Palliative Care Nurse - common sense in 'warts-and-all' approach

  This opinion piece from WA Today
 includes an interview with a palliative care nurse named, Von. 50 years of experience with dying patients provides a wealth of experience and reflection:
The author opens his article by commenting briefly on the recent assisted suicide film, Amour. He then segues brilliantly to give voice to Von:
The swiftness of our existence is the ghastliest kink of life. One day you're kicking a football around with your little kids and in the blink of your eye you're staring down at that blinding light surrounded by children suddenly grey-haired and with kids of their own.
But is it all really that bad? I spoke to a recently retired nurse, Von, who has spent the previous 50 years in long-term, aged and palliative care. After seeing 13-year-old boys turned into quads after diving accidents grow old in care and watching dozens of terminally ill patients die, her opinions are worth listening to.
1. She doesn't believe in government-mandated euthanasia but isn't opposed to assisted dying. "Families will say, can't you just give my father an injection? I always say, why don't you do it? How can you expect medical staff to give someone a lethal injection and to have that on their conscience? That's not best practice, that's awful." There's a subtle difference, she believes, between the poisonous IV or injection that causes death quickly, often with terrifying results, and assisted dying, the removal of invasive feeding tubes for instance, that can take place over a number of days, where pain is managed and care and comfort is provided.
2. Mysterious therapies sometimes work. Von is certainly no fan of new-age mumbo jumbo but she recalls watching a Reiki therapist help a dying man with a tumour at the back of his tongue. "His respiration was difficult, the most horrendous rattling, and this girl came in, put her hands on his chest and it just disappeared. I've never been believer but I did see that happen. I don't know how one person can have those skills. But it worked. It made a difference to this man in the last few hours of his life and it made a difference to his family who didn't have to listen to that dreadful noise. He was settled and he was calm. It was really beautiful."
3. Family conflict will always surface. "That's really a standout thing. In 90 per cent of families, there's always some conflict. And it's usually in those last few hours of someone's life when there's a lot of discomfort when all those old accusations bubble up, like, you're here now, but where were you for the last five years?"
4. Believe in chaplains. "Regardless of religion, chaplains play an important role in care. They're always such good people. It's really just about someone coming over and saying hello and establishing a rapport and giving someone a little prayer if they want it."
5. Palliative care isn't the horror you'd think. "It's actually a privilege to look after people at the end of their life."
6. Morphine isn't a miracle drug but it's close. "It's not a miracle because it doesn't change anything but it stops the pain. It has no ceiling." In second place of awesome drugs,we find Valium and its family of anxiety blockers. "At the end of your life it's not just the pain you have to relieve but the tremendous fear of dying."
7. Time given is as important as expert treatment. "In aged care, you can read someone the front page of the crappy local newspaper and they'll light up and say, wow, that was just amazing. They're so touched that you took the time to sit there for five minutes and read to them."
8. You can't change the behaviour of young men. And therefore every day another boy is going to spend the rest of his life in a chair. "Every mother fears their son wheeling a motorbike down the driveway. But it's never going to change. Young men between 15 and 30 will always ride motorbikes, play sport and surf and jump off bridges into the Yarra. And now with recreation becoming sillier and sillier and more complex there's a million options to hurt yourself."
9. Doctors aren't infallible. "There's an older generation that treat doctors like priests, that they can do no wrong. Now it's challenged all the time. Families know about medication. They have a lot more access to information. In response, instead of having steam come out of their ears, doctors have had to develop people skills."
10. Forget about last words. "I've never heard anyone whisper their final words or say something lovely to someone, smile, and then die."