It made me think...How do they cope?

  1. I just had two 12 hr nites, and had a pt. who is staying with me still. She is a single mom, who has been given the dx of Breast CA...2yrs of chemo, and bil mastectomy, she has now been dx with CA and mets.

    I talked with her at length, in between running trying to keep another Lung CA pt. who is becoming increasing confused. Pulling out two IVs...but thankfully had a place to start others!

    My heart goes out to both! But one is a elderly lady, and the other is a mom...without a job...d/t dx, and no one to really help her. Her mom is unsupportive, and when boyfriend found out about the dx, he decided he couldn't deal with it. On the night she got the dx, I went into her, and found her distraught beyond words!. NO ONE was with her, when she was told this horrible news, and I couldn't imagine being in her shoes!

    She had tried to call her boyfriend, and one of his friends answered the phone, and hung up on her!!! I called her boyfriend, and told the friend, what room she was in, and that she really needed some moral support. The boyfriend came in to see her last nite, and I shamed him into staying the nite. She needed someone there...and I was angry...that not even her family had come, when she told them the dx!!!

    She came out of the room, and told me she was really happy, and thanked me for helping her. I couldn't help but think...what a sorry piece of crap her boyfriend was, and is! He told her ...he had problems of his own...and couldn't help her, until he helped himself. That he had watched his mother go thru CA tx, and couldn't go thru this with her! But she was happy just to have him there...for now at least!

    My heart goes out to her...and I felt I wanted to take her in, and help her...but I knew that wasn't possible. I wanted to leave her money...or offer help in some way....but I didn't. I just pointed her to support groups...and left it at that.

    Because she couldn't sleep...and nothing I gave her helped...I spent a lot of time, in and out of her room ...most of the two nites I worked. I just can't shake her out of my mind.

    Her family is another trip...and made the day nurse's life so miserable...that she had to be given to another nurse, as the family made unfair accusations against this nurse. Then they all left to the pts..relief!

    This pt. was in healthcare also, and worked in the OR...but d/t her dx..she was "let go..until she was better"!!! I'm angry at what happened to her. She now has no job...as she was living paycheck to paycheck...like most single moms do. She can't keep her insurance going, as she has no job now.

    I became to think about...what about all the other people out there who are basically making it week to week. What happens to them..when there is no family to step in and help? What if this had happened to me?? Both my parents are gone...what if I had left my job...and was dealt a blow like this...how would I have taken care of my kids??? How does one find help in these situations??? Does anyone have something to share...that would help this caregiver?? One of the MDs who knew her ...said she was such a wonderful person...and she was a truly caring person. One look at his face...told me he really meant what he was saying..
    Last edit by Brownms46 on Aug 16, '02
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  2. 28 Comments

  3. by   mario_ragucci
    I know what you mean, brownie. Some PT's don't get no visitor or nothing. That is hard to keep up a persons motivation. What i mean is people don't heal so well when they don't feel motivated, or charged emotionally to heal. It's hard not to notice something like this.
  4. by   Brownms46
    Thank Mario..for the response...! There is also another pt. who is on the unit...who doesn't get visitors either. But he ...I has less sympathy for...as he did it to himself, by being a DUI .....and put others at risk by his actions. This person...had no hand in what is happening to her...and I feel for her and the children.

    I just received a pm...from a wonderful person suggesting a site...that will be very helpful to her...mental health. But I'm worried about how she will feed and provide for herself, and her children.. A friend suggested to her about having a car wash to raise money...but there has got to be something else....she can do...besides...public assistance that is.

    Outside of a miracle...this woman is going to die...and it breaks my heart, that she has to struggle....during this time.. Especially after after being such a caring...person to those she cared for herself. This was also the statement of the MD who knew her. Andt here is no way for her to work while being treated...d/t what her tx plan is now...and where the CA is attacking now...

    Hopefully I someone will post some useful information...about how to help in this manner also...
  5. by   911fltrn
    Brownie, As im sure you know we can never change the family situation. We can give a bit of our heart to them. How many bits I dont know, ive thought i reached the limit many times. Hold the hands, wipe the tears, be proud that you were there. If only we had more time to spend with our patients. I find when i'm there, i dont always know how to comfort them but I stay. Being there in the patients time of true need is a blessing! Weather it be physical, emotional, spiritual. Nursing is full of all kinds of b/s. Be there at the critical moments, give a piece of your soul and im sure it will come back to you. "I hope and pray all your dreams unfold before your eyes"
  6. by   sjoe
    Many hospitals have social service/social workerer departments who can help in some of these areas. Others, of course, are less able/willing to help. You might give yours a try instead of trying to do your work and theirs both. Believe me that is a burnout path. Good luck.
  7. by   SmilingBluEyes
    ((((Brownie)))) no words of wisdom but I want you to know I admire your caring and kind spirit. More of us should be like you. Hang in there.
  8. by   teeituptom
    Howdy yall
    from deep in the heat of texas

    Well fortunately in this country any one can medical care and assistance to live. Its what taxes can be put to use for.

    thank the veterans who have kept this country free. and god too.





    doo wah ditty
  9. by   ohbet
    It makes you wonder where God is amongst all the suffering.Just sharing my thoughts.
  10. by   Dr. Kate
    Do what you can while you're there. Get social services involved, this is truly their area of expertise. It sounds like the family is in denial. Social Services needs to be alerted to that as well. There are lots of resources available and this woman needs to be making plans for the welfare of her children while she is still able to do. As nurses we have neither the resources or time to do everything. For good or ill we touch people's lives for only a very short time. For that time do what you can by being a compassionate presence in her life.

