A reminder to ALWAYS listen to your patients.

Antikigirl, ASN, RN · Nov 14, 2004

In my facility they really don't seem to know as much, but on occasion one pops up with a I am going to die and it takes about a week after that.

The interesting thing I have noticed is that as long as their is family in the room they don't go...but send them out for lunch or a good nights sleep and yep..there they go. It is like they are holding out till they aren't in the room! I had one patient who's family wouldn't leave her side..and the poor woman needed to go (hospice and in a lot of pain and respiratory difficulty at the end)...well it happed that there was a time where only her daughter was in the room, and she went downstairs to stretch her legs and get a coffee...yep, enough time and the lady died fast before she returned. It is really wierd!

karenG · Nov 14, 2004

Has any patient ever explained how he or she felt before they die? Is it a malaise type feeling or something else? As a nurse, can you just look at them and tell (not reading labs)?

over here we say that terminally ill patients have a 'look and smell' about them. You usually know when someone is going to die. They just have a look about them. I really cant explain it more than that.

Karen

mattsmom81 · Nov 14, 2004

Some know and express it, and accept it...some fight to the end and will not outwardly acknowledge or accept death. We learn to treat people as individuals...their responses will be as individual as they are, in my experience.

BRANDY LPN · Nov 14, 2004

When I worked LTC I had a lol with CHF who had just been admitted to hospice and who was doing so much better, (I thought) this lady ALWAYS walked to the dining room for every meal and one evening when I was doing her CBG she said "I think I will just eat in my room tonight" I asked her if she was feeling bad and she said "I didn't get much sleep last night and I am very tired, so I'll just eat in here and then turn in early if it is ok" I assured her that that would be fine and told her to get a good rest and she would feel better in the morning. The aide took her her tray to her as I was leaving the room and when she went back about 20 minutes later to get it the lady was dead. She had ate almost 100% of her dinner she had her dessert bowl in her left hand and her spoon in her right and was sitting up dead as could be. Was the first time I ever lost a pt. After that if a res. c/o being tired it gave me the creeps, I was like a first time mom going in every few minutes to make sure they were still breathing.

mattsmom81 · Nov 14, 2004

I remember a sweet little old lady in failing health, AMI in my ICU who had Alzheimers. Suddenly she started reaching upward and smiling, conversing with someone we could not see. Her family members became very upset when she told them they were angels...and tried to argue with her and 'bring her back' to reality. She hung on for quite a long time..at odds with loved ones.... for their sake.

emsboss · Nov 14, 2004

My Dad walked out of the plant where he had worked for 30 years (he was 59), turned to the foreman and said "I won't be back." This was a Thursday night. That night we were working on a car, he had an extinsive MI and at 0630 the next morning he had a brainstem stroke:crying2: . I had the foreman as an MI patient about 2 years later and he told me about it.

zambezi, BSN, RN · Nov 15, 2004

How about when you have a 90 something patient calling for their mother--or any patient calling for someone that you know has passed on. I think most people know--or have a feeling they can't put their finger on...

Ruby Vee, BSN · Nov 15, 2004

it always freaks me out, but patients do seem to know when they're going to die. and they seem to choose whether to do it with their loved ones surrounding them, or alone after the loved ones leave. some folks who have been hanging on by a thread for days will pass when their families give them "permission."

crazyearrings · Nov 15, 2004

patient calling for someone that you know has passes on

The day before my mom died in 1992, she was calling out for her daddy who died in 1965.

as long as their is family in the room they don't go...but send them out for lunch or a good nights sleep and yep..there they go. It is like they are holding out till they aren't in the room!

My mom did that, too. My aunt spent the night with her in the hospital, but had to leave at 6:00 a.m. to take my uncle to work. At 6:15, we got a phone call from the doctor to come to the hospital immediately. I told my dad that Mom was gone but he didn't want to tell us over the phone. Sure enough, that is what happened. Mom knew Aunt Sherry would freak out if Mom died while she was there, so she waited for her to leave.

boulergirl, CNA · Nov 15, 2004

We had a resident whose family put her on hospice. That whole week, the staff kept going in her room and found her on the floor, praying. One night, 11-7 staff found her there, helped her up, and asked her if she wanted anything before she went to bed. She said no, she just wanted to go to bed because she was tired. She NEVER did this normally--always wanted a soda or water or something else first. The next morning, she was on her knees beside the bed, dead as a doornail.

Sis123 · Nov 15, 2004

I can tell you how being near death felt (from my perspective). I was young (27 or 28) and had appendicitis and peritonitis(post op diagnosis). In the ER my diagnosis was not clear at all, and because my pain was extreme and unrelenting, I was admitted to a room. The surgeon came to see me a couple hours after being admitted, and examined me. I had been suffering intense pain for about 16 hours at this point and almost didn't care if I lived or died at this point, but the strange thing is that I felt like my body kept getting heavier and heavier, really sinking into the mattress, and I felt more and more separate from my body, as if my "spirit" was slowly "peeling away".

The surgeon told me that he wasn't sure what they were going to do, since they really couldn't tell what was going on with me, and I told him that if he didn't operate and "fix it" that I would surely die. I just "knew" it, and it was a very good thing that they decided that was what they needed to do. It saved my life.

TiffyRN, BSN, PhD · Nov 15, 2004

I'll have to be the contrarian here and disagree. I was told as a new grad how "a patient knows!!!!". I just haven't seen it. After ten years of working with your general med/surg/tele patients I think I saw one lady that had that "impending feeling of doom" and then actually died (of a massive pulmonary embolism). I've had literally dozens of people declare to me they were going to die. Scared me bad for the first couple of years, then I just got immune to it and would try to comfort them and explain their current condition. Sometimes I would pass it along in report because I felt obligated by this theory that "patients know!!!". It would scare the on-coming nurse but as far as I know, just that one lady that I took care of died after such a declaration.

I think people just tend to remember that a patient that died had made such as declaration. But maybe I'm wrong, maybe I didn't take care of the right patient population.

Now as far as a nurse's impending feeling of doom about a particular patient when nothing is obvious, that's a whole 'nuther ball of wax.