NEED HELP STAT!! How to tell a 10 year old his parent will die? He is on his way!

edmia, BSN, RN · Dec 22, 2012

I hate to be Debbie Downer but is the OP posting on an open internet message board for advice and giving updates on a situation *during* her shift?[/quote']
Yup. Sounds like she is. I think she needs more training... Or maybe her coworkers are so mean they're not willing to help if she needs advice? Anyway, sad situation but this is not the place to ask for help.
Sent from my iPhone using allnurses.com

Esme12, ASN, BSN, RN · Dec 22, 2012

There is no HIPAA violation here...and with the way some are "connected" at all times and never out thier phones down...this would be the logical place to ask nurses a nursing practice question from nurses who have experienced this in their practice. Allnurses is about allnurses talking about nursing.....I think no one should be on their phones at work....but they are. even threads devoted to this subject have proven that many feel it is perfectly ok to have the phones during work.

Not every facility have "child life specialists" or social workers at their beck and call....let alone have someone that has pedi experience. Maybe she did ask and they couldn't help her....or sadly wouldn't help her.

OP....it really isn't your "job" to tell the child their parent is dying. It is the families job to do that.....so that they can involve clergy, or other resources as they see fit. But you will come across those instances where you may have to....or they will ask you to fix their parent.

These are difficult situations but with children it is best to KISS the information (Keep It Simple Stupid) to children. Tell the honestly that there are just somethings that medicine can't fix. That their parent is dying NOT sleeping. Refer questions back to clergy or family.

Once upon a time....I was scaring for the nicest man I ever met. But he was chronically ill. We didn't have the interventional cardiology then.... so we saw a lot of patients that became cardiac cripples. We would see them over and over again...these were young men in their 40's and 50's CHF, Pul Edema, chest pain, MI. That you got to know the families and their children. This man was on borrowed time and he had a little girl. His only child who adored her daddy.

One day her Daddy wasn't well at all....He was not my patient that day.....in hind sight I was glad for I could be with his daughter. A people rushed in and out of his room with tearful family members coming and going.... this wide eyed little girl sat alone on a chair in the hall outside his room. I went and sat beside her on the floor (which I later got chewed out for by Sister *&^%) just in silence with her.

She reached to touch my Cap and asked so quietly...Can't you fix my Daddy? You've fixed him before.....as tears ran down her little cheeks. I told her no I couldn't. That sometimes things break to the point they can't be fixed but that a part of her Daddy was in every part of her body.....from her toes to her eye lashes and will never be far from her heart. She asked me why GOD couldn't fix him and I told her that even GOD knows when someone is so sick that they need to got to heaven and be an angel. I held her as she climbed in my lap and she cried until she wanted to say good-bye.

I cried all the way home that night...angry that I couldn't make it better, angry that this little girls life changed forever that day. Year later I get to work to see I have another orientee to precept to the ICU. I love new nurses and love to teach so I go to meet this young lady who is oddly familiar....when she introduces herself.

My favourite patients daughter.

May this patients family find peace.

CT Pixie, BSN, RN · Dec 22, 2012

Year later I get to work to see I have another orientee to precept to the ICU. I love new nurses and love to teach so I go to meet this young lady who is oddly familiar....when she introduces herself.
My favourite patients daughter.
May this patients family find peace.

This gave me chills Esme! Seems that it came full circle. Very touching.

allnurses Guide · Dec 22, 2012

Our small hospital has a social worker who also works with hospice so that would have been our resource. We also have chaplains available but sometimes they are far from the hospital.

There was a recent thread about talking to parents in trauma/death situations because of the shootings in CT. I'll link the article by a chaplain that someone posted here because it had some good thoughts that can be used for talking to kiddos too.

Rev. Emily C. Heath: Dealing With Grief: Five Things NOT To Say And Five Things To Say In A Trauma Involving Children

....."My first two years in ministry were spent as a chaplain assigned to the emergency department of a children's hospital with a level one trauma center. During that ministry I saw so many senseless tragedies. I also heard some of the worst theology of my life coming from people who thought they were bringing comfort to the parents. More often than not, they weren't. And often, they made the situation worse.
Here are five things not to say to grieving family and friends:
1. "God just needed another angel."
Portraying God as someone who arbitrarily kills kids to fill celestial openings is neither faithful to God, nor helpful to grieving parents................"

Esme12, ASN, BSN, RN · Dec 22, 2012

This gave me chills Esme! Seems that it came full circle. Very touching.

We still keep in touch.....years later she was caring for my MIL and strangely was there when my father passed....she's a special gal....her father would be proud.

