Plainly said, I hate to watch people suffer needlessly and I feel guilty for not having spoken up sooner.  Through my vast nursing experiences in critical care and case management, I have developed very strong feelings about working to ensure everyone over the age of 18 has an advance directive in place.  This document speaks for you when you are unable.

You are likely unaware of the unnecessary misery that plays out on a daily basis, in just about every hospital across this country, over and over again.  Trust me–the Palliative Care Teams’ dance cards are booked days in advance, all to discuss care about a person who, in all likelihood, cannot participate in the discussion.  These conversations are extremely difficult and emotionally laden.  The people who attend are usually wholly unprepared for these chats, often due to denial, grief, a lack of sleep, or a basic lack of medical knowledge.

Clearly, we are asking the wrong people at the wrong time!  You cannot take part in the decision-making when critically ill.  Even if you have verbally expressed your wishes to those who love you, please don’t put these people in a place where they have to make decisions for you.  They often struggle with this burden and second-guess themselves, sometimes suffering from guilt for many years to come, long after you are gone.  Even worse, they make decisions based upon what they want, not what you would want.  I feel like I am being called to try and change this culture.

I, like thousands of other nurses across this great land, have cared for patients when a surprising illness or accident struck.  Some might even say I have been severely traumatized by the countless cases, which I have witnessed unfold, much like slow-motion train wrecks.  The situations are different but the nuances remain essentially the same.

An Advance Directive is a gift that eliminates ambiguity in your wishes and provides some measure of comfort to those you love.  It protects them by literally relieving them of the responsibility for making your life or death decisions.  Folks must understand how imperative it is to have this documentation place, especially if your next-of-kin is not the person who you would want to make your healthcare decisions for you.

It just makes it so much easier for everyone concerned when a written advance care plan is in place.  Healthcare providers know who to call and at what number.  Your care can proceed with confidence because the team knows which course you would want the team to take on your behalf.  Family members are alleviated of making decisions, like about organ donation, during their time of grief.

Please take the time to document your wishes while you are able.  Life has a way of sneaking up on you, catching you unprepared.  Come talk to me, while we can have a little fun in the process!  I promise I am not selling caskets!  Do not put your family through the wringer, when they are at one of the very lowest points of their lives!

This is my way of giving back and perhaps preventing the necessity for those tough conversations altogether.