I have only been a Hospice Nurse for a few months. I absolutely love it, and feel this is where I belong. My question? I'm having a hard time knowing what to say to a man in his early 60's who is experiencing a huge amount of anger and frustration, which is understandably so. I usually feel pretty comfortable, asking patients about their feelings, and allowing them to express themselves. This gentleman, however, has started to refuse all meds exept for his morphine, and is extremely restless(not due to respiratory distress). When I brought up Ativan, he threw his hands up, and his wife looked at me, like I shouldn't push the issue, so I respected that, and told him so as well. I'm wondering how others handle angry patients, and what might help bring him more at peace with his situation. He has periods of confusion but alert enough to have input in his care. I know this must be a common challange for hospice nurses, but I haven't had to deal with this level of anger yet. I already have a social worker involved. Any suggestions would greatly be appreciated.
BTW, This website ROCKS! I have learned so much in reading threads this past week.
Wow! That's pretty deep. I like the fact that it is one of your goals. I never thought of it that way. Interesting......
you don't have any goals w/your pts (other than the obvious of being pain-free)? actually my goal is always to get and keep my pt pain-free: yet i ascertain their pain is addressed physically, emotionally, mentally and spiritually.
To be honest, I felt I could forsee more goals during my first month of working with hospice. Ya know when I was "shadowing" people. I know I have it in me to make up a great unique careplan for my patients, but lately, its been difficult, because in the past 2 months, I've had to learn so many things about pain management, company policies, AND use of a laptop. It seems so hard to keep up with recerts, updating care plans, orienting home health aids, communicating with other members on the interdiciplinary team, etc., its easy to get off focus. (This is only my 3rd month as a hospice nurse) Don't get me wrong, I LOVE IT. It was just nice to have read your post, and what others wrote. It helped me to sort of "re-focus" if you know what I mean.:) I recommended this website to several employees today. It has definately had a positive impact on my job. Thanks! I hope I can inspire someone out there as well.
Cut yourself some slack. You have to learn to walk before you can run. There is a tremendous amount to learn just in terms of the basic nuts & bolts before you can focus on the finer nuances.
When you do get to where you can perform the basics without having to think them through, the ultimate goal for each patient is to help them cross over consciously. Many (perhaps most) will not achieve this, but that is the ultimate goal.
Expediting a man’s capacity to resolve his buried fear and sadness may be useful in some instances. Expediting a woman’s capacity to express her buried anger may be useful in other instances. But these are just tactics serving a broad strategic plan; i.e. to experience life (which includes death) consciously.
You sound very much as though you have what it takes to excel in hospice, but be kind to yourself.
I've been a hospice nurse for 7 years now and I am always learning new things. I try to remember that the loss of control and choices is also a reason for anger. I make sure that my patients know that they are in charge of their care. As long as it is safe, they can do what ever they want. Sometimes that helps. I also encourage family members to give them choices whenever possible since they often feel like things are slipping away. Finally, I find that my daily mantra is that "people have the right to make bad choices". It's not our place to tell someone how things or feelings should or could be.
I would be mad, too. I think it "stinks" that he is dying. I call it compassionate anger. Don't take it personal. He just needs to do things his way for now. Get on his side.
There is a wonderful story behind it. But long story short, I'm holding a rescued hummingbird. Its my favorite pic. Thanks for inquiring!
bay bay
28 Posts
Wow! That's pretty deep. I like the fact that it is one of your goals. I never thought of it that way. Interesting......