Dear Nurses: Please Forgive Me

A letter of reflection, a plea for forgiveness, a note of encouragement for ED, ICU, and Floor Nurses, who work so hard with sometimes so little, understand where the "family members from hell" are coming from. A gentle nudge to remind that the person lying in that bed belongs to the heart of those around them. Ultimately, this is a note of deep, deep gratitude. I could never do what you do and I am so very thankful that you chose your current role. You are unique, powerful, and so important. Kindly remember. At the end of the day--remember. Nurses Announcements Archive Article

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 option but with the dismal survival rates, we opted for rehab. He is now eight years post diagnosis.

We know we are lucky have had him this long. It doesn't make this any easier. Please don't say it like it's a mantra of comfort. For reasons I don't know or even fully understand, it only makes the sting more sharp.

We see it, you know. The mental status changes. The lack of control. The shuffling gate. The use of accessory muscles.

We see it.

And we know exactly what it means.

When he can't remove his bipap to eat, we know. When he can't lower the head of his bed past thirty degrees, we know. When he can't talk, we know.

We know.

Forgive me, please, my many sins. Forgive me the overbearing stare and raised eyebrow. Forgive me for repositioning him and demanding another pillow for under his heels. I'm helpless, you see, to stop the very shadow that will claim him and I have nothing else to cling to. I have nothing else but what now feel as tedious, miniscule scraps of knowledge that amount to nothing. No cure. No hope. I'm lost.

I'm lost.

You must understand that when I nearly demand to read the orders or see the chart, when I loom over your shoulder, it is not that I don't trust you...it is that I don't trust myself. I don't trust myself to be cope, to make all the right choices, to advocate, to deal with the loss and reconcile the feelings of guilt, of doubt, and pain.

I beg you to understand that I'm scared to death and helpless and a control freak and for once I can't make it better. Understand that I glare instead of cry, laugh instead of scream, and go silent when angry. It's dysfunctional, but it's my way.

And I don't want to be up later at night, pacing a hole in my carpeting, consumed by nausea and a feeling of coulda-woulda-shoulda.

So when you see me wandering the halls, wringing my hands, biting my lip and growling under my breath, please don't be afraid to offer a kind word. It is what I need to hear. Even if I do not acknowledge that I heard it at all. Trust me, it got through. And I will remember.

You must understand that this man is precious to me--that I want to guard him the way he guarded me from myself. That when I call every two hours to demand a neuro status check it is because I am not there and I am struggling to convince myself that I really do need to sleep even after being up for nearly thirty six straight hours and you are my eyes and ears and everything else.

Please see what that cranky, demanding creature is to me. He wasn't always this way--a brain sitting in an acid bath is a terrible thing. I can't control what's happening to his body but I can control the flavor of his Jell-O and so, you know what? If that means raising holy hell with Dietary so I can get red Jell-O for him, then I will. Because it's all I have.

Be genuine with us. We can handle it.

Know that he is the first man, since my grandfather, who treated me with kindness, and god help me, love, even though I was a crazed woman-child dwelling in a familial household, riddled with hormones and a gloomy past, laden with baggage, sociopathic tendencies and unable to form any sort of bond and yet he never left. I lived years without that bond. Years without feeling the need for the guidance and protection only a father could give. Some part of me missing that bond and loathing "daddy's girls" everywhere. But he's trying to leave me now...I survived nearly a lifetime without him and suddenly I 'm not ready.

I'm not ready.

I'm not ready.

Know that I never encourage him to use me as some kind of threat...some unholy boogie man that will get you if you don't help him right this very second. Because, "my daughter is a trauma nurse and she will know what you haven't done right." Know that when I come in and acknowledge that, ::sigh:: yes, I am a nurse and then talk a little shop with you, I am not trying to be in your business but show you that I understand what you are trying to accomplish and understand what you are dealing with on a day to day basis.

I am nothing without you and neither is he.

But he is my dad.

Please understand.

Specializes in PeriOp, ICU, PICU, NICU.

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....

Hugs!

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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....

Hugs!

Therein lies the torture. As nurses ourselves we are all too aware of the nurses dilemma so we hurt a little more sharply inside.

CP.....:shy: Thanks.

Specializes in PeriOp, ICU, PICU, NICU.
Therein lies the torture. As nurses ourselves we are all too aware of the nurses dilemma so we hurt a little more sharply inside.

CP.....:shy: Thanks.

Yes :(

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!

Specializes in Critical Care; Cardiac; Professional Development.

When 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.

Nothing 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)))

Hey 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......

Peace

Thanks 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.

Specializes in Peds, School Nurse, clinical instructor.

Wow.....very emotional, I am sorry for the pain you are going through....prayers and support

Specializes in kids.

What a beautiful article....

Specializes in Hospital, med-surg, hospice.

As 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.

Specializes in Perioperative; Cardiovascular.

Goosebumps! So raw and honest. Love it. Thank you for sharing your journey and I give you my condolences.

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......

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.