Using the Conscious Dying Principles in a Clinical Setting
I recently certified with Conscious Dying Institute as a Sacred Passage Doula. Some people asked me why I took the course since I am already a registered nurse certified in Hospice and Palliative Care. I work at a fifteen bed inpatient hospice unit and have done so for over seven years. My answer is thoughtful and measured. Working in the inpatient hospice setting I feel comfortable giving medications, managing symptoms and educating the dying and their families. I am also comfortable with integrative therapies such as Healing Touch, Mindfulness, Aromatherapy, and Guided Imagery. I hold certifications in Healing Touch and Focused Awareness Meditation. And yet, I felt there was more I could learn about working with the dying and their families.
I was right. The Sacred Passage Doula program gave me tools, insights, and practical information to bring back to the hospice unit.
Especially meaningful to me was a reading about an anointing ritual before death or at the time of death. The article had a research component with high family satisfaction ratings. Since all medical units are measured these days it seemed a worthy improvement project for my unit. It is a secular ritual that can be adapted to any spiritual belief or no religious belief at all. It met a need for families to feel involved in care and to honor their loved one in a concrete way.
The anointing ritual seemed a good way to increase family involvement and satisfaction with the death experience in an institutional setting. My patients are not able to be at home for many different reasons. We make the environment as homelike as possible but it is still a hospital setting. To bring this new service to the unit I met with the Chaplain, my manager, the hospice Nurse Practitioner, and a few nurse colleagues. We were already approved to use lavender oil for aromatherapy so that became our choice of oil for the anointing ritual. A soft music component was added along with an LED candle to be lit at the time of the ritual. I adapted the script from the resource article and tried it with the wife of one of my patients at the time of death.
When I offered the ritual the wife readily agreed. She took the lead in placing a drop of oil at each point of the body in the script and also added her own words as she lovingly said good-bye to her husband’s body. She and I both felt a sense of completion and acknowledgement of the momentous event of death.
A second family quickly took to the idea of anointing and carried out the ritual without any staff involvement outside of supplying the oil and the script. We learned how individual the ritual could be.
The project was outlined at a staff meeting and some staff felt uncomfortable with the procedure. A video example was filmed to help them understand the ritual. Staff was also given the ability to opt out of providing it by asking another staff person or Chaplain to participate in their place. My hope is that experiencing the richness and comfort of the ritual will encourage reluctant staff to embrace it.
Our plan going forward is to provide small bottles of lavender oil, a script printed on nice cardstock, an LED candle, and soft music and lighting. The dying person and family will be shown this option ahead of time so they can choose to do it or not and have some time to customize it for their situation.
Trish Rux, R.N., CHPN is a certified Sacred Passage Doula affiliated with Conscious Dying Institute. She can be reached at firstname.lastname@example.org
Trish Rux is a graduate of the Conscious Dying Institute Sacred Passage Doula program.
The training received has given many tools to provide compassionate care to the dying. The Anointing Ritual is just one of the learnings from the Sacred Passages Doula class. Since the class I have found myself even more present and aware with the dying and their families. I look forward to bringing more of the class ideas into the inpatient hospice environment.
Reference: Rodgers, D., Calmes, B., & Grotts, J. (2016). Nursing care at the time of death: A bathing and honoring practice. Oncology Nursing Forum, 43(3), 363-371. Dio:10.1188/16. ONF.363-371.