"Dear Nurses: Please Forgive Me" : A Response

[RNdynamic]

This thread is not directed at any person in particular; it assumes the subject of the OP is a fictitious character. This is the response to the thread linked below, from a couple years ago which some of you may remember. It written from the opposite perspective -- the perspective of the innocent caregiver being abused by the example below.

https://allnurses.com/general-nursing-discussion/dear-nurses-please-789883.html

Dear adult child of dying patient,

You are not forgiven.

You say you know he's dying. You say you get it. You acknowledge that in spite of his inability to overcome his illness, and after all the attention and treatments he was given by his dutiful caregivers, he significantly exceeded all expectations you had of his remaining lifespan by three years. For reasons you don't know or fully understand, you have elected to be socially abusive and all but criminally assault the people trying to help him live. You have chosen to impact the lives of complete strangers in very hurtful, damaging ways.

You say you see the changes in his activity level and respiratory pattern, and you say you know exactly what those changes mean. You reinforce, over and over again, that you see it, and you know, and in in spite of you admitting that fact, over and over and over again, you continue to be rude, abusive, and cruel toward nurses, who to you are strangers struggling with their own lives, their own careers, their own families, their own finances, and perhaps their own dying parents. How dare you ask for forgiveness. You have no idea how much hurt you have caused.

You say your dysfunctional ways (your words) need to be understood; that you prefer to glare instead of cry, prefer to be a control freak instead of being helpless. What understanding do you think you deserve? Why should you be catered to? You have selfishly managed to make your father's dying process all about you, your needs, and your own inner turmoil and seething. You are extremely self-absorbed, and people like you are toxic. You have demanded that resources designed to make your father either healthier or more comfortable be diverted to placating your sick thinking. Interesting that you mention that you are guilt and fear laden. Could that be you don't love him and never have? You go on to mention that you were once laden with sociopathic tendencies. It shows.

It shows.

Forgive you please, your many sins? Get out of nursing. Get out of healthcare. Get out of this world.

(thoughts?)

[Ruas61, BSN, RN]

You don't have to forgive but you should let go. Carrying around that kind of **** off is not worth the burden.

[Fiona59]

Totally agree with your post.

Why IS it acceptable to expect nursing staff to put up with this bull pucky?

My father died. I didn't question the unit that treated him, the palliative nurse who was with him at the end.

I let them get on with their jobs and did mine as a daughter. To arrange his funeral, his documents and look after my mother and brother who survived him.

[VANurse2010]

Agreed. Many other professions - particularly male dominated ones - would never in a million years put up with such BS.

[Pangea Reunited, ASN, RN]

I agree with the sentiment, but honestly, the wording seems way overboard and makes me feel like I'm about to witness a bar fight.

[Meriwhen, ASN, BSN, MSN, RN]

I see this a little too often in psych: that family member raising hell and hiding behind excuses...but it's not about the patient--it's about that family member's wishes and desires. And often it's their desire that the patient remain locked up for as long as possible so they don't have to deal with them. Or that what they want out of treatment takes precedence over what the patient wants because hey, the patient's crazy, what do they know what's best for them?

That being said, I can relate to the sentiments in the opposite thread as well. Being in a psych hospital can be scary...scary for the patients and scary for the families. It's not uncommon for family members to lash out because of the fear that they feel. We can roll with a lot of those lashings and let it go...but abuse is never tolerated.

[Esme12, ASN, BSN, RN]

I think to take something personal that was shared from the heart of a nurse who's father was dying is not appropriate.

I have to tell you that when my 80 year old father was ill and deteriorating quickly... if I heard ONE MORE TIME "Well... after all he is 80 years old..." EXCUSE ME??

YOU want to make this fat old nurse fly into your face and give you instructions and directions straight to Hell...then so be it.

You know what? Before my father became ill with pyleo he was an active 80 year old man. Sharp as a tack! In FULL control of his faculties. He was a member of MENSA and a far better person than anyone else I know. Yes he had rheumatic heart disease, HTN, renal insufficiency, had a valve replaced, and an AICD. But that by NO MEANS diminished his value to his family. He had just flown back to Chicago from visiting my house in New England. He still walked every day and drove to the store. He LOVED HIS FAMILY above all else!

In the hospital , a hospital I used to work at, he was treated as if he was already dead. Yes he went into renal failure...probably due to the fact when I arrived from the airport my father was unconscious from hypoglycemia, slumped over his bedside tray with his ted hose and footies on the bedside table covered in dry skin flakes next to his lunch tray..... my mother was crying because no one would come..as I questioned the CNA she stated she knew he was dozing when she brought the tray...OK sonorous respiration's is dozing! I WAS OUTRAGED!!!!

