Please advice...YOUNG cancer patient and I feel helpless

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    I have a patient who is in her 20's and has 4 children, 2 are 1.5 years old. Very sad situation. She was diagnosed with gioblastoma. She cries all the time, which is understandable. She has given up. I feel so helpless when I go there. I cant say "it will be ok" or "it will get better" or "give it time". Time is something she doesnt have much of. WHAT CAN I DO FOR HER. I mean, when I did her admit, I did the PHQ depression screening, but she didnt have this diagnosis then and scored low. Should I get a MSW in there? If so, what can the MSW do for her? Everytime I leave this home, I feel so sad for this family. Ive grown so attached and I want to help her so much. She is on palliative care. Please someone give me some advice.....
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  3. 5 Comments so far...

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    I don't know what you can say... you sound supportive. You're a hospice nurse? Home care? I would imagine getting additional therapy/support for her to work through her feelings (and her grief regarding death) can only help her, and her family. I don't know how you do that job.... good luck to you. I feel fortunate to have brief, yet still impactful, experiences with patients in the ED. I can detach and get through it and think about it later. Having those connections would make the job much harder. I feel for you and hope you get good responses from here.

    http://www.crisiscounseling.com/Trau.../GriefLoss.htm
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    She needs a referral to Hospice, IMO. If she's not ready for hospice, then a behavioral health consult (psych nurse) is in order. If you don't have psych nursing available through your agency, then MSW is probably the best thing you can do at this point. For your own benefit, call a local non-profit agency and ask if there's anything they can do for you as a nurse to help you deal with cases like this.
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    We do have a psych nurse, but she said that this isnt a situation for a psych nurse. I am like you, I thought a psych nurse could help. What kind of service would a MSW do? I am wondering how to write the order, such as.. "New order.. MSW referal for _________" I would of course call the doc first, but still its ultimately up to me as to how to write the order. I wish she would go into Hospice, I think she could benefit from it, but she isnt ready for that. She just wants to ignore it and pretend life is normal. But she is learning quickly that it isnt normal, she cries constantly. Today was such a hard visit for me. I went from one dying patient's house to this one. I was emotionally drained by the time I got home and HAD to take a nap to try to clear my head. Please, any advice, I really dont know what to do for her.
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    Sounds like your psych nurse doesn't want to face it either. Write your order as:
    MSW referral for community resources. I still recommend getting a hospice consult for yourself. The major agency here where I work does great teaching and support for the community as a whole, not just patients. If nothing else, maybe they can hook you up with an experienced hospice nurse who can give you some guidance.
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    An MSW consult would be helpful, they can offer counseling and help the family find support groups and other resources that she may not be aware of. I'm not sure how I would write the order, I would ask your social worker what language they would recommend. You can certainly do another depression screening, and notify the physician of the results. It sounds like such a sad situation. Even though this patient may not get better you should take some comfort in knowing you can help her make the best of the time she has left. It's unfortunate she isn't ready for hospice, but she may change her mind. Don't push her but keep that door open for her. Good luck and hang in there.
    MassED likes this.


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