship.
B – Providing nursing care for the patient before and after MAID, such as education and support.
C – Not in the room, because nurses are not allowed to be part of MAID.
D – Not in the room, because you believe it is wrong and you do not agree with the patients’ decision
My Explanation:
“When any nurse is assisting an NP or a physician to provide medical assistance in dying in accordance with the law, they may perform activities such as educating clients, providing support to clients and family, or inserting an intravenous line (with an order) that will be used to administer medications that will cause the death of a client.”
It is important to speak with your manager about whether or not you are willing to assist in the process of MAID, and if it is not something you are comfortable with, you would not be assigned to participate. However, it is not your place to state your opinion to the patient about the subject.
College of Nurses of Ontario. (2018). Guidance on Nurses’ Role in Medical Assistance in Dying. Retrieved from http://www.cno.org/globalassets/docs/prac/41056-guidance-on-nurses-roles-in-maid.pdf
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cultural competence in nursing 