End of life situations are both extremely difficult for the family and the patient. This VR experience of end of life with Clay allowed me to witness this process in order to better myself as a nurse. As a nurse, it is imperative that physical, social, spiritual, psychological, cultural, religious, and physical needs are met when assisting with end-of-life care. During my clinical rotation at Southern Maine Health Center (SMMC), I was given the opportunity to float to the Special Care Unit where I experienced and assisted with end-of-life care. The patient sadly had severe COPD among other heart conditions and was on an IV drip of amiodarone for a couple of weeks as well as on a ventilator, but sadly neither intervention was successful, and her vital signs and condition continued to worsen. The morning I arrived at the unit, the doctor had informed both the nurse I was working with and myself to call the patient’s family and advise them that sadly it is her time and that she might not make it through the day, so it was important that they come to the hospital as soon as possible. As a result, we followed the doctor’s orders and once the family arrived and the difficult decision to end life was made, we provided the patient with morphine to ease her pain through the transition and life support was subsequently discontinued. This experience was an extremely sad and emotional time for the family, but I am so grateful I was given the opportunity to be there as part of their support system. My passion is to work in a critical care setting, and my opportunity to care for this vulnerable individual and their family, although emotional, was inspiring. I realized afterwards that nurses have such an important role during such a difficult time not only with the patient but as support for the family as well.  As someone who intends to dedicate my life to ensuring people receive the best possible patient care, I want to be the nurse who is there to support families and the patients through their most vulnerable and painful times.

After my experience with end-of-life care, I feel that the priority goals or focus of nursing care for terminal/end of life patients is not only to provide superior healthcare but to be a support system for both the patient and the family. Once it is identified that a patient is at end-of-life, it is of utmost importance that the nurse communicates to the patient and the family sensitively and comfortingly the information for them to make hard decisions. This is an extremely difficult time for the patient and the family, and it is the role of the nurse to inform them accurately in detail about all the facts and to gently provide them with the reality of the situation. Often, it is very hard for these families to understand the difficult decisions needed regarding end-of-life care and about the treatment that will support their loved one in their last stage of life. The nurse needs to ensure to remain being the patient’s number one responsibility and ensure to make sure their wishes regarding end-of-life care are honored. The focus becomes allowing the patient to have the best quality of life in these situations. The nurse should ensure to continue assessing the patient via a physical assessment and vital signs, as well as perform all orders directed from the doctor. To ensure optimized comfort, the nurse should ensure the patient is not experiencing discomfort or pain through administration of pain medication (e.g., oxycodone). The nurse should also ensure that the care plan for the patient includes adequate hydration and nutrition. Notably, the nurse should not only perform interventions to treat the patient physically but should ensure to enhance their emotional and mental health as well by sitting at their bedside talking with them, holding their hand, rubbing their arm. End-of-life care is often lonely and distressing for the patient, and as a nurse we can do everything possible to ease that transition for them.

Overall, this VR experience helped me practice nursing care for patients who are at the end of life as well as in supporting their family/friends. This experience gave me an understanding what it would be like for a patient and their family experience during this tragic period at the end of a client’s life.  Having these opportunities to support end-of-life care, both in virtual reality and real life, I have tried to be empathetic and have imagined myself in the shoes of the patient and their family. In doing so, I recognize important priorities that should be consistently maintained through the end-of-life process for both the patient and their family. I especially understand that it is important that I am an advocate, making sure that the patient is as comfortable and pain-free as possible as well as helping ensure their final wishes are met. And I will be sure to do all I can to maintain the patient’s dignity and allow them have control over decisions involving them for as long as possible. And for the family, I will be committed to working with them, helping support them during this difficult time. It is a period in life that is painful for everyone involved, and it will be my job to ease both the patient’s and family’s pain as much as I possibly can.