There are very few issues in healthcare right now that generate stronger emotions than MAID – Medical Assistance in Dying. In June 2016, MAID became legal in Canada. Since then, some of the people who met the criteria for MAID have chosen to die with MAID. As people become aware of MAID, they may explore and ask questions. It is now more likely that PSWs and nurses will be asked questions about MAID and will be supporting families that are struggling with their loved one’s decision about MAID.
When you are responding to difficult questions, such as those about MAID, you will want to be compassionate and supportive. And, you will need to respond appropriately within the scope of your practice. You can do this if you have clarity about the following four areas of your practice.
1. Clarity about your role as a PSW or nurse, and what you have to offer to those in your care.
It is crucial for you to be clear about your role as a PSW or nurse when providing care for people who are struggling with grief, uncertainty, conflicting family viewpoints, and strong emotions as they try to make life-and-death decisions.
You offer your skills in relationship building, listening without judgment, witnessing without taking sides, empowering instead of fostering dependence, and remaining supportive but neutral, even in the face of family conflict and turmoil. These skills are the foundations of professional and ethical practice.
2. Clarity about the baggage you bring with you everywhere you go
When we talk about “personal baggage” or “baggage” we are referring to the beliefs, opinions, and values that we all carry with us as we live our lives. These beliefs and opinions shape our worldviews and inform how we approach living, dying and death.
Developing self-awareness will help you to learn about your baggage. When you know your baggage, you can set it aside and be supportive when working with people who have different ideas, for example, about MAID and suffering, quality of life, and an individual’s right to choose how they die. Putting aside your baggage means keeping your personal feelings and beliefs about MAID separate from your work. In this way, you protect the rights of people in your care to make important decisions without the added burden of trying to carry your baggage.
3. Clarity about the value of therapeutic boundaries and what they look like in the context of difficult conversations.
Boundaries are valuable in your work because they prevent over-involvement with the people in your care. Respecting boundaries allows you to provide passionate, and trustworthy care, in which you feel deeply, but still, think clearly and act wisely.
Simply stated, maintaining healthy boundaries helps you to know where your needs end, and the other person’s needs begin. Whether you are responding to a question about MAID, discussing a person’s request for MAID or providing care to someone who is scheduled to receive MAID, boundaries allow you to maintain enough separation to focus on the needs and wishes of the person and family, rather than on your own needs and wishes.
With clarity about your boundaries, you can use your skills to provide compassionate support that protects and respects the autonomy and rights of each person in your care.
4. Clarity about your own need for support, including what it looks like for you and how you can access it.
Maintaining healthy boundaries in your work requires that you pay close attention to your own well-being and needs for validation and support. This is especially true when you are involved in discussions or care related to such a complex and emotionally intense issue as MAID.
Experience tells us that baggage tends to pile up and boundaries may disappear if you do not feel supported as you struggle with strong emotions, uncertainty, or confusion related to MAID. Knowing that MAID is becoming more common, it is very important for you to seek clarity about your organization’s expectations and guidelines regarding staff participation in MAID.
It is also important to clarify the availability of support including opportunities to debrief situations that cause you discomfort or challenge your ability to maintain healthy boundaries.
Compassionate, respectful, nonjudgmental, person-centred care is what PSWs and nurses are called upon to provide. It is the essence of the work and helps to create a safe place where the person and family can find their way on a journey that may at times be gentle and beautiful, and at other times challenging and scary. MAID can generate all of these feelings, which is why people in your care need you to be clear about your role, aware of your baggage, respectful of boundaries, and proactive in seeking the support you need.
Thank you for joining us here. Consider leaving a comment with your thoughts, or your own experiences in this area. Best wishes in your caregiving journey.