dying child...how to cope?

  1. I currently have a nine-month-old patient who has come to my hospital to die. When he first arrived, he was weaned from his CPAP and was taken off all meds, but we were still feeding him and giving him morphine. Now, his parents decided that they don't want that anymore. He is now back on a nasal canula and is on CPAP PRN with codes, yet he is a DNR. I am confused about me feelings of this. It seems to me that his parents are just prolonging the inevitable. I understand that it has got to be a horrible decision for any parent to make, but these parents are never around. They never visit him, they just call maybe once a day to check on his status. I've actually seen them just once. I just don't know what to think of it. Any advice on how to cope?
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  2. 19 Comments

  3. by   jnette
    (((HUGS)))

    I'm so sorry. This must be extremely difficult for you.

    If it were ME... I would simply be all that I could be FOR that child, and provide all the love and comfort measures you possibly can... sprinkled with lots and lots of touching... and softly speaking to the child every chance you get.

    I'd put the parents out of my mind as you cannot dictate their actions or lack thereof.

    Just do what comes naturally to you from the heart, and be there for this child... speaking kindnesses and love. The child will be aware of your voice and your touch, even though he may not respond to it. Be his angel at his side.
  4. by   missmercy
    Have been in similar situations countless times and it NEVER gets easy. Hugs to you and lots of prayers and good thoughts!! YOU ARE MAKING a difference for that child when you love them -- it is not possible to get inside the parent's heads -- grief makes people do some pretty weird things -- and of course, everyone grieves differently. I know there were times when I wanted to bean parents for what I felt were pretty stupid decisions. However, while beaning them MIGHT make me feel better (VERY short term), it would do nothing for the precious little person who needs me (and you). Remeber, you can love that baby and care for their needs like no one else. It hurts like the dickens, but in the end.... you will feel better knowing that you have given that child love and that is better than any med, any treatment... Maybe no one will notice, I believe that God notices and HE cares and He will reward you for giving a piece of our heart to the little ones who need you!
  5. by   UK2USA
    This sounds like an awful situation for you to be in. The parents have put a lot of stress onthe staff on your unit - albeit unintentionally. I have been in similar situations and my saviour came in the form of the unit's clinical psychologist. We utilised her to talk over our problems and fears and through some short interviews she was able to help us see our goal. In addition to this she was also prepared to talk to the parents of the child and discuss their fears... it emerged that the family were having a tough time coping and didn't know what to do, so they distanced themselves from the situation and the inevitable decision making that they felt extremely guilty about. My heart goes out to you... I send my best wishes and hopes for a satisfying conclusion to all parties involved
  6. by   Loving Life
    Quote from jnette
    (((HUGS)))

    I'm so sorry. This must be extremely difficult for you.

    If it were ME... I would simply be all that I could be FOR that child, and provide all the love and comfort measures you possibly can... sprinkled with lots and lots of touching... and softly speaking to the child every chance you get.

    I'd put the parents out of my mind as you cannot dictate their actions or lack thereof.

    Just do what comes naturally to you from the heart, and be there for this child... speaking kindnesses and love. The child will be aware of your voice and your touch, even though he may not respond to it. Be his angel at his side.
    I agree. I work with cancer kids and have also had children die on general peds. Just love them and be there for them. Parents do cope with grief differently. They may be withdrawing early. You will be fine. That child will love you for it even tho she can't express it.
  7. by   txspadequeenRN
    Sounds like a a horrible spot to be in. Sounds like the parents are having serious coping problems. It has been my experience that when things get out control for patient families and they lose that grasp, unable to control the situation they start changing orders, adding this, stopping that. By the time we slow down things are so screwed up. I personally have a short tolerance for this and in a nice caring way have always spoke with the families getting the pro's and con's straight. If he is a DNR I would really be concerned about pain control and the d\c of the morphine. Alot of people think that morphine is the killer instead of the disease. God Bless you, after all this I would sit and have a good cry.. Good Luck



    Quote from vjcnurse
    I currently have a nine-month-old patient who has come to my hospital to die. When he first arrived, he was weaned from his CPAP and was taken off all meds, but we were still feeding him and giving him morphine. Now, his parents decided that they don't want that anymore. He is now back on a nasal canula and is on CPAP PRN with codes, yet he is a DNR. I am confused about me feelings of this. It seems to me that his parents are just prolonging the inevitable. I understand that it has got to be a horrible decision for any parent to make, but these parents are never around. They never visit him, they just call maybe once a day to check on his status. I've actually seen them just once. I just don't know what to think of it. Any advice on how to cope?
  8. by   vjcnurse
    Thank you to everyone for your wonderful words of encouragement. I do feel like I am the this baby's angel, and that's okay with me. I knew what I was getting into when I accepted my job. I've only been there a year and this is my first death and dying experience. Your support is greatly appreciated and will be held in my thoughts each day I watch this child die. Your wisdom will help me get through it knowing that I have a support system at this site. Thanks again to all!:angel2:
  9. by   UK2USA
    I hadn't realised that this was your first death, that must make it especially hard for you. Make sure you utilise all of the support you have around you. And try to bear in mind that not all deaths will be like this. Most of the time, when I am involved with "pulling out" on a patient,I find that there is a calm, loving and (quite strangely) satisfying end - especially for the healthcare professionals and the family. You are in my thoughts. If you need an outlet for your frustrations please use this fabulous forum... there are lots of people here that care.
  10. by   Energizer Bunny
    Quote from jnette
    (((HUGS)))

    I'm so sorry. This must be extremely difficult for you.

    If it were ME... I would simply be all that I could be FOR that child, and provide all the love and comfort measures you possibly can... sprinkled with lots and lots of touching... and softly speaking to the child every chance you get.

    I'd put the parents out of my mind as you cannot dictate their actions or lack thereof.

    Just do what comes naturally to you from the heart, and be there for this child... speaking kindnesses and love. The child will be aware of your voice and your touch, even though he may not respond to it. Be his angel at his side.
    What Jnette said. In defense of the parents, do they have other children? I just don't know what to think about them, but it isn't for me to judge I guess.
  11. by   vjcnurse
    Quote from CNM2B
    What Jnette said. In defense of the parents, do they have other children? I just don't know what to think about them, but it isn't for me to judge I guess.
    They have two other children. I recently found out that transportation and childcare is an issue, but at the same time I'm forced to judge a little. I don't have children myself, but I feel like if I did, I would do whatever it took to be with my dying child. It's hard for me to put myself in their position since I can't relate what-so-ever, but I just feel like there are ways to work out situations like these. I've been feeling a little better about things since I realize that I am this child's family while I'm working. I feel like he knows I am here for him.
  12. by   UK2USA
    Dear Vjcnurse,

    Has there been any resolution to this awful situation? How are you coping? Let us all know if we can help.
  13. by   eb_rn
    its hard not to judge...where i work, we have lots of babies without family...frequently it is a childcare/transportation issue....or a single mom with 3 kids and simply must work to pay the bills.....then sometimes we have 12-13 year old moms who have no idea how to be a mom to a normal child, much less a sick one.......we have kiddos with chronic lung disease and vents--chronic vent use, and out of the 10 in this room now, there are only 4 with families i agree with above posts, give them all the love u can. it is very difficult and it takes an amazing nurse to deal with what ur going through. my prayers are with u and the little one.
  14. by   purplemania
    Be proud that you are able to provide comfort to the patient. As for the DNR status, that needs to be clarified. Maybe social work or ethics committe should be approached. You sound like a caring nurse.

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