Thank 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.