Does her family know how sick she is? - page 4

by SuesquatchRN 3,675 Views | 34 Comments

Asked the doctor this morning. I told him that they come in a lot and he mentioned comfort care, which can mean many things, but it always means end-of-life. They had come in to see their mom and I opened the discussion. ... Read More


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    Quote from TwilightRNurse
    We are all real actual nurses. Having a relationship with your patients is a part of your specialty but doesn't make you anymore a nurse than any other nurse in another specialty. I may have a shorter contact/relationship with my patients but I can still have a big impact on their lives. I know you didn't mean it the way it sounded, or I hope not, but I felt the need to clarify.
    You misread it, Twilight. The poster was referring to the fact that we in LTC are looked down on by many as being less than "real" nurses.
    Nascar nurse and tewdles like this.
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    In my state, at least, "end of life" care DOES mean dc-ing labs, most meds, etc. And it has been drilled into my head that I am not allowed to give recommendations on what I think they should do. I'm only allowed to give the facts. You know, end of life means this, if you go to the hospital they will probably do this, if we don't treat this this is what happens, the natural progression of the disease is this. I'm not allowed to recommend end of life; I'm only allowed to state it as an option and educate the family about what it is and what it entails. It is considered up to the dr to make recommendations. I only educate. Does that make sense? IDK if it's different by state or by facility or what. Maybe the poster who thought the OP was in the wrong has the same regulations as I do? Because I thought the same thing when I read the OP. Believe me, I've WISHED I could tell the family what I think they should do, but, again, in school and in my facility is has been drilled in my head that I'm not allowed to.
    SuesquatchRN likes this.
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    Quote from DizzyLizzyNurse
    In my state, at least, "end of life" care DOES mean dc-ing labs, most meds, etc. And it has been drilled into my head that I am not allowed to give recommendations on what I think they should do. I'm only allowed to give the facts. You know, end of life means this, if you go to the hospital they will probably do this, if we don't treat this this is what happens, the natural progression of the disease is this. I'm not allowed to recommend end of life; I'm only allowed to state it as an option and educate the family about what it is and what it entails. It is considered up to the dr to make recommendations. I only educate. Does that make sense? IDK if it's different by state or by facility or what. Maybe the poster who thought the OP was in the wrong has the same regulations as I do? Because I thought the same thing when I read the OP. Believe me, I've WISHED I could tell the family what I think they should do, but, again, in school and in my facility is has been drilled in my head that I'm not allowed to.
    So basically your employer is limiting your ability to apply the nursing process to those clinical cases and situations...?

    What do you do with a nursing diagnosis of knowledge deficit or impaired decision making, etc? Your employer wants you to notify the doctor and then wait until he/she responds and tells you what to teach them??? In many EOL cases the patient would literally DIE before a medical POC would be developed. The sad but honest truth...nurses in this setting are too often limited in their ability to carry out the duties of their profession within the scope of their practice by employers ignorant in the field of nursing. Just my
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    I too have opened the conversation with family members on this subject. It has always been well received. In all cases the MD discussed palliative care and hospice first but the family wasn't ready or didn't understand. The patient and the family sees the doctor for minutes at a time. Sometimes I have gone in later and they didn't even realize the person they had seen was their dr. But they see me there 40+ hrs a week, sometimes for weeks or months on end. I know them and their family dynamics, and the family knows me well. I have gently opened the discussion and then answered questions. I see nothing wrong with that. I would answer other questions about their care, why should death be any different?

    I think you did the right thing, and I think the family is and will be grateful for allowing their family member and them a positive end of life experience. Good for you!
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    A ot of the nurses where I am have told me that I can't discuss this. The DON and admin and physicians have all asked me to bring it up. I will continue to go with my heart and head and advocate that families let demented, sick old people go in peace when the time is obviously near.


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