I just lost someone whom I was very close to, so these will be a mixture of what witnessed and what I have done in clinicals.
1. Understand that everyone is going to react to this diagnosis different. Your patients will all be at different stages in the grief process.(In regards to the 5 stages of death) Remember that this model is a framework, some people skip steps and revert back often to previous steps.
2. Therapeutic communication is very helpful to the patient and family if they WANT to talk to you. If you keep getting short answers, or the person keeps bursting in to tears, please stop badgering them.
3. Review the disease processes, for instance, someone with cancer receiving treatment can have very dry skin, not have an appetite, be very nauseous, etc. Apply lotion unless contraindicated, apply Vaseline or chapstick to lips, if needed. For heavens sake, please do not try to force feed your patient. We had a nurse try to feed my friend's mother while she was half asleep and medicated because "she keeps refusing when I ask" Of course she began coughing on it and was very stressed. I almost came close to an assault charge on that one.
If your patient refuses food kindly leave it available for a while, and maybe prompt one or two more times before taking it away. Document and report to your nurse so dietary and the Dr. are aware.
4. If your patient is taking pain medication, please be aware of when it can be given. It is completely agonizing to watch someone moaning/crying/screaming because the nurse cannot be found. (Went off the floor on a break. Covering nurse was MIA. Charge nurse ended up medicating.)
5.If your patient is having problems sleeping, when they finally do fall asleep please leave them be unless you MUST wake them. Again heart breaking to see someone restless and exhausted for 20 hours to finally fall asleep comfortably only to be awaken by dietary or a student coming to do therapeutic communication. (I find a great time to do communication is during assessment. Two birds with one stone, especially for someone who tires easily.)
6. Lastly, if you have lost someone and you can relate, feel free to share that with the family. If you have not, PLEASE do not tell them about how you understand. This happened many times, two i will share. "Oh I know exactly how you feel, my husband's mother died of cancer a few years before I met him, when he told me i was so heartbroken." Obviously this does not compare to someone losing someone they have known their entire life. That was from a nurse, another from a family friend. My friend's dear mother was in pain and was trying to sit quietly but asked a few of us to find the nurse for meds (she was a little disoriented so she would ask someone then a minute later ask again) "Oh you want to talk about pain, I had pneumonia a few weeks ago and you would not believe how painful that was! Be glad you don't have to deal with that."
Of course, be glad she doesn't have pneumonia when she has terminal cancer metastasized to 6 places.
Some people right?