Am I going to die?

Olli · Apr 10, 2008

Just find out what makes them think they are going to die. My reaction would to patient's words would depend on the diagnosis, prognosis and etc. I mean I would have a different reaction if the person after appendectomy asked me that question vs a person with terminal illness.

TiredMD · Apr 10, 2008

My answer is usually: "Everybody's going to die eventually, but today's not your day."

Unless, you know, I actually think they might die. Then it's usually something along the lines of, "We're going to do everything we can to keep that from happening."

I like your idea of exploring their feelings and assumptions about the issue. Something I should do more, but usually avoid.

Ms Kylee · Apr 10, 2008

We were taught to ask them to share their thoughts and concerns... this actually happened to me.. I told the patient we were doing all we could to make sure that didn't happen... she died a week later.. back at her nursing home. She was a sweet lady and I just loved her...

registeredin06 · Apr 10, 2008

I'm not sure what the correct reply is, but personally I always ask them in return "Do you feel like you're dying?" This allows for further assessment, because, nurselovescoffee, when they say that to you, get ready!!!

I have said "not if I can help it" when I have been asked that, because I feel confirming their fear leads to an increase in anxiety :uhoh21:, thus creating tachycardia, hypertension, hyperventilation :banghead: .

Wendy_RN · Apr 10, 2008

My answer is usually: "Everybody's going to die eventually, but today's not your day."
Unless, you know, I actually think they might die. Then it's usually something along the lines of, "We're going to do everything we can to keep that from happening."

Those are pretty much my standard answers. I was caught off guard the first time a patient asked me if she was going to die. I was a student at the time also. I think instructors really do need to address this with students, as a lot of them will be asked this question at some point in their career.

PsychNurseWannaBe, BSN, RN · Apr 10, 2008

I think your reply was quite acceptable. Your question allowed the patient a moment to reflect and also demonstrated to the patient that you were listening and willing to explore. There are many right answers or should I say questions that you could have asked. Therapuetic communication takes time to learn. The one thing you do not want to do as a nurse is to ignore or avoid the question that is being asked. You also do not want to use cliche type answers.

Just be in the moment and be open and honest. Obviously this patient was scared enough to ask the question...patronizing or placating has no place in this. Therapuetic communication is for the patient, and is different from social communication.

You did a fine job! :up:

Crocuta, RN · Apr 10, 2008

I'm not sure what the correct reply is, but personally I always ask them in return "Do you feel like you're dying?" This allows for further assessment, because, nurselovescoffee, when they say that to you, get ready!!!

This is an excellent point to keep in mind. It's interesting how many people have a sense of the end, and sometimes they'll give you clues. Watch for sudden peace and contentment or talking to a deceased spouse or parent as well. When you see those signs, along with clear statements of "I'm dying" in a lucid, non-anxious patient, be sure you've got your DNR status clarified.

2bnurselovescoffee · Apr 10, 2008

Thanks for all the great replies! We have not addressed this issue in class so I was very unprepared. I appreciate all of you sharing what you have experienced with your patients and how you respond. Thank you.

nyapa, RN · Apr 10, 2008

I was looking after a lady who was to have a permanent pacemaker insertion (think it was the defibrillator type). She was terrified she was going to die. I guess there are various reasons for the fear. In her case I called the anaesthetist, who ordered temazepam as a premedication. When I went to give it to her, she was much more relaxed. Obviously the discussion with the anaesthetist must have helped. And maybe my quick response to have someone see her showed her and her daughter that we took her concerns seriously.

My point here is that there is no right answer. It depends on the situation. I really can't see anything wrong with your question; you showed you were prepared to listen...

aeauooo · Apr 10, 2008

I turned it back to the patient and replied "what are your concerns about dying?"

Not bad. That's what we're taught to say in nursing school, and it makes sense.

People seem to want to know 'chances.' "What are my chances?" "What are the chances that mom will recover?"

What do you mean by 'recover?'

Most lay people, IMO, don't understand statistics well enough to know what "chance" really means. Without that understanding, any answer is really meaningless - it makes them feel better ("There's a chance!"), and they can tell people, "The doctor said mom has a xx% chance of dying."

The most accurate answer to the question, "What are my chances of dying?" is 100%. I asked my surgeon what were the chances that my varicose veins would come back after having them removed - "100%" "How long will it take before they come back?" is another question all together.

Odds of survival has to be placed in the context of time. Cancer recovery is most often measured in survival to 5 years. The odds of a 40 year old, perfectly healthy man living another 100 years is so close to zero that it might as well be zero - but there's still a chance that it could happen!

Sorry for the diatribe - it's a pet peeve of mine.

Justlearning · Apr 10, 2008

That is what we were taught to do in class. Ask the question and allow them to tell you what is on their mind. I am worried I won't be ready for what they say or how to handle that. How did she respond to you?