A wonderful, delightful elderly resident for whom I had great affection and rapport was found gasping for breath, ashen and moaning early one morning . According to POA directives, he was sent to hospital. When the POA was called to let them know what had happened they said he wasn't supposed to go, they didn't want that. ???? I felt terrible- it is my biggest peeve in LTC that we are too aggressive and should allow more natural deaths. However, one must follow family wishes. I thought back to the aggressive treatments this family insisted on only several months ago, the bullying tactics of family members trying to get this resident to eat, drink. The overwhelming picky directives staff were to follow about when he was to be up, what he was to wear or not wear despite the protests of the resident, he was TOLD he must do this or that... the numerous " stomping down the hall to hunt up the charge nurse to tear a strip off her".
I am disheartened with my nursing role right now. If I didn't need the money I would work somewhere else. Is it guilt, miscommunication, lack of knowledge that makes these families so obnoxious? When a family makes the decision to move their loved one to LTC, don't they see it is end of life care, not rehab. We have care conferences, set up nsg care plans but it doesn't matter, if Mary wants her mom dragged out of bed every morning for breakfast and put in a hot fleece track suit we have to follow her wishes -even though mom might be stripping in the hallway because she is so hot- if we change her and Mary finds out or God forbid comes in and sees her like that there is Hell to pay. I have families who ask every day why their loved one, who is in a locked alzheimers unit, is restless, confused, agitated? Or better yet, the ones who insist on the MD discontinuing all their meds and putting them on vitamins and then at night when the sundowning kicks in they get upset because their father/mother fell, or hit them or attacked a co-resident.
Mar 21, '12
by IEDave, CNA
Quote from MN-Nurse
Nope. It's denial.
You left one out - fear. I can't speak for the family that the OP refers to, but having been there it can be a very frightening experience for family members - between the legal ramifications of actions, internal strife between family members, caregivers suddenly having to make decisions that mom/dad/grandpa/grandma/etc. typically made, and the general lack of knowledge of exactly HOW to deal with managing end-of-life care it can be a maddening experience to say the least. And, unfortunately, in some cases the medical staff get caught in the middle of a whole buncha ugly when emotions are running high and higher-order brain functions are shutting down (not with the pt - the family members).
Wish I had a good answer for the OP - but I don't. I'm very sorry that you have to go through those experiences, but unfortunately when the H&P is signed off on by the attending MD, the POA's on the hot seat, and at least in California at that point what the POA says, goes.
Incidentally, I start orientation for my new CNA position tomorrow morning - LTC, with all the trimmings. And yeah, I expect to be getting my share of a$$ chewing, black eyes & bloody noses from family members lashing out at me because I'm a convenient target - but, better me than their loved one. Just hope I can stand by that statement 5-10-15 years from now. Or, for that matter - next Friday.
Wish me luck.
Last edit by IEDave on Mar 21, '12
: Reason: Didn't finish editing - bad toad!