I mean why be concerned...he is after all 80 years old.

After surgery for his 3rd VAS cath because of incompetency of the staff...one "clotted" one "leaked" could that be from the scissors you were using? To betadine still on his skin with old OR patches 3 days later. To the dialysis tech who at my fathers bedside happily chatted how she wouldn't wish dialysis on her worst enemy. But that is OK he is, after all 80 years old.

As his condition deteriorated my sister and I (ALL RN'S) decided that we would try dialysis....see of we could pull this out. The next day he was his old self! The calm before the storm? Probably.

ON the third day he was due dialysis agai even though his "numbers were "OK" but his LOC had slipped once again. As I watched the dialysis tech...yes tech...touque his vas cath and fracture the hub...after I told her not to and asked her to get help...after I called the staff to help stop her..she fractured the VAS cath.

But it's ok he is 80 years old.

It was decided that because it was Saturday, his numbers were good and he "was 80 years old" it could wait till Monday. I told the MD that I had known for years that I would hold him responsible is anything happened...I had a bad feeling...I mean he had always listened to my bad feelings before..but after all my Dad is 80.

My dad coded that night and we removed from him life support the next day...he wasn't there anymore. I mean that's ok he was after all 80 years old.

I loved my dad like no one else. Who your parents are the luck of the draw and I happened to get a good ones. Oh... he had his flaws but above all else he LOVED his family. To infer that because someone is a pain in the nurses behind that they maybe didn't really love them and are guilt ridden makes me really angry.

I am extremely patient and a peacekeeper. I will go to great lengths to avoid conflict....but...If I am a pain in your behind you need to pay attention.

Don't get me started when my BIL died from bone cancer and the conversation a nurse had with my RN sister about her dying husband in HORRIBLE pain and paralyzed by the tumors in his spine.... how they had to be careful of addiction...and a DNR coughing up clots the size of liver didn't belong in ICU...do NOT START ME!!

That thread was about someones father dying. How can any nurse wiht an ounce of compassion in their pinky ignore the the poiginant story of how one nurse felt as her father lie dying and trying to give a families perspective and that they are just not ready to let go.

There are those who meed to leave those profession but it is not the writer of that post.

Forgive you please, your many sins? Get out of nursing. Get out of healthcare. Get out of this world.

To infer that someone should leave being a nurse outrages me even more. To say get out of this world is outta line.

I seldom get angry and I am angry. I miss my DAD EVERY SINGLE DAY! He was my friend. My cheerleader. My mentor. My DAD.

[brandy1017, ASN, RN]

I'm sorry for your loss Esme. I agree age is not a number and it is insulting to use age as an excuse to give less care and delay treatment. My dad is almost 80, but like yours very physically fit and walks everyday, still does manual labor to help out friends and family, works in the garden, can get up on the roof to put Christmas lights up. His parents both lived into their 90's. My mom on the other hand in her 70's is frail and uses a walker to get around. He takes care of her and keeps her home, otherwise she could have ended up in a nursing home. But he is frugal with his savings in case she ever needs a nursing home so that there will be money to get a good nursing home and not depend on medicaid.

I would be heartbroken to see either of my parents ill or dying and would be upset if I heard someone using their age to delay or defer care. I think it is good to put pictures up of your loved one active and independent so caregivers will see them as the active full of life people they are and perhaps they will be less likely to use age as an excuse to defer appropriate care. We are there to be patient advocates. Only God knows when it a person's time on earth is up. We are there to do everything possible to heal and treat the person.

So sorry for your loss, Esme.

[Esme12, ASN, BSN, RN]

As a nurse you need to understand how the family is feeling. Frightened, alone. confused. As a medical professional and a family you are burdened to make the right decisions. Whatever that may be. I am not one to be a pain in the behind but I WILL advocate for my family...no matter what. If you find that offensive...then so be it.

To respond to such a painful thread about someone heartfelt grief and pain with such disdain amazes and disappoints me.

Where are we going? Who are we? Why are we here if not for the common bond of compassion and forgiveness?

Thanks rant over.

[Esme12, ASN, BSN, RN]

I'm sorry for your loss Esme. I agree age is not a number and it is insulting to use age as an excuse to give less care and delay treatment. My dad is almost 80, but like yours very physically fit and walks everyday, still does manual labor to help out friends and family, works in the garden, can get up on the roof to put Christmas lights up. His parents both lived into their 90's. My mom on the other hand in her 70's is frail and uses a walker to get around. He takes care of her and keeps her home, otherwise she could have ended up in a nursing home. But he is frugal with his savings in case she ever needs a nursing home so that there will be money to get a good nursing home and not depend on medicaid.

