just need some input.

[deegal.lpn]

Ok heres the problem. New pt. 73yo dx, esophageal ca with mets to lungs, liver and bone family can't except pt is terminal. They refuse comfort care in hopes father/husband will get strong enough to go to another state and get chemo.,and go home. When discussing advanced directives family wants everything possible done except DNR. Pt knows he's dying but goes along with families wishes and does what they want. I have a hard time talking to this family when they have such high hopes and expectations and pt knows he is going to die. They only want him to have minimal pain meds because they're afraid he'll be "snowed" and not be able to participate in PT/OT and get better.The man is in no doubt in severe pain. His prognosses looks grave How do I answer there questions about how he's doing or progressing when all they want to listen to is the good stuff and I want to say he's dying let him go in peace and pain free.

[kids]

Originally posted by deegal.lpn

Update- after a meeting with the family and doctor today (and many tears) The family decided to go with comfort measures. Thanks for all the good advise

HALLELUJAH!

[hapeewendy]

thank goodness for that

if I see another patient gasping for his or her last breath and suffering in their last moments only because his or her children think that they are going to recovery I'm gonna scream...

everyone should be able to die as comfortably as possible

if something should happen to me , I will make my family so obviously aware of my wishes, that in the event they dont follow what I want, I will come back and HAUNT THEM!

I understand that family members can often not come to terms with whats going on and the dying process , but I had a patient once who's family would not let us give him morphine because it "made him too sleepy"

so yeah writhing in pain is much better

I try not to judge but sometime this poor heart of mine just aches for these patients....

[deegal.lpn]

new update: This patient went to be with the lord in peace today. He's in a better place now than we are. congrats MR. XXXXX.

[deespoohbear]

Glad to hear the family came to their senses....but I have a couple of questions for you?

1). Does your hospital have an ethics committee that you could have brought this case to?

2) Surely someone is covering the Social Services department while the other Social Service worker is recovering. I can't imagine the state board of health or JCAHO allowing for that.....

Jenny P-

What a nightmare family....sounds like the doctor didn't have any balls to stand up to them either.....if my family ever would do something like that to me, I would come back and haunt them for the rest of their life, so help me.....

[deegal.lpn]

I work in Long-term care. We have nurses covering the MDS part of the job. Our Doctor is from India and has some different views on death and dying. He tends to look more @ the medical side of things than the social. He's a great doctor always teaching us new things. Very supportive of us and backs us up always. Remember the saying dead people don't sue, There families do. I think this is why a lot of doc's tend to go along withn the families wishes.

[NRSKarenRN, BSN, RN]

Deegal:

What a great patient advocate you are! Glad our years of experience were helpful to you. I'm sure your patient was grateful for you intervening + the pain relief.

You'll have this expereince to carry you forward in future battles on behalf of patients.

Welcome to allnurses and hope to see more of your posts!