Empathic part of nursing

[Antikigirl, ASN, RN]

Now before you think I am going off the deep end...LOL...let me describe what I feel is empathic! It is someone that is so intuned to reading body language and the way a patient speaks, uses their eyes and facial features that you can almost feel what they are feeling it seems! I have this happen constantly...

Well the other day I had a woman who is only in her late 50's just get dx with liver cancer that has spread to her lungs, spine and brain. A darling of a woman, kinda a hippy really...all tie dye, natural everything...no use of products except organic...stuff like that. Makes you sad that someone that works so hard on lifestyle changes for the better gets cancer...but, that is another story.

She quietly asked me last night about Physican Assisted Suicide. She doesn't want her family to suffer money or emotional cost when she knows she is going to die. She wants more than anything to provide for her family till she is gone, and make sure they are all taken care of before she leaves this world. She also is terrified of the pain...go figure...

I didn't know really who to point her too...but did talk long and lovingly about how wonderful hospice is...and she was going to call them (actually I put in the request, so they should be there today!).

Sadly, I could basically feel what she was saying without her even talking! My eyes met with hers and it was like we knew we could talk freely and that we cared what eachother said! It was wonderful and sad at the same time.

SO the Cancer MD came in and she shared that she was interested in learning about PAS...he immediately ordered anti-depressants, ativan, and acted like she was nuts! I WAS FLOORED!

NO NO NO, I told the MD who doesn't really care for nursing imput..but I don't care! "NO, she is looking at her options and is scared of so many things...she isn't a medical professional, she is seeking information on trying to get her goals met and what she knows....everyone knows of PAS because of the media...very typical for pts to go with things they have seen on the news...she wants options not being mentally altered! If she is mentally altered, then how can she make her heart felt wishes happen before she goes?".

The Doc basically dismissed me, saying "what...you think you are an empath or something...you don't know what cancer patients think...I do, and I am here to help them!".

Okay...ticked me off big time! I can understand his point of view...but what about my natural talents of being a very good comunicator and someone people seem to trust automatically? What about her wishes and the fact she opened up to me on a contraversial topic.

I will update on the rest of the story as it happens...

HOW about you guys...ever had those moments where you just KNEW what the patient was feeling and saying but can't explain to anyones satisfaction?

[SuesquatchRN, BSN, RN]

Heh. I always marvel at diagnoses of depression when the person could only possibly respond in that way if sane. There'd be something wrong if she weren't depressed at her cancer diagnosis and terminal status.

[SuesquatchRN, BSN, RN]

And I have those moments all the time, mostly with my aphasic, anxious patients. I feel their fear, and their bewilderment.

[CaLLaCoDe, BSN, RN]

my heart goes out to you. to have your empathic understanding of the patient's situation dashed to pieces by a cold hearted md is truely daunting to the merits of why we're in this profession. but keep positive, your patient needs you! keep centered and hopefully with hospice's consult things will look up and up. the md is not the final say on a patient's wish list! :wakeneo:

ps. hey, triage...ever considered writing a book on nursing? you write so very well.

ps ps..don't really know what wake up/ neo means..googled neo and came up with near earth object...oh, i get it wake up neo (new), that's it!

[jjjoy, LPN]

Wake up Neo is apparently from the movie the Matrix. I don't know how it ended up as an icon on allnurses, however!

[mvanz9999, RN]

The Doc basically dismissed me, saying "what...you think you are an empath or something...you don't know what cancer patients think...I do, and I am here to help them!".

And that's exactly why I respect nurses (and want to become one). Precisely because medicine doesn't address all issues. Like you've said, she needs emotional/spiritual comfort and information, not pills......

[sister--*]

I understand what you're saying. I come across terminal cancer patients that are struggling like crazy to live because the cancer docs just won't discuss or acknowledge "terminal" with the patients or the patients' family.

So many suffer needlessly. So many patients and families go through such agony in second-guessing their instincts, beliefs, and feelings. Time is wasted lost in this twisted roller-coaster of a jungle. Very precious time that could be spent bringing a patient and family reconciliations, final bondings, and peace.

[Antikigirl, ASN, RN]

Well as I see it...we humans consider things in extremes...go for worse case, best case..and then fill in the blanks. Of course with cancer..worse case typically comes first to the mind....

So if every patient tries to express fear or interest in gaining information on the worse case...are they automatically pysho? NO! It is a sign that they wish information to get their goals met...how hard is it to point them into the direction vs writing on a pad some pych meds?

Anywhoooooooo...who else has had those moments where they wonder about empathic abilities or those feelings that come and don't leave you after talking to a patient as if you KNOW....

[nursemaa]

American Heritage New Dictionary of Cultural Literacy, Third Edition

empathy [(em-puh-thee)]

Identifying oneself completely with an object or person, sometimes even to the point of responding physically, as when, watching a baseball player swing at a pitch, one feels one's own muscles flex.

So you showed great empathy for your patient- you could almost feel the same feelings she had- good job! Empathy helps us advocate for our patients, as opposed to sympathy, which is merely feeling sorry for them.

[Tweety, BSN, RN]

I think perhaps one should definately rule out depression, but should not definately rulle out PAS. (I see you're in Oregon where it's allowed).

I had a similar experience when a patient this week was talking about not going on dialysis when his kidney's inevitably fail. He has other system problems as well. So the MD orders a pysch consult and another antidepressant added to the one he's already one (which he promptly refused).

Just keep being the advocate and carry on with your gift. It is a gift because not all nurses are empathetic. Some are judgemental. Or at the very least a lot of us, including doctors like this one, put our own values on the patients.

[Antikigirl, ASN, RN]

THank you all!!!!!!!!!!! I have these moments so many times I do tend to daydream about the possiblity of real empathic...but I am science oriented.

There was just something...I can't put my finger on...it was like talking to myself. I thought long and hard about my own thoughts if I had the Dx...and well...I would think the same...but her...she was brave enough or comfortable enough with me to ask...I don't know if I would be able to do the same.....

Oregon does allow for this..but the red tape, lack of MD's that will help, no way to get the meds...well...might as well be illegal. You can't get to the aide basically for PAS. So legal yes, implement..no.