End of Life Experience

tbtg9878 · Apr 21, 2012

I would like to say that I hope your kind of nurse would be my nurse at my end of life! Well done!

tothepointeLVN, LVN · Apr 21, 2012

I hate to say this but from my experience as a hospice nurse you start out remembering every patient you ferry over to the other side but the more you do this the more you start blocking them out and it becomes a blur. It really does become where you mean more to the patient/family that the patient does to you and thats ok. Thats what you need to be able to do in order to be able to give the best of yourself to yourself and still have something left. I'm more compassionate/empathetic/selfless now though.

BostonTerrierLover, BSN, RN · Apr 21, 2012

Your sympathy, empathy, and general spirit takes such a beating in Nursing it HAS TO BE almost or is "Faked" sometimes. After my Naive years on the emotional rollercoaster of being a few months into ER Nursing, I almost totally wrecked my 6 year in (at the time) marriage. I noticed most of my friends quit coming around, or really going out of their way to connect. I got married younger than most, so I chalked it up as they were starting families, so on/so forth.

Now, my wife, being stuck with me- she confronted me. It hit me like a ton of bricks that I was totally give out emotionally drained. I didn't want to "FEEL" anything positive/negative after I got off work, totally numb. I gave her ZIP in the affection, reassurance, and encouragement departments. I also see how easily someone could succumb to a drug that "covers" negative emotions. I sought help real fast, I knew she was right, I had lost interest in everything I used to be passionate about. I became distant. I hated to leave the house. The help I got saved me as a person, and I then seen how demanding the emotional strain had been- and how isolated I had made myself.

Why post this on this thread?

I hope if you remember feeling better mentally in an earlier period of life (I don't care how long), seek help. If your not interested in things you once were- somethings happened. It will effect EVERY aspect of your life untreated. I have seen so many nurses turn to drugs, risky lifestyles, and even suicide to "escape." Reach Out if You Need Help.

I know I am not the only one to have this gut reaction to "I will never forget my patients," seeing above post. And like that poster, I am just saying, guard your heart. If you don't take care of yourself first, it just gets harder to take care of anything else the way you'd like too. Don't set self aspirations too high like that is all, your going to have a hard enough demand on your spiritual health anyway.

Just don't take yourself tooooo seriously, and BE GOOD TO YOURSELF- You deserve it.

tbtg9878 · Apr 21, 2012

All care-takers are subject to "burn-out".... It takes a very special and spiritual person to be able to assist, be therapeutic and empathetic without care resulting in "distancing oneself" from the patient and family. This seems only to be done by the grace of God who strengthens. My personal experience has observed some hospice nurses actually "hasten" the pt.'s death by injection, because they "saw the family panic" or the nurse was panicked. This "hastening" is a phenomena that is not written about in nursing. It's Nursing's "dirty little secret". I would interview any hospice nurse extremely carefully to make sure that they are compassionate within the appropriate boundaries, as defined by morales that reflect a respect for life as well as a "comfortable" death. I would hope that we as nurses do try to recall our patients and their families. It's the "human component" of our vocation. Any "burn-out" issues should receive peer support with team-mates and hospice chaplain. I actually pray for my patients and staff too!! Have a wonderful weekend!

tothepointeLVN, LVN · Apr 21, 2012

BostonTerrierRN.

Your spot on, on this one. I've come to the conclusion that it really doesn't matter whether your empathy is real or faked as long as your patients and family feel it. I often get told by the family that I bring a "calming" presence to the room which I wouldn't be able to achieve if I hadn't left the real TTP in the car.

tbtb9878,

Have seen hastening before in but I always felt it was laziness on the nurses part or at least in the cases I saw when the patient was overly sedated and the nurse was sitting in another room reading a magazine. Prolonging I have also seen where the nurse on duty was scared and didn't want the patient dying on their shift or in one case where the nurses wanted to be able to have more shifts with the same patient flushing the GT with H2O even though that had already been d/c'ed. Thats the longest I ever seen a patient last on cc. I don't know what else was happening it seemed every time I left a shift she was transitioning and I would have said minutes to hours and then next day had rebounded.

I would also point out that not everybody believes in a God so I disagree with the concept that being therapeutic and empathetic can ONLY be done with the "Grace of God"

BostonTerrierLover, BSN, RN · Apr 22, 2012

yep, totally in agreement with you tothepointeLVN!!!! And on the Hastening, It is my worst fear to have a long-suffered, drawn-out death. Just keep Boston comfortable with IV fluids so I won't have "Deathbreath," and a little butt and oral care- and let me go---> (As fast as possible w/o losing your license)!

(all dogs go to heaven!) Lol.

tothepointeLVN, LVN · Apr 23, 2012

No dog breath got it. ;D

WongRN-4lyf · Apr 24, 2012

It's nice to you two agreeing!!!!

"They is a God!!!" -Cealy The Color Purple

And, I'm in agreement. No tubes, monitors, or heroics that are POINTLESS. Let me slide into what ever's out there. But, by all means, keep the morphine and IV fluids going, just don't feed me!!! I WILL HAUNT YOUR ESTABLISHMENT!!!!

Brandywyne30 · Apr 24, 2012

I actually created an account after reading this post! It's nice to know I'm not alone in my feelings regarding this delicate matter! I'm so impressed with the responses here! It's such a hard balancing act between being a nurse and your personal life and not becoming distant with your loved ones after you've witnessed so much, nursing does take a toll on your heart and soul. I'm dealing with that myself these days after 15 years of nursing. Kudos to you guys and thank you so much for sharing your experiences!

GwenDaNurs · Apr 24, 2012

A nurse from my graduating class sent me this:
"Was talking with a pt about the dying process and what he will be going through. After many tears together, I told him I would be sure to say goodnight before I left.
When I came in, as promised, he held my hand tightly and said, "I do not know you but the part of you I got to know tonight, I love. He cried again, I gave him a hug and as he kissed my cheek he tenderly whispered, "Goodbye, I will see you again someday".
I will never forget my patients."
This is what I think of when I think of spirituality and nursing.

I am a hospice nurse and while I can't tell you every name of every patient I have stood by when they passed, they are not a blur to me. I make sure to take care of myself so that I am able to take care of my patients. I love my friends, family, my life, because I watch it end, I know how valuable this trip on the planet it.

ncat · Apr 24, 2012

i have been an lpn and an rn and then a bsn--u can not fake empathy and caring-u can not fake a gentle hand or a tearful eye.in certain places where i precepted new to company nurses or brand new nurses i always said the same thing. every time u see a patient it is monday morning-they deserve that energy,they deserve the 100% of your skill base. i have been in this profession for 30plus years and had the good fortune to have a wide background of exp. everyones tears are salty-all blood is red-fear is fear and compassion is compassion. never fake it!