Depok, August 3rd 2023. “A man on the brink of death was visited by an X-ray officer to have a chest photo taken. The patient is in a coma. The family refused to take photos considering that there would be physical manipulation to obtain an image of the lungs. The officer agreed and they both (nurses) asked for a signature to show that the family refused. About three hours later the patient died. From this case, the question arises, what is the actual nursing intervention at the end of a patient’s life?” said Prof. Dr. Krisna Yetti, S.Kp., M.App.Sc., when delivering her inauguration speech as UI professor.
Prof. Dr. Krisna is a Permanent Professor at the Faculty of Nursing (FIK) at the Universitas Indonesia (UI) who was inaugurated by the UI Rector, Prof. Ari Kuncoro, S.E., M.A., Ph.D. on Wednesday (2/8), at the UI Convention Hall, Depok Campus. In her scientific oration entitled “Nurses’ Concern at the End of Human Life: An Ethical Study of Expected Death”, Prof. Krisna discusses how nurses care at the end of life of patients whose death is predicted, as part of nursing care services which are examined from an ethical perspective.
Nursing is a caring profession. Nurses will provide interventions by referring to ethics, which are norms that determine good and bad human behavior, including nursing interventions for patients at the end of their lives. Ethics as a nursing guide has five pillars, namely Respect for others, Compassion, Empathy, Advocacy, and Intimacy.
Quoting a German philosopher, Karl Jaspers, Prof. Krisna said that it is impossible for humans to avoid death because death is the final limit of existence. The nursing profession does not determine a patient’s death, but if agreement with the patient can be predicted, the involvement of nurses can be more optimal. This is because at the end of the patient’s life, the nurse is always with him.
Nurses can provide appropriate nursing interventions for patients at the end of their lives by letting them go naturally or with dignity. This means that the nurse does not prolong the patient’s life by providing further interventions, such as fitting the patient with medical devices, but rather let them go with planning before the dying process arrives.
Death that does not prolong life is called natural death. In order to achieve natural death, nurses need to understand what events the patient may experience and what help they need. This understanding can be obtained if the patient or decision maker in the family knows the course of the patient’s illness and knows the steps to be taken long before the death process.
“For clients who are sick for a long time, nurses must be able to provide peace of mind at the end of the patient’s life. By using their advocacy role, nurses must talk to other health teams about avoiding the use of medical devices. All of this aims to provide peace to patients at the end of their lives,” said Prof. Krisna.
The nurse’s intervention is to meet the patient’s basic needs. Nurses must be able to help patients with their psychomotor and affective abilities. Nurses’ verbal and nonverbal abilities are a strength in providing care to patients. However, not all basic needs can be met, especially in patients with serious illnesses. This understanding can determine how optimal the results of nursing intervention will be to help the patient prepare, educate the family to understand, and help the patient make a will and grant the patient’s last wish.
Research Prof. Krisna is one of the many studies she has conducted. Several other scientific works that have been published include Predominant Factors Affecting Sexual Dysfunction in Patients with Continuous Ambulatory Peritoneal Dialysis (2021); The Effectiveness of an Appreciated Inquiry-Based Intervention to Improve Nursing Handover Process: A Queasy Experimental Study (2021); and Exploring Nurses’ Perceptions of their Workload at Coronavirus Disease 2019 Isolation Ward in Jakarta, Indonesia: A Qualitative Study (2022).
Prof. Dr. Krisna’s inauguration procession was attended by the Main Director of UI Hospital, Dr. Dr. Astuti Giantini, Sp.PK(K), MPH; Chairman of the Regional Management Board (DPW) of the Indonesian National Nurses Association (PPNI) DKI Jakarta, Ns. Jajang Rahmat Solihin, M.Kep, Sp.Kep. Kom.; and Chair of Iluni FIK UI, Dr. Atik Hodikoh, M. Kep, Sp.Mat. She graduated from the Nursing Academy of the Department of Health, Jakarta General Care (1976); Bachelor of Nursing PSIK–FKUI (1988); Master of Applied Science in Nursing, Faculty of Nursing The University of Sydney, Australia (1989); and PhD in Philosophy, Faculty of Humanities UI (2014).