I would be heartbroken to see either of my parents ill or dying and would be upset if I heard someone using their age to delay or defer care. I think it is good to put pictures up of your loved one active and independent so caregivers will see them as the active full of life people they are and perhaps they will be less likely to use age as an excuse to defer appropriate care. We are there to be patient advocates. Only God knows when it a person's time on earth is up. We are there to do everything possible to heal and treat the person.

So sorry for your loss, Esme.

Thank you...It's been almost 5 years. Threre are days I miss him so much. My daughter just graduated high school...my niece just got married. He would have been so proud. I would call and talk to him and my Mom everyday when I moved away. They flew out every 3 months to be with us. I miss his guidance I miss his sense of humor. I miss having a beer with him. I just miss him.... We all do.

[calivianya, BSN, RN]

I agree with the OP in this thread. I also agree with Esme that we need to show compassion for family members and not be condescending.

I would never say a dying patient didn't belong in ICU to the family, that's inappropriate. I would never say, "Well, he is 80 years old;" I say, "I am sorry this is happening." Yes, there are nurses who have no tact, just like there are people in other professions who have no tact.

However, I am not one of those people with no tact, and even if I was, I still wouldn't deserve to be treated like a punching bag. I got a 80s-ish year old man up to my ICU recently. I admitted him, and was trying to do admission charting while the family members kept trying to look over my shoulder and snoop in everything I was doing. I suggested to them as nicely as I could manage while my skin was crawling and my brain was shrieking at me to get the heck out of the room - "You don't have to stand; you're welcome to sit down if you like." I am not claustrophobic usually, but in that moment I was.

I got pulled aside the next day by my manager; the family had complained about me.

Apparently, I was "throwing my weight around" and "trying to control them." I "forced them to sit" and "talked down to them like they were children." For the record, they had asked if someone needed to stay and I wanted to yell, "NO!!!!" with all of the volume I had because of how uncomfortable they were making me with their hovering and being right up in my personal space, but instead I told them we had a policy that one person was indeed allowed to spend the night, and that I would be happy to get sheets, blankets, and pillows for whichever family member wanted to stay. I am a person who needs my personal space. I don't even let my best friends stand so close to me that I can feel their breath on the back of my neck, but that's exactly what these perfect strangers were doing to me. They were also standing so that they were between me and the door. I literally felt trapped and like I had no escape route, and I still managed to be pleasant to them.

These families need to take responsibility for their own attitudes. I am still irate that I got complained about when I was nothing but polite, and offered a gentle suggestion to the family members that they sit down instead of telling them to back the **** off because they were giving me the creeps, which is what I wanted to say. Next time, I think I may just refuse to let family back into the room before I get my admission stuff done. I have been greatly soured by these nasty pieces of work. I understand that they were losing their father, and it was awful, but... when the family makes me dread going into the room, when my flight or fight response is telling me to never go back into the room again because I feel threatened, this is a problem, and the person who suffers the most is going to be the patient. These nightmare families need a reality check that their attitude is possibly going to cause their loved one harm. No nurse intends to neglect a patient, but if I know I'm going to get harassed when I walk in a room, the temptation to not walk in at all is really strong. Don't get me wrong, I'll still do my job - but I will do it in as few steps as possible and make sure I cluster my interventions as much as I possibly can so I can spend the bare minimum amount of time in the room. If these people really care about their loved ones, maybe they should learn not to threaten the people who can save their loved one's life.

I am obviously still bitter. This was the first complaint I've ever received, and I didn't even deserve it. I have never wished so bad that I had really told someone exactly what I thought about their behavior. If I was going to get pulled aside by my manager anyway, I wish I could have educated the family a bit on exactly how being hovered over made me feel. My coworkers might have benefitted from the family being made aware they were exhibiting threatening behavior. I'm quite sure that the family has no idea of how their actions are being perceived, and I'm sure they still are engaging in threatening behavior with everyone else. At least I have the benefit of not being allowed to care for this patient anymore. My coworkers are not so lucky.

[ixchel]

I think to take something personal that was shared from the heart of a nurse who's father was dying is not appropriate.

I have to tell you that when my 80 year old father was ill and deteriorating quickly... if I heard ONE MORE TIME "Well... after all he is 80 years old..." EXCUSE ME??

YOU want to make this fat old nurse fly into your face and give you instructions and directions straight to Hell...then so be it.

