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

The time I lied...to my patient's family. I hope it makes me a good nurse and helped the family, because it made me sad as hell.... Sometimes as nurses we need to blur the lines. Sometimes we deal with things that erode our soul, and only other nurses will ever understand the things we have to deal with, the things we have to internalize and go on. Nurses Announcements Archive Article

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.

You did the right thing

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I'm in agreement with nearly everyone else - you did the right thing and gave the poor man some peace during what was possibly the most difficult time in his life. I'd have reacted similarly, I like to think.

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Specializes in Hospice, LTC.

This was beautiful. Thank you for sharing, and thank you for the gift you gave this family. If you've ever considered a career in hospice/palliative care, I'd highly recommend it. It can be truly rewarding and you clearly have the compassion and communication skills for it.

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Give yourself pat on the back...it's a priceless memory a family can have...not everyone will understand, I admire your passion&kindness handling this delicate situation. I dealt with dying patient on my graveyard shift in a long term care facility, the patient had bowel cancer and his secretions were too much until his final breath, I made the decision to call in the family after he is all cleaned up, rather than having them around when he was struggling(the family have been very involved in his care). Eyebrows were raised with that decision and I don't regret it, my reasoning being, spare the family a good memory of him than having them so see how he suffered.

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Specializes in Geriatrics.

I wanna be just like you when I grow up!

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Specializes in telemetry, med-surg, post op, ICU.

I was in a similar situation once. I had a patient who was having crushing chest pain. He was literally screaming for nitro, his pain was so bad. Eventually, he completely coded out and died. We cleaned him up and staged him so it looked like he went in his sleep. When the little old mother asked my nursing supervisor if he suffered before he died, he said no very quietly. I remember that very well because it was a lie. However, what else could he say to her? No, he died thrashing and screaming. It still made me feel uncomfortable to by lying, but that brought a little comfort to an older woman grieving her son.

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Not trying to stir things up but...as a new grad rn, who is totally overwhelmed (but not stressed or worried about it I should be overwhelmed at this point) your story is without a doubt touching, inspirational, and extremely motivational (to me), but...

I feel so much pressure to protect my license, protect the institution who took a risk and put me in the ed with zero experience, and protect my patients that any lie, even one as altruistic as yours scares me.

Is the ability to do this (flat out lie, even when it is the right thing to do) some confidence you gain after working in the field, or ed/icu/hospice/anywhere people can die with regularity for a time? Or is this something you have or you don't? My first impression on reading this was, I would tell the family when they were dead and if people weren't there to "fill I'm the blank" that's sad, but not worth my ability to practice.

Obviously that line will move with experience, but from what I am thinking about reading this I'm not sure it will move THAT much. I'm not 23 out of college. I'm pushing 40 with a family and a step child with three kids of their own. I am not a guru, but I'm not new to the real world either.

Thanks for sharing and I admire your strength and courage. I'm just seeking clarity as to why so many posters applaud and hope to mimic your actions if faced with the same scenario and my first thought was, " I couldn't do that"

Sent from my iPhone using allnurses

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I am so mad I had to log on via computer so I can comment on this article. How dare that nurse make a decision like that, How dare he decide that seeing his wife die is better then seeing her dead. How dare he lie to the family and how dare he think his lie was believed by the patients daughter. Not only did he lie to the husband but he made the daughter complacent in that lie. This is why I am reluctant to ever send our elderly who are close to death to the ER.

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Specializes in hospice.
I am so mad I had to log on via computer so I can comment on this article. How dare that nurse make a decision like that, How dare he decide that seeing his wife die is better then seeing her dead. How dare he lie to the family and how dare he think his lie was believed by the patients daughter. Not only did he lie to the husband but he made the daughter complacent in that lie. This is why I am reluctant to ever send our elderly who are close to death to the ER.

Really? SMH

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Specializes in CEN, CFRN, PHRN, RCIS, EMT-P.
I am so mad I had to log on via computer so I can comment on this article. How dare that nurse make a decision like that, How dare he decide that seeing his wife die is better then seeing her dead. How dare he lie to the family and how dare he think his lie was believed by the patients daughter. Not only did he lie to the husband but he made the daughter complacent in that lie. This is why I am reluctant to ever send our elderly who are close to death to the ER.

Ridding on a high horse huh? The OP did not technically lie, just because you're on asystole it doesn't mean you are completely dead, it takes a few minutes for the brain to die due to hypoxia, also if you want to get technical, many of your cells will live for hours after your heart stops. So get off your high horse already ok?

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Specializes in Med-Surg.
I am so mad I had to log on via computer so I can comment on this article. How dare that nurse make a decision like that, How dare he decide that seeing his wife die is better then seeing her dead. How dare he lie to the family and how dare he think his lie was believed by the patients daughter. Not only did he lie to the husband but he made the daughter complacent in that lie. This is why I am reluctant to ever send our elderly who are close to death to the ER.

Are you a nurse? What setting are you in? Of all the people who have commented on this post, you seem to be the only one who interpreted it this way. That's interesting. Have you had a negative experience with death in the acute care hospital setting before?

I ask you... What is the harm in the lie? What are the benefits?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
I am so mad I had to log on via computer so I can comment on this article. How dare that nurse make a decision like that, How dare he decide that seeing his wife die is better then seeing her dead. How dare he lie to the family and how dare he think his lie was believed by the patients daughter. Not only did he lie to the husband but he made the daughter complacent in that lie. This is why I am reluctant to ever send our elderly who are close to death to the ER.

I am guessing you're a nurse, as you refer to "our elderly." I am curious - what about her actions angered you, exactly? Do you feel there was harm done here, truly? I know if it were my husband dying in the bed, I would want to think I had been with him in his last moments. Beside, no one is dead until a doc declares it anyway ... at least not in my ER.

The original poster didn't come to us seeking forgiveness, or permission ... she vented in what should be safe space. Let's keep our comments constructive for all parties, even those who disagree.

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