When a medication is discontinued or has passed its expiration date, the nurse may not dispose of the medication, but should instruct the patient/client and/or caregiver on safe medication disposal. It is no longer considered safe for the environment for medications to be flushed down the toilet. Federal guidelines indicate they should be taken out of their original container and thrown in the trash. The Office of National Drug Control Policy recommends mixing them with an undesirable substance such as kitty litter or used coffee grounds or putting them in a nondescript container such as an empty can. Some communities have a pharmaceutical take-back program for gathering unwanted medications at a central location for safe disposal. Care of the Dying Patient/Client As a healthcare professional, you can make a difference in the end of life experience of the dying patient/client and their family. Being diagnosed with a terminal illness produces many different reactions in people. These may include emotional reactions such as disbelief, fear, anger, depression, and guilt. Fear or apprehension is a common initial reaction. People fear pain or disability. Apprehension may result from a sense of losing control over life. The ability to manage our lives is tied closely with self-image and self-respect. Guilt may result from not being able to accomplish all the tasks or needing assistance with activities of daily living. Guilt feelings about “letting down” your family or friends may envelop the patient/client. Depression may be characterized by withdrawal, melancholy, and helplessness. Grief is experienced by nearly everyone. It is an emotional response to a significant loss and may be experienced when the individual first expects the loss or by the family, after the loss. The Stages of Grieving: • Denial is characterized by shock or disbelief, and may have physical symptoms as pallor, faintness, nausea, and confusion. • Anger is characterized by impatience, uncooperativeness, bitterness, feelings of helplessness, sarcasm, and increasing awareness. • Bargaining is characterized by exhaustion or depression, or final attempts to avoid reality. • Depression is characterized by withdrawal, melancholy, and the gradual acceptance of reality. • Acceptance is characterized by contemplativeness and serenity, and the ability to talk about the loss. It is important to understand and support the family as they lose their loved one. It is also important that you understand your own feelings about death and dying in order to provide care and support to the dying patient/client and their family.
