"Closure" with long term patients

[Kytrejela]

Hi,

I am a nursing student in my final semester and am interested in the topic of nurses getting "closure" for lack of a better term with their patients that they have cared for on a long term basis. I am performing my clinical hours in an antepartum setting and many nurses have stated that it's difficult or frustrating to care for their patients for many months and then to have them disappear into L&D and not know what their patient's (mom & baby) outcomes are. It's my understanding that privacy issues prevent further communication upon patient transfers out of the unit. I am putting together a discussion topic for my clinical conference & was hoping to get some feedback from nurses who face this or similar issues in their workplace and how it may effect morale. I cannot seem to find any research in the literature either so am limited to the input from the nurses in the unit I am working in.

Thanks for your input!

[AliRae]

It's my understanding that privacy issues prevent further communication upon patient transfers out of the unit.

I work PICU, and we'll have patients come in as traumas and stay with us for a few weeks (or longer, depending on the situation...). When they leave us, they'll usually go to the floor for a while before going home or to rehab. There's nothing in our policies that states that once they're off our floor they're "inaccesible" to us. In fact, just yesterday I had a floor nurse call me up and suggest something she had thought of in the care of a kid I had. We frequently go to the floor to visit kids we had been involved with, and the same is true for floor nurses coming up to us. It happens especially with NICU babies who have "graduated" to the PICU ... their primaries will always come a-visiting. We welcome it, because often they know things about the kid that help us care for them better.

In fact, I was recently in a situation where I had really bonded with a baby we had for 6 months. When he went to a rehab hospital, I called them up and got them to check with the baby's dad and used to go visit him there.

Maybe it's a peds thing, all this love and visiting, but it definitely happens in our hospital. Not to say that we go and look up labs or rifle through charts, but we definitely stop by for visits after they've left us.

[jill48, ASN, RN]

For me, closure is after I get all of the family members there to say their goodbyes and then I can say, "It's okay now. Don't be scared. You can go if you want." And then hold their hand or brush their bangs from their face. Great, here come the tears.

[Kytrejela]

Thanks for your input. I appreciate it. It will help with getting my post-conference discussion organized and I'll have more viewpoints to offer.