When you work in Hospice you learn it is necessary to be brutally honest. It sounds like this nurse who was brutally honest did this patient great justice, and it sounds like she is experienced. She got the patient who has very specific ideas about the care he will and will not allow, to agree to go to the hospital. And now, he has been discharged with Hospice to make him as comfortable as possible. This is what we do best.
If there were more honest Professionals out there, there would be a lot more people who could die at home with dignity. Most GP's are unskilled in the management of chronic pain, and therefore tend to be stingy with the meds to keep patients comfortable. We are the palliative care experts, it is our primary goal to keep our patients as comfortable as we possible can. If somebody isn't honest with these patients, they are not usually knowledgeable enough to know they are going to die, so someone
has to tell them. Experienced professionals, regardless of what is behind their name, know when womeone has a condition that they cannot live with for a very long period of time. So it is their responsibility to be honest with these patients/families. Home Health and Hospice nurse's are used to working with a lot more autonomy than a hospital or LTC nurse, so we tend to be more comfortable being what some consider to be bold or brutally honest. There are times when people don't want to know certain things, though. At those times I will ask them, "how honest and forthcoming do you want me to be?" And you can tell them a little at a time, if there is time. But there are other times, when you have to be honest to get them the care they need.