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Kittypower123, ADN, BSN, RN 4,428 Views

Joined Feb 13, '09. Posts: 143 (66% Liked) Likes: 285

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  • Dec 18 '16
  • Jul 2 '16

    The Dark Side of Hope
    By Joelle Yanick Jean, RN

    About a year ago, I witnessed hope in the worst way. It wasn’t the hope that in the back of your mind you prayed was going to come true and it actually did. This hope was malicious; a menace. It was taunting, a bully, a liar. Being a nurse, you are often faced with this type of hope. The hope you know is not going to end well because of your experience and medical knowledge. It's the hope that parents, patients, family members, even staff members have; the hope their loved ones or their patient is going to live despite a poor prognosis.

    One evening, as the charge nurse, I received a phone call from a hospice nurse who was calling in her patient to the ER because her NG tube fell out. She was calling me directly because she wanted to warn me. The patient was very sick, and the parents did not want any interventions other than replacing the NG tube, and once replaced, the patient was to go right back home.

    The young girl was twelve, and had end stage cancer. The parents were in denial about her illness. They refused to sign a DNI/DNR. They were hoping she was going to get better. They were hoping she was going to be cured from the cancer. The hospice nurse cautioned me the patient looked very ill and probably should be in a hospital, but the parents understandably wanted her home.

    When the patient arrived in the ER, I was immediately aware of the situation. Hope had wrapped its ugly hands around this family. It had taken over their lives, just as the cancer had taken over this young girls’ body.

    The young girl was fully conscious, on a bipap machine, frightened and suffering. When we placed her in a room, I introduced myself and touched her hand. She had skin breakdown around her nose and eyes. Her eyes were puffy from the pressure of the bipap machine which was helping her breath. A foley catheter was placed to catch her urine because she could not urinate on her own. A fentanyl patch was placed on her arm for pain control. All interventions used to prolong her life because Hope had said so.

    According to the Oncologist, the family was counseled many times on the prognosis of the young girl’s disease, but the parents just could not accept it. They hoped through prayer and faith, this young girl was going to walk again, play again, laugh again. They prayed loudly around her and with conviction as we replaced the NG tube.

    Hope allowed this girl to suffer, to be in pain. Maybe their hope had seeped into us as well, allowing the medical team to honor this family’s wishes. Where was the ethical team? Where was the person who says, this is enough, let her die in peace. Hope had not allowed them to be present.

    That night, I wanted a different hope for this young girl and her family; a hope that I often wish would come sooner than later for some families. I wanted a forgiving hope, the hope that kept its promise. I wanted the hope to take over that doesn’t let you down. I hoped for the suffering to end for this young girl; I hoped she would die a peaceful and painless death. I hoped this young girl’s family would come to the realization she was suffering and the God they prayed to wanted her to come to his home not theirs.

    As nurses, we are often faced with the uglier side of hope. However, I believe that through experiences and knowledge we can and should educate our families about a hope that allows one to let go and to grieve appropriately. I know it is extremely difficult to let someone go, and not everyone has the strength, but I believe since we are nurses we are better equipped to deal with these types of situations.

    Sometimes it's the nurse's role to be the voice of reason. Families listen to us and value our opinions. I wish I had had the courage to tell this young girl’s family that she is dying, and to please let her go, but I’m hoping, hope finally came to its senses and told the family the truth.

  • Jun 3 '16

    When a staff member says "here comes the death lady" or "palliative care kills people" or "I am not going to take morphine because everybody knows that once you are on it you are basically dead" --- pointing to misinformation, bias, and uninformed populist announcements.
    I like to say that while everything centers somewhat around end-of-life and serious illness, it is more about quality of life, how to deal with serious illness and how to take control over your life and the time left.

  • Jan 10 '16

    Yes! Casa de la Luz is fantastic. Hospice family care I've also worked with but not as impressed. Emblem is also good.

  • Aug 22 '15
  • Jun 6 '13

    Man....I gotta tell you by the end of a 12 hour shift this thing weighs a TON!!!!!!!!!!!!!!

  • Mar 17 '13

    Don't worry. With all the body fluids we encounter, they'll be colorful soon enough.

  • Feb 6 '13

    I never understand questions about weaknesses and "where will you be in 10 years?" If I were an interviewer I would know these questions are unfair and will almost never yield a truthful (truly) response.

    If I were to answer this question I would say I will come in every day and work very hard, but I am not going to suck up to you/coworkers, I will probably not add you/coworkers on facebook, and I will probably never go out with you/coworkers outside of work.

    I personally don't view this as a weakness, but it sure has given me a lot of flack over the years I've been working.

  • Dec 12 '12

    All I want for Christmas is a New Elf Care System

  • Nov 14 '12

    It's time to quit arguing about who gets to be the Indian next, you can trade places tomorrow. Now please, lets go back to your room so I can finish my med pass.

  • Nov 7 '12

    What do you call someone that craves HIPAA policy.

    Hungry, Hungry, HIPAA

  • Oct 23 '12

    You don't want to know where they found Dr. Smith's stethoscope this time!

  • Jul 5 '12

    when you believe every patient needs tlc: thorazine, lorazepam and compazine

  • Jul 5 '12

    eating microwave popcorn out of a new bedpan is perfectly natural

  • Jul 4 '12

    I hope this attachment works. I took a diabetic resource nurse course last year and for my project, I made cards regarding types of insulin and their actions. They fit in a plastic sleeve to wear with your name tag. I refer to mine a lot! I gave them to all of the nurses in the ED. It has been most useful! If this attachment works, you are more than welcome to use them.

    There are good resources out there that can be made into pocket cards for quick reference.
    Attachment 11259