Dear Nurses: Please Forgive Me - page 2
Dear floor, ED and ICU nurses, Please forgive me. I know he's dying. I get it. I do. We were told five years. Five years on an outlier and he would be gone. We were told transplant was an... Read More
Oct 2, '12Quote from Jessy_RNTherein lies the torture. As nurses ourselves we are all too aware of the nurses dilemma so we hurt a little more sharply inside.What a touching script. Thank you so much for sharing. On the other hand, as the bedside nurse, our jobs are truly difficult. The guilt of wanting to be more present and available to you, this same scenario times 3+ per shift, the pain we share with you although in a less intense way, adds up. Ah so many things....
Oct 2, '12Quote from Esme12YesTherein lies the torture. As nurses ourselves we are all too aware of the nurses dilemma so we hurt a little more sharply inside.
Sometimes, it hurts to just think or wonder how you came across to a grieving family. Just last night, I held a mother crying at her child's poor prognosis (PICU trauma kiddo), while in the next room my other trauma with just an even bleak prognosis, the parents complained about me leaving the door cracked to run in and out between my two pts and they couldn't get quality sleep! The monitors were annoying, my constant presence in their room and pushing buttons on the many drips, perhaps a bit much.
No matter how much I educated the couple, the end result was a complaint to management, because they couldn't sleep well. sigh
Not to mention I was in charge and having to be very available to help my coworkers as well.
Ah the disparity!
Oct 2, '12When my oldest son was dying in PICU I read his chart every single day. I could so relate to what you said about doing that. I wasn't checking for mistakes or scrutinizing anything, I was trying to absorb what was happening, to face reality so that I could make the best choice on when to discontinue the ventilator and try somehow to say goodbye. It was the only way I found to know what was really going on.
Your dad sounds like an amazing person. Your pain is a testimony to the depth of your love. I am so, so very sorry.
Oct 2, '12Nothing like a 7am cry to wake you up. That was a stunning article. I am but a lowly nursing student, and I can assure you I will NEVER forget this story. Thank you so much for sharing it. (((Hugs)))
Oct 2, '12Hey guys,
I am a floor nurse at an LTAC so I run into this situation on a daily basis.
I have been the nurse and I have been the family member. Both sides of the fence you know?
In my mind, I dont see how a loving family member can watch their loved one suffer and struggle just to breath. The quality of life is zero, probably even a negative number.
I know it is hard, but many times the best possible outcome for a patient is death. I advocate for my patients and I am not shy about discussing CMO and DNR with the families. Of course I am kind and caring and gentle but I do my best to help the families let go and to help my patients be free of their suffering.....
Hugs to all, I know it is hard, but please if you love someone but their best interests at the forefront......
Oct 2, '12Thanks for the article. Sometimes it is good to hear from the difficult family member's point of view, especially the ones who are not coping well.
Ironically, it is the family members with the good coping skills who get the lion's share of support from the staff. The families who say "thank you so much for all the care you gave our son" even when their hearts are broken are the ones who the nurses take extra time to listen to.
Even a very tolerant person like myself tends to avoid spending much time in the rooms where the atmosphere is thick with tension. Just this weekend I had a family conflict (wife v/s girlfriend and daughter v/s daughter). I did what I had to with the patient and got out. I think the stress and arguments affected the patient, the very person these ladies were supposed to be helping. This leads to the cycle of the family who senses the nurse is doing the minimum and gets more demanding, causing the nurse to withdraw more.
Oct 2, '12Wow.....very emotional, I am sorry for the pain you are going through....prayers and support
Oct 2, '12As family members as well as nurses we have to remember our first duty is to the patient, I have been on both sides of this and when my father was dying he called the nurses and asked for them to send me home! Being difficult only causes stress to the patient, we have to put the patient feelings above our own even though it hurts.
Oct 2, '12Goosebumps! So raw and honest. Love it. Thank you for sharing your journey and I give you my condolences.
Oct 2, '12I know it is hard, but many times the best possible outcome for a patient is death. I advocate for my patients and I am not shy about discussing CMO and DNR with the families. Of course I am kind and caring and gentle but I do my best to help the families let go and to help my patients be free of their suffering.....
Hugs to all, I know it is hard, but please if you love someone but their best interests at the forefront......
If only it were this simple. When I first started in oncology I felt the same way, and oftentimes was frustrated with well-meaning families. The longer I am there, the more I realize how complicated life and relationships are. It really isn't fair to say that families don't have the pt's best interest at heart when there is a hard time letting go. It just doesn't tie up in a neat bow like that.
