Community Health Nursing
SZT Task 2
Mary Valori-Schmidt
Western Governor’s University

As an RN, with many years of experience in critical care and trauma, I have had to witness death and dying on a regular basis. After leaving the acute care setting, I functioned as case manager and clinical director for Medicare certified home health. Referrals to Hospice were frequently made for many patients. One’s perceptions regarding death and dying tend to be influenced by one’s cultural and religious (if applicable) beliefs, however, working in healthcare has had a significant impact on my own perceptions. Quality of life is of paramount importance as opposed to length; living with unbearable pain, for example, is not a life at all. One of the most important factors for me, though, is respect for the dying person’s wishes. All too often have I seen well-meaning family members push for any and all extreme, life sustaining measures for their loved ones, while the patient is praying for death. I have had to advocate for the patient many times when there is no further viable treatment and palliative care is all that is left. Honesty, with compassion, tact and sensitivity, I believe, are the keys to imparting information to grieving family members. These experiences have taught me to always educate patients and family members about the importance of advance directives and durable medical proxy appointment while they are well enough to make informed decisions about their wants and needs, which are really all that matter. As the community health nurse, three strategies I would implement in the case scenario would be a referral to a mental health professional, a referral to home physical therapy and occupational therapy, and a referral to a cancer support group locally. The mental health professional would be valuable for Mr. Thomas in evaluating his depression and possibly