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Focusing and Nursing

by Virginia L. Burton MSN, RN, Trainer-in-Training, Illinois, USA

Virginia Burton, pictured here with her three children, has a Master's degree in nursing and teaches Community Health, Families in Crisis and Foundation Concepts to Junior and Senior nursing students. She is also involved in hospice work.

When people receive a life threatening diagnosis, their inner and outer environments change suddenly and radically. Fear takes over. Often turmoil, conflict and despair mark the last months and days of their lives. This experience can be much improved by anyone at the bedside who can consciously help the patient and loved ones to slow down and "sense inside" what needs to happen next.

The person accompanying the patient and family can create "Focusing moments," using the Focusing attitude and invitations to "check inside" for answers to the many questions that arise. Should we get a second opinion? Should we go to Mayo or to Mexico? Will he die today? Should I postpone my plans? Someone is needed who can sit in the presence of fear and sadness without losing her own sense of being safe. As Focusers, we know that the person has an inner guide that offers exactly the right help at the right time. We just need to be there to help them hear it!

We cannot necessarily expect people in crisis to "clear a space," but they will naturally quiet down when we sit quietly with them. If they have nothing to say, we listen to the silence. If they say something, we listen to their words. Sometimes it is important to remember for the dying person because the people closer to them sometimes cannot hear through the fear, exhaustion and pressure.

Daniel's Death  Seventy-year old Daniel had terminal cancer. His loving companion, Bonnie, and his family (grown children and siblings) met at Daniel's bedside in the hospital. Daniel spoke with short and broken breath, and in a few but certain words, "I have been told that I may not live to see July first. I hope that I will live longer but I do not know that I will." Then he asked Bonnie to stand. As she stood beside him and took his hand, Daniel said, "Bonnie, will you marry me?" "Of course I will marry you."

The next day Daniel was moved to intensive care. The family forgot about his request. Bonnie felt that she should step back. I gently reminded them of what Daniel had said. This gave Bonnie "permission" to go Daniel's side and stay there in the loving partnership that was theirs. The patient's brother, Jim, asked for advice on his scheduled flight back home. I asked Jim what his felt sense was of his brother's feelings. He sensed inside for a half a minute and then responded, "Well when I told him that I was leaving on Tuesday, he told me that he felt a great let down." Jim stayed.

The next day the couple married. As soon as the ceremony ended Daniel relaxed deeply and slept for many hours. The following morning Daniel began to change over--and with his wife by his side, he slipped away. Many Focusing moments occurred in the few hours I was with the family. A peaceful or "good" death occurred because the people involved were able to make choices consistent with their values and personal needs.

Other Nursing/Focusing Settings   In addition to using Focusing in nursing practice, I use it in the classroom with student nurses to teach them how to hear and to value what the patient says she would like to work on.

I just returned from the End of Life in Nursing Education (ELNEC) Conference where I shared Focusing information with all of the nursing faculty. Joan Klagsbrun's article was taken in hand by some for use in nursing courses already this week. I suggested to one faculty member that she look on the web site for Doralee Katonah's article on Medical Decision Making, since she was meeting with patients, surgeons and families on the very topic this week. My immediate plan is to integrate Focusing tools into the ELNEC curriculum. Focusing moments and attitudes fit into every one of the nine modules.

Additionally, I am on the start-up committee of a large mid-west health care system for a palliative care program. Focusing will easily fit in there too. Just so much to do!

Visit www.focusing.org --click on the Medicine link.


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