Oct 2, '12Quote from Esme12I lost mu dad in March of 2009.
I wish those nurses could read this now and try to understand my fear. As I watched him slip through my fingers, I became angry that, after snatching so many strangers from the jaws of death......... why I couldn't do for the most important in the world.....why SOMEONE couldn't do it for me.
I totally get that. Oh boy, do I ever get that.
2008 for me.
And Cheesepotato's post made me choke up, too.
Oct 2, '12Thank you for this. Thank you, thank you, thank you.
At the beginning of my shift one night on a med-surg floor, I was told I'd get an admission; a patient from a bigger hospital who was coming to us on a 'virtual hospice bed'.
My hospice patient arrived close to 8:30 that night, and his family came with him - his wife, two grown daughters (who were both nurses), their children, and his two grown sons. They came in irate. Our hospital rooms are tiny, and they had been promised our 'hospice' room - a double occupancy room with one bed removed and a couch in its place. They were not told that the hospice room was occupied, or that they would be getting a 'regular' private room. I got my hospice patient bathed and changed into a new gown, did my assessment, then told the family I would be back as soon as I gave a stat med to one of my other patients. We have a new call system, with a remote control in the rooms to call the nurse, so the call bells on the beds do not work. I explained this, told them how to reach me, and was off. Apparently while I was gathering the med, a new family member came in and hit the call bell on the bed. I was standing outside the hall of my other patient's room when she came storming up the hall, a murderous look on her face. I didn't recognize her, but I asked her what was wrong. She said, "You can find me the worthless nurse for my DYING FATHER and get her down here NOW." She pointed towards the room, and with a sinking heart, I told her I was her father's nurse. I told her I had to pass this med and I would be down to her father's room immediately.
I passed the med and went down to his room. The woman was standing outside his door, arms crossed. I opened my mouth to say something, but didn't get a word out before she exploded. "I have been hitting this call bell for fifteen minutes and NO ONE answered. I think my father's in pain, and this room is too small, and we don't have enough room for our family to be here, and this is ridiculous and cruel. I want to speak to your house supervisor, NOW." I told her I would go call the house supervisor, and as I was walking up the hall, several of my fellow nurses who had heard her commented - all along the lines of "Wow, what an awful family." I called the house supervisor and returned to her father's room with pain medicine. On the way down there, I thought about what his family was facing. This man had only received his diagnosis six weeks prior - they hadn't even had time to process that this man was sick, let alone dying. And now here he lay, in a tiny, cramped room, nonverbal and unable to turn himself, unable to control his bladder or bowels, and he had just endured an hour-long ambulance ride with his family following behind.
I gave her father the pain medicine, then approached the woman and told her, "Listen, I think we got off on the wrong foot. I have called the house supervisor and she is coming, but while we're waiting, please allow me the chance to talk to you." I asked her if she had used the call bell on the remote and she said no. I explained that was why I didn't get her calls. I went over the new call system and demonstrated it for her. Then I told her how sorry I was that this was happening to her father and her family, and that I understood their frustration with the small room, especially when they were told they would have the hospice room. I told her I didn't know if we could switch his room, but I got extra chairs, pillows, and blankets from the supply closet. I told her that it was my desire to do everything I possibly could to make sure her father and her family was as comfortable as I could make them. Then I went to the pantry and fixed a pot of coffee, and brought coffee down for everyone.
We were unable to switch rooms that night, but the woman and her family warmed up to me as the hours wore on. Before I left that morning, she pulled me aside and said she was sorry, that she had misunderstood the night before and was afraid that I would be negligent towards her father. I told her she had no reason to be sorry - she didn't know me from Adam and wanted to make sure her father was properly cared for -- any daughter would want that.
What I have written a book to say is that, as nurses, it is so easy to forget what it's like to be the family member. It's easy to see the families as difficult and demanding, and pass judgement without ever really considering the enormity of the changes they are facing in their lives. We forget sometimes to read between the lines, and to realize that we are just an outlet for these families' anger, hurt, and confusion. That doesn't mean that we should allow ourselves to be mistreated, but it does mean that they need the very best of our nursing skills - our compassion, our understanding, and our ability to bear witness and stand beside them. As CheesePotato says, they know that their loved one is dying, even if they don't understand the medical jargon for it, they don't need any more demonstrations from us on how we know the person is dying. They need us to say, "I am so sorry. I am here, and I am honored to care for your loved one and your family, and I will be here with you through this. I AM HERE, AND I CARE."
Sorry this is so long, but CheesePotato, your article really, really touched me.