does this every worry you?

  1. In our palliative care, we call family members if patients have a sudden change for the worse and, of course, when they pass.

    When this happens in the middle of the night, especially in bad weather, do you ever worry about the state of mind of the person who is driving?

    This occurred to me the other day when I had this lady in her 70s who was going to drive to us in the middle of the night if her husband changed at all. Another time, it was a father in his 70s whose 35 yr old dd was in our residence.

    I worry that if I call them and tell them that their loved one has passed, that they may be so stressed and tired that they may have an accident. I would feel just so awful if that was to happen.

    I've asked admin about having a slush fund of some sort for those who we are really concerned about so that they can take a taxi, especially in the winter. They're looking in to what may be the most feasible way of implementing something like that.
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  2. 14 Comments

  3. by   caliotter3
    A slush fund for taxi service is a very good idea. I had a hospice pt in my LTC facility who passed on my noc shift one night. When I called to inform his wife she became very distraught. What was different about this (other than the fact that this was the only hospice pt per se that I had in LTC) was that the poor spouse actually lived down the street. Bad weather was not involved, but it was a small facility and I was the only licensed staff on board. I really wanted to leave my place of duty and go to her house, I was so worried about her state of mind. When I called the hospice nurse (as I was required to do), she stated she would take over with the bereavement work. I was emotional the rest of my shift and have been interested in hospice work ever since.

    I remember from my other LTC place of employment that sometimes we would wait to notify family as long as possible (i.e., as close to 7 AM as possible) and even planned to recommend to family members that they could go directly to the funeral home. This was told to me by seasoned LTC nurses who saw many people pass on noc shift.
  4. by   Pepper The Cat
    I remember from my other LTC place of employment that sometimes we would wait to notify family as long as possible (i.e., as close to 7 AM as possible) and even planned to recommend to family members that they could go directly to the funeral home. This was told to me by seasoned LTC nurses who saw many people pass on noc shift.
    While this is a good idea for most people, remember that some religions have certain rites that must be done before the deceased is moved.
  5. by   TazziRN
    I have this worry everytime I call a family member from the ER, and one thing I will stress to them is to DRIVE CAREFULLY!!! I even suggest that they have a friend or neighbor drive them if possible.
  6. by   CHATSDALE
    i think that the idea to see if someone else is available to drive is a good one

    but i take issue with the idea of waiting till 7a to inform a family of something of this significance..i know i would not appreciate being treated in this manner

    telling someone that a loved one has died is the hardest part of nursing but is has to be done, frequently the person is so distraugh that they can not think clearly..i ask them if they have prepared arrangement and if not i will call back in 30 minutes or so or they can call me

    i read once about a family that was killed because the nurse called and told them to come at once if they wanted to see pt alive when in fact the pt had already died and the nurse said she didn't want to tell them the bad news over the phone
  7. by   Pepper The Cat
    [QUOTE
    i read once about a family that was killed because the nurse called and told them to come at once if they wanted to see pt alive when in fact the pt had already died and the nurse said she didn't want to tell them the bad news over the phone[/quote]

    This is one of our biggests debates on our unit. Do you tell someone that their loved one is dead, or do you tell them to come in at once and then tell them once they arrive? I am on the tell them the person has died. While they may be upset, it is better than having them speed trying to get there in time. I don't think there is really a right answer to this question!
  8. by   gitterbug
    Yes, I have faced this problem several times. I attempt to find out names and numbers of other family members who will assist the remaining spouse.
  9. by   clemmm78
    Quote from Pepper The Cat
    [QUOTE
    i read once about a family that was killed because the nurse called and told them to come at once if they wanted to see pt alive when in fact the pt had already died and the nurse said she didn't want to tell them the bad news over the phone
    This is one of our biggests debates on our unit. Do you tell someone that their loved one is dead, or do you tell them to come in at once and then tell them once they arrive? I am on the tell them the person has died. While they may be upset, it is better than having them speed trying to get there in time. I don't think there is really a right answer to this question![/quote]

    I agree with you. One of the things that I really hate the most is if I call someone to say that a patient's status has changed (as per their request for a call), only to find the patient passes before the family member arrives. I feel so worred that the family will always wonder if they could have gotten their quicker or sooner.

    I really disagree with waiting to tell a family member until later on, unless they have requested not to be called, which happens from time to time. In fact, when a patient is admitted, it goes on the kardex who is to be called about what and when. Sometimes it isn't the primary family member, but someone else who will go over to the family member's to break the news.
  10. by   dosamigos76
    I like the idea of a fund. I work in Hospice and we usually have developed a relationship with the family and have a plan. For example, one patient lives in an Assisted Living Facility. If/when she passes, the director will go and get the daughter to bring her in. Another family we made arrangements that when it was time for "that call", we would speak with the son-in-law.

    I love that you're thinking for the people involved. Come join us in Hospice!

    Cheryl
  11. by   txspadequeenRN
    At the last facility I worked at we had small hotel rooms for families that needed to stay because a loved one was sick. It really worked out well for our families.
  12. by   clemmm78
    Quote from txspadequeen921
    At the last facility I worked at we had small hotel rooms for families that needed to stay because a loved one was sick. It really worked out well for our families.
    Family is more than welcome to stay in our residence; we are set up for that. I'm thinking of those who live in town and want to go home.
  13. by   clemmm78
    Quote from dosamigos76
    I like the idea of a fund. I work in Hospice and we usually have developed a relationship with the family and have a plan. For example, one patient lives in an Assisted Living Facility. If/when she passes, the director will go and get the daughter to bring her in. Another family we made arrangements that when it was time for "that call", we would speak with the son-in-law.

    I love that you're thinking for the people involved. Come join us in Hospice!

    Cheryl
    Hi Cheryl,
    I've been reading in Hospice but I find my situation very different - or maybe I'm imagining it - from most who post there. I work in a 9-bed palliative care residence and our place becomes their home once they are admitted. They are admitted with prognosis of 3 months or less so we get to know them quite well, for the most part. OF course, we do end up getting patients who don't even live the day once they're admitted.

    I'll check it out again.
  14. by   Havin' A Party!
    No matter all the "ifs" that may happen, think the best policy is to inform the family timely and accurately.

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