    Does this woman have friends? It bothers me that none were mentioned.

    Remember, as close to home as this situation may be, nurses can't fix everything. As was said above, these are the kinds of situations that can rapidly lead to burnout and disillusionment.
    Thye will break your heart with their pain and their strength.
  11. by   Flo1216
    Due to complications in her labor, my mother gave birth to a severely handicapped little boy 6 years ago. Because he requires full time care, my mother has been unabale to work. We have a nurse, but my brother still has a lot of doctors appointments and gets sick often. She receives welfare and food stamps. Welfare=$300 a month. She pays the rent with the SSI. His deadbeat father gets child support deducted from his check but his boss sends it whenever he feels like it. Since it's from outta state, it's hard to do anything about. Anyway, on the rare occasion she gets a child support check, her food stamps get cut down to $30 a month. Then she may not get another check for 4 months. I would definitely apply the nursing dx of " caregiver role strain" to her. I don't know how she does it. I guess she just takes it one day at a time.
  12. by   micro
    Originally posted by sjoe
    Many hospitals have social service/social workerer departments who can help in some of these areas. Others, of course, are less able/willing to help. You might give yours a try instead of trying to do your work and theirs both. Believe me that is a burnout path. Good luck.

    browns........you know i respect and admire you.....
    but there is so much sadness and things we do not understand that we see in our nursing......
    that all I can do is give ALL THAT I AM during my 8 to 12+++ hours at work.......

    my thoughts and i am off today, so time to be selfish.........

    yee haw!!!!!

    micro :chuckle
  13. by   Brownms46
    Thank you guys for the great replies, and I hadn't even thought about Social Services...and for me...with a mom who was one...I can't understand why it didn't. I know...I shouldn't be trying to fix this...but you ever had a pt. who just stayed with you? Who you just wanted to do anything it took to spare them what you know they will have to deal with? I guess I saw myself in that bed...and the situation just grabbed my heart. For ...but for the grace of God...there I could be.

    She asked me...why did it have to happen to her? And I tried to be upbeat...but in the back of my mind...I knew what was to come. And yes she does have a friend...and there was one who came to see her. And I had mentioned that her friend was the one who mentioned the car wash....to raise money. But the night she got the news...her friend was working in the OR...and couldn't come to see her.

    I have rarely worked with oncology pts, and I'm at a lost to know how or what they do...once there is no job...or insurance to help. The ones I have seen...were much older ..or younger and had family support. I guess I have just been lucky in not seeing this kind of situation before. And I have never been the nurse, when they received this kind of news. And maybe it's because of I have found out so much about her...and her situation could have easily been me!

    And you all are right...I know I should keep a professional distance...put my heart won't let go. If I could let go...I would...put I keep seeing her face...and how distraught she was...and knowing her situation...I let myself be drawn in.

    Hopefully she is there today, and I will be able to give her the information I have gathered from the person who PM'd me.

    Please...those of you who can, and wish to...please say a prayer for this mom, and for all those who suffer....and shouldn't...

    Flo1216...I'm so very sorry to hear about your mom, and your brother. My heart goes out to you all... I had a child with a birth defect...and who had a trach for 2yrs, while I was going to school for nursing. But... I was married, and a military wife at the time...so I didn't have the same problems...but it was difficult none the less. I can't even begin to imagine, how one deals with this...without adequate finanical support! We spent 60 days in the beginning of her life...in the NICU, and every 6 weeks there after for two years! I even had to do CPR on my own child...while just a student...after EMS got the wrong address. I almost lost my daughter three times..during those two years. I guess that is how I ended up working in NICU myself.

    Again...thank you to all who responded...and for the words of wisdom.
  14. by   live4today
    I will surely add that mother and her children to my daily prayers.

    The best thing you can do for her from a nursing standpoint is to write up a Social Service Consult so they can begin to meet with the family, the patient's doctor(s), and the patient in preparation for her chemo treatments and any other outpatient assitance she will need. They should get the ball rolling from that end once you put in the consult for it.

    Pray about the situation, and asked God what He would have you to do for this woman on a personal basis, then trust your gut instinct. I have helped patients before outside of nursing because I felt it my duty to do so as a child of God. I have never regretted doing so, either, and would do it again in a heartbeat.

    Stay abreast on her case and make sure everything that can be done for her is being done for her by Social Services within the hospital setting. Discuss with her who she will leave her children with after she dies. Does she have a will, an advance directive, or any other plans outlined to be instituted after her death. These are things she must eventually deal with as her time of grief allows.

    Putting her in touch with Cancer support groups is an excellent idea! That will be a great resource to her alone.

    Also, mention to her about tape recording messages for her children to hear and grow up by after she is gone. This has been known to be a comfort to dying mothers and fathers who have little ones they will not be able to see reach adulthood. They should record the family history for the children's health reasons, and any other pertinent information the kids will need for survival purposes while growing up (i.e. Parental advice, wedding wishes, kisses for future grandkids, etc. ) You'd be surprised what things are taped on tapes like that. Heartbreaking, but oh so necessary and very comforting to the one dying, and the ones left behind to grieve their loss. :kiss
    Last edit by live4today on Aug 16, '02

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