I lied...a story of how I outright LIED to patient's family.

[JDougRN]

I got the call on the EMS radio around 5 am. This is the usual time we get calls from EMS responding to nursing homes- The nurses are rounding on their patients to give am meds, and they find their residents dead or in distress. An 87 yo female, febrile, and in severe respiratory distress coming in. Pt is a DNR, but family is very involved, is aware, and will meet them in the ER.

I'm alerted that family is in the waiting room before the patient even gets there. I go out and introduce myself, tell them I will be her nurse, and that I will bring them back as soon as I get her settled in the room.

EMS arrives, and carefully transfers their frail burden onto one of my stretchers. You can see the relief on their faces, that they got her here and are able to hand her off before she dies on their watch. I'm now the proud owner of one very ill person. Temp 102+, Respiratory rate 14 and irregular. HR 50's, sat 84% on NRB, I don't need my Littmann to hear the rhonchi- Other hx is advanced dementia, DM, CHF. Has been in the nursing home for about 6 months- her husband had taken care of her at home as long as he could, but it finally got too much for him to manage, as he was also dealing with his own health problems at the age of 92.

I got her settled, and the Doc comes in- I give him the pertinent info- Not a whole lot we can do at this point other than make her comfortable and treat the infection. Chances are poor that she will make it, and we both know it. Doc moves on to deal with people he can help, leaving me in control of this mess.

I bring her visitors in, including her only daughter in her 60's, and several close friends of the family. I get them settled in and TRY explain to them what is going on. They don't get how bad off she is- I try to explain it to them in soft terms- They share with me who she is- a wife, a mother, a friend.I learn her husband is frail and elderly. I strongly suggest that if he is able, that he come. The daughter tells me she is going to leave to go get Dad. I explain that mom could go at any moment, each gasp she takes could be her last. I don't want them to have to deal with the idea that she died without ANY of her family around. But I REALLY wanted her husband there. The daughter calls her husband, who is dispatched to go get him dressed and here.

In this age of technology, we can keep up with a lot of things. I'm updated that son in law is at dad's house, he's getting him dressed, getting him loaded in the car with the wheelchair. I'm watching my patient brady down, 50's, 40's 30's....The monitor is alarming, and my pt.'s daughter sees it. Husband lands in the parking lot, and the son in law is getting him loaded in his wheelchair.

Then she died, no resps, asystole on the monitor. The daughter asks me- "Is she gone?"

"Not yet" I told her her- I gave her some silly answer- the monitor isn't picking up anything because she is so sick. I mute the alarms, turning the monitor away so she can't see the flat line.. I send 2 of my male coworkers to go out and GRAB the husband, RUN him in.

He arrives, looking a bit baffled at the whirlwind of men running out to snatch him out of his van and deliver him to trauma room 3.

I kneel down and introduce myself. I told him. "I'm sorry, but your girl is dying." He looks at me without comprehension. I took his hand, and joined it with his dead wife's. I told him "Your wife is dying right now- tell her you are here, tell her you love her- these are the last things you will be able to tell her....Tell her it's OK to go-"

He grasped her hand and brought it to his temple. "I love you baby....it's OK to go, I'm here."

I waited a minute and placed my stethoscope to her chest, made a big deal pronouncing her time of death as just then.

I lied- she died without her husband.... but that is something they will never know, but I will live with forever. I know I helped the living, but damn, holding this stuff inside hurts. I tried to explain it to my husband when I got home. He didn't get it. This is something I carry inside.

I know my fellow nurses will understand. Thanks for letting me vent and get this out.

[Papa Don]

We finally got the family to go to the hotel, get cleaned up, and get some sleep. 90 minutes later he bradys down. We call the family and they rush in. I pulled up a chair and sat for 15ish minutes with a dead man's hand in my armpit to keep it warm. The wife comes in and I put her in my chair with his Gandalf in hers. Otherwise, it's the same story.

Guilt at deceiving them into thinking they made it back in time? Yes. Am I sorry? No, not really. He was gone. He didn't die alone. I was there. At that point, my job was to care for the family.

[agiboma, BSN, MSN, NP]

Wonderful story thanks for sharing. You did the right thing!

[djh123]

Oh yes, I get it. I applaud you for doing what you did, and for doing what sounded like the best you could do in the situation.

[Lexxy500]

I'm not sure if I'm posting this in the right place or not. But I felt very moved by this post. I worked at a staff nurse in a hospital the first 10 years of my nursing career and I have worked in home health the last 9 years. In all of that time I've been fortunate enough to always have family present in a situation where a patient I was caring for left this world. Reading this made my heart so very happy. It made me feel so proud to be a nurse and simplified for me the exact reason that I wanted to be a nurse in the first place: COMPASSION. Kudos to the poster for "lying" to a patient's family. My heart just aches thinking of how this woman's husband would have been crushed if he wouldn't have had the chance to say those last words to her. He was given the ultimate gift of love by her nurse. Truly inspiring and so beautiful.

[post-it]

OP - I am a nursing student and I hope to one day have the courage you did in that moment to put such a weight on your own shoulders in order to provide peace for the family, and especially the husband. You are the kind of nurse that I aspire to be.

[iluvivt, BSN, RN]

There is nothing wrong with what you did,in fact is was an act of love and caring. If we are not here for each other on this journey then in my book you are not worth much, apparently you are rich in what matters!

[ORnurse2003]

I realize this thread is a few years old....but I had to comment anyways.

A few years ago my grandmother in law was taken to the ER from the nursing home she was in. My grandfather in law had passed away 10 years before. My husband and I live over an hour away from where she was, my father in law lives 3 hours away and my uncle in law lived 3 hours away. She was taken to the ER for a cardiac event. The ER staff knew she wasn't going to make it. She looked at the ER nurse and asked if her son's were here and the ER staff said yes. Shortly after she passed away. We were so thankfull the staff said that to her as we felt she at least would feel like she wasn't alone. In your case it was about the family and their comfort. You did a great thing for them!

[Dogsarebest]

Just saw this on Facebook, don't know if it's old or new. I know it brought tears to my eyes, your compassion was just what that family needed. You did nothing wrong, in my opinion.

[nancyratched]

that was the kindest thing you could have done!

[Cab411]

I was with several pts when they have taken their last breath. Their hearts always still beat for 10 to 15 min afterwards so techincally you were right.

You did the right thing. It is hard. As nurses we do our best to help.people through hard times. You did a wonderful job. (((Hugs)))

[Jussayn]

You did great!!!! You have served not only your patient but her family as well. You want positive healthy outcomes for pt AND FAMILY. She is already gone, the next priority is her family which includes supporting positive mental health. That 93 y/o man has enough on his plate without having to deal with the fact that he missed his wife in mere seconds!

[RNikkiF]

I know this is old, and I've seen it before, but God bless you!! You gave them a gift. I hope you sleep well with that knowledge.