Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,704 members! Join today to network with other nurses, laugh, share, and much more.
| Advertisement Sponsored Links | | | | No. 41 | 
Oct 12, 2009, 01:11 PM
 Re: Do family members know how annoying they can be? Originally Posted by wherehastimegone  When dealing with death it is REALLY, REALLY different to be the nurse than it is to be the family. Depending on someone's personality, closeness of relationship, culture, faith, personal values, beliefs about death etc..facing the death of a loved one can be an excruciatingly difficult time for people.............
Two of my grandparents died from withdrawing treatment - basically they starved / dehydrated to death. I can tell you it was very difficult to watch and be a part of even though we all knew it was the best thing. Watching someone you love code and not doing anything goes against human nature.
Yes - it is hard but it is our duty to help the families SEE DEATH and then make the decisions regarding their loved one's care based on what their loved one would want- Not what they or we want.....We have to be comfortable using the ugly words-some families respond better to written literature or videos then face to face communication.
You grandparents did NOT "starve to death" That takes weeks to months. Dehydration may have been a contributing factor but a "dry" death is much more comfortable for the patient (and a little easier for the loved ones) then a "wet" death in most cases. In your case someone dropped the ball-I feel that you did not get the support you needed just judging by your comments.That said-being part of the extended family you may not have been privy to that support when it was offered. Was it truly a matter of withdrawing treatment or was it actually letting nature take it's course? In this case the tough decisions belonged to your grandmother's children-it sounds like you did not agree with the treatment course.
 | | No. 42 |
Oct 12, 2009, 01:29 PM
Re: Do family members know how annoying they can be? Originally Posted by wherehastimegone When dealing with death it is REALLY, REALLY different to be the nurse than it is to be the family.
I think most posters know that as we have families of our own. I've got four dead grand parents. I have dealt with death on a personal level as have the majority if not all the posters here. When I went to hospital at the age of 17 and my Grandmother was dying - though I didn't know it at the time. There was nobody around it seemed to feed her, so we did. She didn't want to eat, she didn't want to take pills, she verbalized that she just wanted to die. So as hard as it was, we just let her. Yes, she starved and dehydrated to death too, but her medical condition made it pretty quick.
I don't understand why some families have to make the death of a very aged relative someones fault. Especially if that relative has been pretty much hospitalized or in a rehab for the majority of their last two years of life. The family were told by a cardiologist, urologist, hospitalist, and patients own GP that there was not really anything else that could be done. They declined grief counselling and anyone who mentioned hospice was a granny-killer. I can understand anger that comes with death, but yelling murder and I'm suing is a problem with the family member who is doing it. Nobody lives for ever. I'm not being callous here, just realistic.
| | No. 43 |
Oct 12, 2009, 03:11 PM
Re: Do family members know how annoying they can be? Originally Posted by wherehastimegone When dealing with death it is REALLY, REALLY different to be the nurse than it is to be the family. Depending on someone's personality, closeness of relationship, culture, faith, personal values, beliefs about death etc..facing the death of a loved one can be an excruciatingly difficult time for people. Even if the person is elderly, and intellectually knowing that it is right to let them go, actually making those decisions and dealing with the emotion can be devastating. The idea of showing a video like you've described to me shows an incredible lack of understanding of where people are coming from when they make a decision that you as the nurse see as the 'wrong' one. If you want them to see your perspective, you have to be able to understand theirs.
Some of these responses are pretty callous. I think it comes from being on the professional end of things all the time, you become indifferent to peoples pain because you see it day in and day out. I also get this is a discussion board and most would be are able to fake some compassion / understanding in real life so families aren't aware of how you feel.
Two of my grandparents died from withdrawing treatment - basically they starved / dehydrated to death. I can tell you it was very difficult to watch and be a part of even though we all knew it was the best thing. Watching someone you love code and not doing anything goes against human nature. With respect, most of us know how different it is to deal with death as a family member rather than as a nurse because we've dealt with it both ways. I've lost four grandparents, a father and a father-in-law. I know. Withdrawing care on someone you love is a painful and difficult decision and an even more difficult and painful process. I don't think that difficulty exempts family members from behaving with dignity and courtesy towards the staff, however. Nor do I think we, as health care professionals would be out of line in showing someone a video depicting exactly what "do everything" means. After all, we want them to make informed choices. | | No. 44 |
Oct 12, 2009, 03:22 PM
Re: Do family members know how annoying they can be? Originally Posted by wherehastimegone
Some of these responses are pretty callous. I think it comes from being on the professional end of things all the time, you become indifferent to peoples pain because you see it day in and day out. I also get this is a discussion board and most would be are able to fake some compassion / understanding in real life so families aren't aware of how you feel.
Two of my grandparents died from withdrawing treatment - basically they starved / dehydrated to death. I can tell you it was very difficult to watch and be a part of even though we all knew it was the best thing. Watching someone you love code and not doing anything goes against human nature.
First, I watched my grandmother have a stroke. In front of me. When I was 19, long before I became a nurse. And no, I didn't run screaming for everyone to code her; I had sense enough to know when you've got cancer in your lungs and brain and liver and pancreas, coding them isn't going to fix it. I sent my sister out of the room to get the nurse, made sure the nurse knew we were comfort measures only. This was the grandparent who raised me, I loved her, but I loved her enough to let her go.
And I don't "fake" compassion. I care about my patients. But I don't think having compassion for a person means you should torture them their last days on this earth because of someone else. It's their death, not yours.
