HH is showing me a side of the death process I'd never even thought about

SaderNurse05, BSN, RN · Nov 2, 2007

{{{{{{{{{{T***i}}}}}}}}}}}}} I am sure it is hard seeing people get worse and go on hopsice. BTW do you work with only Ca patients? From what I remember you were an ER nurse for a long time. I think it may take a while to adjust to this new population of clients. I imagine when you were a new ER nurse you felt a lot of feelings that were difficult as well. Hang in there. Your patients (and their families) are lucky to have you.

prmenrs, RN · Nov 2, 2007

Take some time to work out some of your feelings. If there is a psychologist/social worker associated w/your service, you could maybe bend his/her ear for a while. Re-read stuff about death and dying you've learned over the years, and maybe find new material to read. Joy Ufema is one good source.

Don't know how appropriate this suggestions seem to you, but you know we support you, kiddo!!

TazziRN, RN · Nov 2, 2007

{{{{{{{{{{t***i}}}}}}}}}}}}} i am sure it is hard seeing people get worse and go on hopsice. btw do you work with only ca patients? from what i remember you were an er nurse for a long time. i think it may take a while to adjust to this new population of clients. i imagine when you were a new er nurse you felt a lot of feelings that were difficult as well. hang in there. your patients (and their families) are lucky to have you.

umm.....is my name a bad word.....? :lol2:

sorry....back on subject.....no, we actually do not do end of life care, when someone gets to that point we transfer to hospice. i just seem to have a run on ca pts right now. i have one other one, a smoker younger than me with a huge tumor on the side of her neck, getting paliative rad tx; helping the so learn dressing changes on the rad burns.

take some time to work out some of your feelings. if there is a psychologist/social worker associated w/your service, you could maybe bend his/her ear for a while. re-read stuff about death and dying you've learned over the years, and maybe find new material to read. joy ufema is one good source.
don't know how appropriate this suggestions seem to you, but you know we support you, kiddo!!

thanks, preemie, i do know that. we do have an msw that is easy to talk to. and i love reading joy ufema's stuff.

i knew i was going to get close to some pts and families, i just never thought about the ones with impending death. it's taking a lot out of me not because i can't handle it, but because i didn't expect it. i know i can do this and i will adjust, just like i did when i started er as a new grad.....thanks, sader!......i was just caught off guard.

leslie :-D · Nov 2, 2007

if anything, you will find yourself examining your feelings on death.

you can't help it.

going through the journey w/your pts, it is next to impossible to ignore one's feelings of mortality.

as you go through this, you will likely become much more comfortable when caring for terminal pts.

it is indeed, a journey the pt takes.

there are many facets and steps in achieving a good death.

the nurse will walk away, a changed, enlightened and far more spiritual person.

and so, despite the sadness, embrace the experience.

it will indeed change you, for the better.

leslie

JennaRN1006 · Nov 2, 2007

t***i, i know how you feel. i am an oncology nurse and it so hard not to get attached to your pts. its great when i have surgical patients and we have removed their tumors and send them home. most are grateful and leave with big smiles, hoping that we got it all. and i am proud to say, i helped them and wish them luck.

however, when my pts come in for long term chemotherapy -- its hard not to become apart of their lives. for example, we treat young men with germ cell/test. cancers. we have one young man who is 24 yo married. he has a bad germ cell and some sort of dic or itp. mds arent sure. he has been with us for 7 weeks now. plt counts of 2, 3, 8, etc. we have become his family. his prognosis isnt good -- but we are trying our best. if he doesnt make it, it will impact me hard.

sorry to drone on, but it is hard when you are sending your pts home to die or to hospice. you cant say to them good luck, or get well. you just know it isnt going to happen. instead i just smile, tell them it was a pleasure and honor caring for them.

t***i my best advice is to deal with your feelings -- and yes its ok to be sad and to cry. you are human. just know you did your best to care for them. you are doing a great job from what i can see!

recently a favorite pt of mine passed away a week after i transferred her to hospice care. i spent some time before that easing the daughter into accepting that her mom was dying.

i have another pt with liver ca who knows she's terminal but refused hospice because she was in denial about just how close the terminality is. earlier this week she was crying and saying "i'm so tired, i can't take this anymore." i think she will be going to hospice tomorrow.

yet another pt with ca has had increasing confusion over the last couple of weeks....she literally went from alert and oriented to periodically confused within a week, and in the week since then has become completely confused. her daughter has been calling me often, and today her mom was taken to the er when she collapsed at home. ct (which was clear last week, for some unknown reason) now shows a large lesion in the left hemisphere. mri will be done in the morning but it's pretty certain she has met.

i have mixed feelings about all this. from all my years in the er i'm used to sudden deaths, and helping families cope with the immediate aftermath. i'm not used to helping pts and their families deal with impending death, and it's taking a lot out of me. it's gotten to the point where the hospice coordinator and i have each others' cell numbers programmed in.

JennaRN1006 · Nov 2, 2007

ok -- hahaha -- i just tried in my last post to you to write your name. an must be censoring those three little middle letters, t!!! lol sorry. so strange.

umm.....is my name a bad word.....? :lol2:

allnurses Guide · Nov 2, 2007

Taz - they think we are trying to use a euphemism for orifice. I wonder if I can type that.

I've been in your position - we have a hospice room at our local hospital and we took care of many local folks, most who I know and some who I love, who died of cancer.

It is hard. Is there anyone available for you to talk with?

Besides us? :-)

steph

luvschoolnursing, LPN · Nov 2, 2007

Taz,

I know most of the above posters said it all, but just know that I am thinking about you and the adjustments you are making. If you are able to do this, I know from your previous posts that you will be a great help to these patients and families. I never worked home health but when my dad was ill for 19 mos. before he passed away, I know that we needed all the support we could get and some of us did not always behave so good. Keep up the good work!

Sabby_NC · Nov 2, 2007

Awwwww Taz you are going through a very special journey with these patients.

I agree this will make you search your own feelings.

You will meet this in HH and have that opportunity to speak with your patients about hospice if that need arises as it seems to have done so with you.

Bless your heart. Do the best you can and always be that wonderful advocate for your patients.

I love hospice as you all know but sometimes emotionally I am so spent I have to step back and recharge.

Emotional exhaustion will make you feel so slap worn out.

Reboost your own levels by doing some fun things that take that feeling away. REST and try to keep a healthy outlook on life and all that goes on.

PM me if you just need to chat ok? *HUGS*

DDRN4me · Nov 2, 2007

((((T***i)))) I know what you mean about the attachment ... these folks become part of your life, and you a part of theirs... much different than in an ER , and your goals are very different; you are there to support them and their family; but the journey is longer than you are used to as well;so it is definitely more introspective.

One thing i can tell you is that those families will never forget your kindness and caring. I still run into pts from many yrs ago who bring that up.. and all i can say is that I was doing my job.

Sounds like you are seeking resources to help you; thats good. and dont forget to take some time for you; and care for yourself!! Mary

ps,,, it is an that is editing i typed your whole name!!!

sharona97, BSN, RN · Nov 2, 2007

T***i,

Often reading your posts it is plain to see you are a very giving and compassionate caregiver. All I feel I can add is that this path you've been brought upon has been emotionally charged for you (as stated), but the relief your concern goes so much deeper than you know to those affected and involved.

Seriously, I wish you peace in continueing this journey & A much needed emotional relief to regain again.

Sharona