NURSES DESCRIBED COMMON DILEMMAS THEY ENCOUNTER
IN THE CONTEXT OF THEIR MAID-RELATED CARE.
There are no simple solutions to these dilemmas, but it is important to be aware of them so that you can consider what you might encounter in your practice.
ALLOCATION OF TIME
Good MAID care is time intensive – even though the procedure itself only takes minutes. Much of that time is related to planning and preparation. Further, MAID applicants often take priority in your workflow because of the need for a timely response.
UNAVAILABLE HEALTHCARE SYSTEM RESOURCES:
Persons who request MAID should be offered palliative care under the legislative requirements. However, we know that palliative care services are not available everywhere in Canada. Further, persons who request MAID, and do not have a foreseeable natural death, may do so because they do not have access to services that could improve their quality of life (e.g., housing, caregiver support, comprehensive mental health services). These realities can be challenging to negotiate and can become a source of moral distress for nurses.
Caring for family, and in particular family who disagree with MAID, can be one of the most stressful parts of care. Family may be under intense pressure leading up to the MAID death and so it is important to frame their responses in light of that pressure.
HAVING THE RIGHT CONVERSATIONS
Persons who are dying often tell nurses that dying is taking too long, and they may even ask nurses to help them die faster. However, this does not mean that they are requesting MAID. It is important to clarify the nature of such requests. One of the most important skills you can develop is knowing how to clarify the patient’s intent and to talk comfortably about MAID with patients who may be wondering about it as an option for them.
To qualify for MAID patients must be suffering. However, this eligibility criterion can be confusing if persons applying for MAID do not appear to be suffering or the suffering is being expressed in a manner that is difficult to interpret. It can be disconcerting for nurses when persons who seem relatively well receive MAID. Open conversations about the suffering the person is experiencing can be helpful for deepening your understanding. Reflecting on the nature of suffering, and knowing how it applies within the MAID legislation, is an important aspect of your preparation for MAID-related practice.