You know what? Before my father became ill with pyleo he was an active 80 year old man. Sharp as a tack! In FULL control of his faculties. He was a member of MENSA and a far better person than anyone else I know. Yes he had rheumatic heart disease, HTN, renal insufficiency, had a valve replaced, and an AICD. But that by NO MEANS diminished his value to his family. He had just flown back to Chicago from visiting my house in New England. He still walked every day and drove to the store. He LOVED HIS FAMILY above all else!

In the hospital , a hospital I used to work at, he was treated as if he was already dead. Yes he went into renal failure...probably due to the fact when I arrived from the airport my father was unconscious from hypoglycemia, slumped over his bedside tray with his ted hose and footies on the bedside table covered in dry skin flakes next to his lunch tray..... my mother was crying because no one would come..as I questioned the CNA she stated she knew he was dozing when she brought the tray...OK sonorous respiration's is dozing! I WAS OUTRAGED!!!!

I mean why be concerned...he is after all 80 years old.

After surgery for his 3rd VAS cath because of incompetency of the staff...one "clotted" one "leaked" could that be from the scissors you were using? To betadine still on his skin with old OR patches 3 days later. To the dialysis tech who at my fathers bedside happily chatted how she wouldn't wish dialysis on her worst enemy. But that is OK he is, after all 80 years old.

As his condition deteriorated my sister and I (ALL RN'S) decided that we would try dialysis....see of we could pull this out. The next day he was his old self! The calm before the storm? Probably.

ON the third day he was due dialysis agai even though his "numbers were "OK" but his LOC had slipped once again. As I watched the dialysis tech...yes tech...touque his vas cath and fracture the hub...after I told her not to and asked her to get help...after I called the staff to help stop her..she fractured the VAS cath.

But it's ok he is 80 years old.

It was decided that because it was Saturday, his numbers were good and he "was 80 years old" it could wait till Monday. I told the MD that I had known for years that I would hold him responsible is anything happened...I had a bad feeling...I mean he had always listened to my bad feelings before..but after all my Dad is 80.

My dad coded that night and we removed from him life support the next day...he wasn't there anymore. I mean that's ok he was after all 80 years old.

I loved my dad like no one else. Who your parents are the luck of the draw and I happened to get a good ones. Oh... he had his flaws but above all else he LOVED his family. To infer that because someone is a pain in the nurses behind that they maybe didn't really love them and are guilt ridden makes me really angry.

I am extremely patient and a peacekeeper. I will go to great lengths to avoid conflict....but...If I am a pain in your behind you need to pay attention.

Don't get me started when my BIL died from bone cancer and the conversation a nurse had with my RN sister about her dying husband in HORRIBLE pain and paralyzed by the tumors in his spine.... how they had to be careful of addiction...and a DNR coughing up clots the size of liver didn't belong in ICU...do NOT START ME!!

That thread was about someones father dying. How can any nurse wiht an ounce of compassion in their pinky ignore the the poiginant story of how one nurse felt as her father lie dying and trying to give a families perspective and that they are just not ready to let go.

There are those who meed to leave those profession but it is not the writer of that post.

To infer that someone should leave being a nurse outrages me even more. To say get out of this world is outta line.

I seldom get angry and I am angry. I miss my DAD EVERY SINGLE DAY! He was my friend. My cheerleader. My mentor. My DAD.

Sometimes, I think knowing more about healthcare makes it even harder to watch loved ones go. My husband's grandmother died in November, and as I heard the details from her nurse, and watched the machines, and saw after they pulled her off vent that she wasn't on the originally intended dose of morphine - it was 3x higher, we just know. We don't have the bliss of not knowing what's happened, what's next. It's being unable to say you aren't knowing, hearing that this loved person isn't in pain and simply believing it. And on top of that, the realization by the nurse that you, too, are a nurse (or are becoming a nurse, as I was), so you must be immune to "talking shop" because, after all, this is your normal, talking about these things. For me, I was okay until I saw the pretty big morphine increase. The nurse had told me where she would start, and then the parameters and indications for increasing it. I was okay until I knew what that meant. I never did tell my husband or his family that their loved one was probably in pain.

Your story has touched my heart, Esme, and I am deeply sorry for the nonchalantness and the vulgar way you were approached. Just because the family in front of you is filled with nurses doesn't meant it's time to "talk shop". To those nurses caring for loved ones, I say, we're not here as nurses. We don't need opinions. We probably don't need graphic truths. Be kind and gentle. And, as Esme said, if we're irate, listen. The family members that are present are the eyes that you can't be because you do have other patients. I think that's important to remember.