Dezy · Dec 22, 2012

Esme your story made me water a bit. Op, I think it was in a way good for you to cry. For yourself and the family. Seeing so many stones faces in a horrible time would make me feel alone in dealing with it and like her death didn't matter to anyone else. You were there and I bet that child or family will remember the nice nurse that grieved with them.

allnurses Guide · Dec 22, 2012

We still keep in touch.....years later she was caring for my MIL and strangely was there when my father passed....she's a special gal....her father would be proud.

Some of the most profound experiences in my life have been when someone comes up to me and says "I remember you" and thanks me.

Working in L&D, ER and now hospice and school district nursing . . . .I get that a lot. It makes nursing worthwhile.

(I will say that sometimes this works out badly - I was in a grief group a few months ago - first meeting. A woman came in late, very drunk and took over the meeting. She looked at me and said "I remember you" and proceeded to tell everyone about her father's death and how the mortuary folks almost dropped him and how she and I had to "stuff his body in the body bag" . . . this came up more than once and I realized I'm too well-known in this small town to attend a grief group).

PalmHarborMom · Dec 22, 2012

My heart breaks for this young one. Too often, we shield children from the realities of what is going on. By doing so, they lose what precious little time they have left to say goodbye or make some sort of peace with the situation. I praise you for trying to find help for him. He needs all the support that can be mustered. Whether he says it, he will forever be grateful for your kindness.

KelRN215, BSN, RN · Dec 22, 2012

Children often understand a lot more of what is going on around them that they let on to. A ten year old probably knew on some level that his mother was gravely ill.

I am a pediatric nurse and have worked with terminally ill children my whole career so I'm used to these kinds of conversations. I remember helping a father prepare to explain to his daughter that her brother was likely going to die. I remember him telling me the conversation went something like this:

"When is my brother coming home?"

"He might not."

"What do you mean?"

"He might go to Heaven."

"I know."

Children want to protect their parents/families as much as the adults want to protect them. This child understood that her brother probably wasn't coming home before her father ever told her so, but she didn't want to bring it up because her parents were hoping for a miracle and she didn't want to upset them.

I also remember asking a group of bereaved teenage siblings for advice to give to parents whose children are dying on how to communicate with the siblings and how much information should be shared with them. The overwhelming majority of these kids said that they needed to know the truth. I had asked them this because I was trying to help another family whose child was dying and that particular family was trying to completely shield their two other children from everything that was happening to their big sister. Their daughter (the one who was dying) told several nurses and her psychologist that she knew she was dying and instructed us not to tell her mother that she knew. She was 10 years old as well.

Often times, if a child asks "is my mommy dying?", "is my sister dying?", "am I dying?", if you ask them "what do you think?" they will tell you what they already know. Sometimes they just need permission to talk about it. I am a big fan of being honest with kids.

Esme12, ASN, BSN, RN · Dec 22, 2012

Some of the most profound experiences in my life have been when someone comes up to me and says "I remember you" and thanks me.
Working in L&D, ER and now hospice and school district nursing . . . .I get that a lot. It makes nursing worthwhile.
(I will say that sometimes this works out badly - I was in a grief group a few months ago - first meeting. A woman came in late, very drunk and took over the meeting. She looked at me and said "I remember you" and proceeded to tell everyone about her father's death and how the mortuary folks almost dropped him and how she and I had to "stuff his body in the body bag" . . . this came up more than once and I realized I'm too well-known in this small town to attend a grief group).

Isn't that the truth....

OCNRN63, RN · Dec 22, 2012

I'm in ICU and we have a woman in her 30s who has a 10 year old son, her only child. His grandparents are dead and his father is in jail. If she goes, he will stay with the father's mother. The mom might not make it within a week or so. The patient's sibling has no idea how to break the news and wants me to do it.... OMG!!!!! He is on his way within an hour, what do I do?????? How do I say it in a compassionate way??? I think I'm soooo going to bawl my eyes out! Anybody with any experience in how to break the news to a child?

Just out of curiosity, are you on the computer asking this while all of this is going down? Aren't there any experienced staff you can turn to for guidance dealing with the child? It just seems very strange to me to be on the internet if the patient is actively dying.

The patient's sibling needs to step up and tell the kid. It's part of being a family. You don't get to pick and choose.

OCNRN63, RN · Dec 22, 2012

I hate to be Debbie Downer, but is the OP posting on an open internet message board for advice and giving updates on a situation *during* her shift?

You beat me to the punch...my thoughts exactly.