I'm done with this one.
| | No. 45 |
Oct 12, 2009, 03:22 PM
Re: Do family members know how annoying they can be? Originally Posted by ktwlpn You grandparents did NOT "starve to death" That takes weeks to months. Dehydration may have been a contributing factor but a "dry" death is much more comfortable for the patient (and a little easier for the loved ones) then a "wet" death in most cases. In your case someone dropped the ball-I feel that you did not get the support you needed just judging by your comments.That said-being part of the extended family you may not have been privy to that support when it was offered. Was it truly a matter of withdrawing treatment or was it actually letting nature take it's course? In this case the tough decisions belonged to your grandmother's children-it sounds like you did not agree with the treatment course.
You are making a lot of assumptions here. They did starve to death and yes it took months. No one dropped the ball and we did have support but having support doesn't mean that it is just really easy to let go...grieving and bereavement and processing loss is not some abnormal reaction to the death of someone close to you. There were hard decisions to be made and I completely agreed with the treatment plan, yes I was part of them - and I MUCH appreciated the nurses / doctors who went through that process with us with compassion and understanding of all the conflicting emotions it raises. There were a couple nurses like you who did it using the ugly words and got in our faces to try and make us SEE DEATH and I can tell me it wasn't productive or helpful or supportive in any way. You may think that is what your families need but from my experience that was the LAST thing we needed.
| | No. 46 |
Oct 12, 2009, 03:38 PM
Re: Do family members know how annoying they can be? Originally Posted by Ruby Vee With respect, most of us know how different it is to deal with death as a family member rather than as a nurse because we've dealt with it both ways. I've lost four grandparents, a father and a father-in-law. I know. Withdrawing care on someone you love is a painful and difficult decision and an even more difficult and painful process. I don't think that difficulty exempts family members from behaving with dignity and courtesy towards the staff, however. Nor do I think we, as health care professionals would be out of line in showing someone a video depicting exactly what "do everything" means. After all, we want them to make informed choices.
I agree with you completely except for the part of the video. I don't think showing someone a graphic video "that goes on for 30, 40 minutes, with ribs cracking, the occasional decayed tooth flying, suctioning flash edema, stomach contents coming out around a PEG tube, with real shocks" at a time when family is trying to work through losing a family member is appropriate just because they are having a hard time letting go or are overwhelmed. I get that others disagree with me.
I personally am not for life extending measures at all if that is their choice. I know I don't want them. I agree that family members insisting on reviving someone who is naturally near death or getting angry at staff isn't appropriate BUT I can understand why it happens and I guess I just disagree with the in-you-face approach to dealing with that.
| | No. 47 |
Oct 12, 2009, 05:02 PM
Re: Do family members know how annoying they can be?
There are all sorts of reasons for annoying/disfunctional/unrealistic/suit happy family members.
One is guilt. They feel horrible that they can't care for their loved one so they take it out on us. Another is lack of knowledge. Let's face it. Most people believe what they see on ER or House or any one of those ridiculous shows. We need to be firm, polite, and realistic when dealing with these people. One of the largest corporations makes family members watch videos when grandma is admitted.: People fall; skin breaks down; we can't save everyone. Brutal perhaps, but realistic nonetheless. Do family members have the right to treat us poorly ? Of course not But again, we've been stressing the customer service aspect of our business for a while now so they think they have the right to treat us any way they see fit. I had a patient's daughter in my face ( her mom had been in the facility for 5 minutes) screaming that I had just better take good care of her mom because she was the worst family member I'd ever have to deal with. I took two steps back...put up my hand and said.
"Madam, I've dealt with worse family members than you, in fact I AM a worse family member than you and I would appreciate it if you'd stop hollering at me until I screw up." She was dumbfounded that anyone would talk back to her. She sputtered a bit and then realized how incredibly rude she'd been.
Nurses in acute care wouldn't subject themselves to such obnoxious, outrageous behavior and neither should we.
And as for the "I'm an RN" comment....I look at them and say, "You might be an RN outside of this building, but in here you're the daughter".
| | No. 49 |
Oct 12, 2009, 07:22 PM
Re: Do family members know how annoying they can be?
To wherehastimegone (sorry, tried to include oringinal post, didn't work right)
Do you think that if someone is a nurse they aren't a family member? That they don't know that the death of a loved one is an excruciatingly difficult time for people?? Your "analysis" of nurses is outrageous. No, they don't reflect callousness or indifference to pain. No, they don't have to "fake compassion". From what I've seen, most nurses who feel themselves burning out come here and write soul-searching posts about what they should do, not asking for some acting tips to better fool people.
Since nerdtonurse became understandably exasperated, let me try to give you an idea of why she posted that. She did not literally mean families should be shown a video like that. Since she is compassionate, she knows what is in store for them and their families and would like to spare them that pain when the outcome cannot be changed. The "video" is symbolic of the gritty realities of end-of-life care.
I think a lot of this could be made easier with educated patients and family members. Unfortunately, as end-of-life counseling has been made a political football ("death panels", anyone?  ) we aren't going to be able to make much headway here. I know we've wandered off topic, a bit, but this is such an emotional issue . . .
|
| 281 members
1,747 guests 2,028
| 0 | | | 45 | | | 0 | | | 7 | | | 10 | | | 23 | | | 2 | | | 13 | | | 63 | | | 14 | |
| 43 | | | 1 | | | 13 | | | 2 | | | 10 | | | 17 | | | 11 | | | 16 | | | 16 | | | 42 | | | 14 | | | 21 | | | 23 | | | 20 | | | 24 | |
|
Do you people not recognise, that your training equips you to deal not only with the vunerable patients under your care, but caring & sometimes distressed relatives. I am a SRN in Scotland (although the Scots use RGN), and I must say I am appalled at the remarks on this board and have not heard the like before.
Nursing News