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 Rural Health.

Great article! It is soooo much different to be the family, I watched as my Dad sat waiting and waiting and waiting to have SOMETHING done when his HGB had dropped to 4 and he had the most awful skin color I've ever seen on a LIVING person. In all fairness they were working on getting him a blood transfusion but it felt like nothing was happening, he needed to be transferred to a different facility and it was taking forever. I wanted to scream and tell someone to get him outta here and on his way to where he needs to be. I knew they were doing all they could and we had to wait for the other hospital to accept.

Specializes in LTC, Ortho/Med-Surg.

Thank you for your kind words, CheesePotato. Please know that my heart is with you and your family.

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

Enlightening as well as heart felt, thank you for sharing this post with all of us... Aloha~

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Specializes in Neurosciences, Med-Surg-CNA.

What a beautifully written post. I work in neuro and I have seen this time and time again. It is a terrible thing to see someone go like that. Bless you for being so supportive of your father. I know it means the world to him.

I'm going to print this off and bring it to my nursing classmates, and to the care home I work at and post it on the staff board on every floor. This needs to be required reading. Thank you so, so much for these words, and I am so sorry for your pain. I have no words to offer but loving thoughts sent your way.

This took my breath away. Absolutely beautiful.

I'm so sorry for all you are going through. :cry:

I am sorry for the pain you are going through... This is so sad, I had tears while reading your post. :cry: The sadness can be felt through your writing. I still have my father however I am absolutely terrified of the day he is taken from us. I hope you can find some comfort during this time and I am so sorry. Thank you for sharing and I will pray for you

CP, thank you for sharing such a vulnernable moment in life. My mother died almost 8yrs ago and I feel every moment you are speaking of. 6 weeks in the hospital and feeling so lost...I always say that it is not that it gets better, but different. The morning she died, as I did the neuro checks as she slipped further away and felt so helpless, knowing what was happening and could do nothing to stop it, she did not want it. I am not very good with written words; Esme what you have said is what I know as well. Thank you as well. Stay strong CP, but know that it is okay to reach out, to lean on someone, even if it is only briefly...

This really hit home with me. When my husband was in ICU and we didnt know if he would pull thru (he did that time) I was probably just like this lady was. He eventually passed away a few month later and I sent the nurses in ICU a thank you gift for the care they gave him. It is so true that nurses can be H--- on wheels when its their family. This brought back so many memories when I read it.

Specializes in Sleep medicine,Floor nursing, OR, Trauma.

Again, thank you for all your kind thoughts and words. I am touched at the reply and I welcome those who wish to share this article to do so.

As I have said previously, once my words are released to the universe they are no longer mine--do with them as you will.

Kindest regards,

~~CP~~

Thank you for your transparency. My dad died just over a week ago. I didn't think for a moment when inquiring about his labs, ejection fraction, or prognosis that I was asking too much. It seemed as though no one wanted to follow up by returning with the requested information. Specialists came and went - none of which wanted to answer any questions outside of their specialty ("I'm the kidney and liver specialist"). There were mixed signals - on his last day they were requesting to insert a PICC for long-term antibiotic therapy which I interpreted to mean that they felt he had progressed enough to warrant long-term intervention. He died just a few hours later. No amount of inquiry, due diligence, or nursing knowledge helped to understand his dire condition. I became his little girl and in the final hour of his life, I pleaded with the nurse to please help me decide what to do because I couldn't "think like a nurse anymore."

Please, if you feel challenged by an inquiring member of the patient's family, understand we're just looking for information so we can know clearly what we're dealing with. It's not to lay blame - it's our area of expertise and we need to process things. Our other family members are also relying upon us to interpret and advocate for our loved ones. Take some extra time to peruse the chart and provide answers - we're in this together. It's likely we will all be in this type of situation at one or more times in our lives. "Difficult" family members are usually the ones you would want advocating for you if you were a patient. I've always admired those who came to intervene for our patients - it keeps us accountable and working at our best.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thank you for your transparency. My dad died just over a week ago. I didn't think for a moment when inquiring about his labs, ejection fraction, or prognosis that I was asking too much. It seemed as though no one wanted to follow up by returning with the requested information. Specialists came and went - none of which wanted to answer any questions outside of their specialty ("I'm the kidney and liver specialist"). There were mixed signals - on his last day they were requesting to insert a PICC for long-term antibiotic therapy which I interpreted to mean that they felt he had progressed enough to warrant long-term intervention. He died just a few hours later. No amount of inquiry, due diligence, or nursing knowledge helped to understand his dire condition. I became his little girl and in the final hour of his life, I pleaded with the nurse to please help me decide what to do because I couldn't "think like a nurse anymore."

Please, if you feel challenged by an inquiring member of the patient's family, understand we're just looking for information so we can know clearly what we're dealing with. It's not to lay blame - it's our area of expertise and we need to process things. Our other family members are also relying upon us to interpret and advocate for our loved ones. Take some extra time to peruse the chart and provide answers - we're in this together. It's likely we will all be in this type of situation at one or more times in our lives. "Difficult" family members are usually the ones you would want advocating for you if you were a patient. I've always admired those who came to intervene for our patients - it keeps us accountable and working at our best.

I feel your pain......I was there.....I know. I can tell you that while it will never go away it does get easier. My heartfelt condolences.