I work in an assisted living facility. I've worked there for only about half a year. I've got two patients: a husband and wife who lived in an apartment together. On the shift 3 days ago, the husband began to decline. yesterday, I came back into work and he was actively dying. I was the only nurse to truly take care of he, and his family, during his decline (we don't have a 3rd shift nurse, because we are assisted living and he really got bad over night). So as soon as I got in, even though I was off the clock, I medicated him immediately. Unfortunately he wasn't able to take mess PO anymore, so I had to give oxycodone rectally and the Ativan sublingually (due to its ability to dissolve easily), per his hospice nurses directions. I was doing my best to get liquid morphine for him all day. I hounded the doctor until he wrote the prescription and sent it right away. And called the pharmacy as soon as he sent it to make sure that would send it out IMMEDIATELY. Unfortunately pharmacy is 3 1/2 hours away and have no back ups. So I had to medicate him rectally and sublingually until they could deliver. All day I checked up on the family, especially his wife because she is my patient is was struggling tremendously with the pending loss. I made sure I was in the room every 2 hours, on the dot, to medicate him and make him as comfortable as possible. When my lunch break came I chose to sit with the family instead. Lots of tears lots of hugs. When the family stepped out I sat with his wife so she wouldn't be alone in her time of grief. At the end of my shift, the family called down in a panic. I felt for a pulse, listened for respirations. He was gone. They all hugged me telling me how thankful they were and how I was a great nurse. (I am a new nurse. I'm only 22. So I think they were surprised with how empathetic I was). This is why I became a nurse. I was to help people. And although this situation made me incredibly sad, I feel honored to have been there when this wonderful man left the world. And I feel honored to have been there for this lovely family in their time of need. My question is, is it appropriate to go to the funeral? When my grandfather passed, all of the nurses came and my mom was very touched.
I wasn't grieving at the bedside with the family. I sat with the wife, who is also my patient, because she was very upset and distraught and was asking questions. And her family had just stepped out. I didn't feel it was appropriate to leave her all alone with so many questions. Exactly, it's my job to support my patients and their family. She's my patient. So I will have to completely disagree that this was "overstepping boundaries". I have 40 patients. So my lunch break was the only time I had to sit down with her to offer this type of support and answer her questions. I understand the medicating off the clock comment. I would like to know what you would do, however, If you had a patient who was dying and suffering and you aren't allowed to clock in early and the family is sitting there begging you to make their father comfortable. No night shift nurse. Hospice had nothing in their lock box. This was a special circumstance. I'm not going to stand in front of a family and say "oh sorry you'll have to wait 20 minutes until I clock in".
I have worked in long term care and many nurses would attend funerals of patients they were particularly close to. I would think assisted living would be similar. Like others, I don't think there is a hard and fast answer to this... I work in a different specialty now where boundaries are much stricter and I can't imagine the circumstance where I would have contact with patients or families "off the clock"-- for their sake as well as mine. You might run this question by more experienced nurses at your facility to get their thoughts, if you have a positive relationship with them and feel comfortable doing so, because I think this is extremely dependent on your work environment and what the expected boundaries are. But personally I don't see an issue with going given the facts as you've stated them.
As a home care nurse, there are times when you cannot help but become close with a patient and often his/her family. I have one patient right now for whom I've been providing care for over seven years, another for almost four. There's no way I'd miss either of their funerals, and it wouldn't just be as a show of support; it would be to express my grief as well. Of course, you don't become close with every patient in that way, but it's almost unavoidable in this specialty from time to time.
I have been to a few funerals of patients. It all depends on the dysfunctions of the family. If I think me being there will be a problem I don't go. I have only felt like that once. I think it can bring closure for the family and for the staff.
I've been in hemodialysis for 9 years now, taking care of the same pts and many have died.
I'm in the minority here but I feel that once you cross the line of patient to friend you can't remain objective enough to care for the pt.
I have never been to a wake/funeral of a pt ever in >23 years of nursing but with the exception of the last 9 years, I worked ER/ICU so didn't have time to develop a relationship. For me, personally, the choice to keep work separate from my private life has worked well for me.
When I was a home health aide, I attended a funereal for one of my clients that I'd known for a couple of years. If the family lets you know about the funereal, I would definitely say it's ok.
Specializes in Mental Health, Gerontology, Palliative.
I've had alot of deaths since I've been out of nursing school 2 1/2 years (palliative and long term care). I've been to two funerals.
I dont have a problem with it. I tend to avoid funerals, they can be overly emotional and hard going. When someone passes in the facility. I will take a moment to say good bye though
When you are with them and their family in the most intimate situations...I believe it is appropriate to attend the funeral.
Dying can be very intense and it seems you brought peace and eased the suffering not only for him, but his family also.
You are a part of his story...a part of their story with him. Please, go to the funeral. Pay appropriate attention to his wife and family-then your job with him will be completed...
In all the services I've attended, it was NEVER an extended attendance. Just in & out to express condolences. To me, my attendance is 'the LAST act of care' I provide. I've never considered it even remotely CLOSE to being 'too close' or stepping over any boundaries. Kinds cut & dry.
In fact, kind of really just one more professional interactive service. I've never thought of it as anything more.
Emily456
17 Posts
I wasn't grieving at the bedside with the family. I sat with the wife, who is also my patient, because she was very upset and distraught and was asking questions. And her family had just stepped out. I didn't feel it was appropriate to leave her all alone with so many questions. Exactly, it's my job to support my patients and their family. She's my patient. So I will have to completely disagree that this was "overstepping boundaries". I have 40 patients. So my lunch break was the only time I had to sit down with her to offer this type of support and answer her questions. I understand the medicating off the clock comment. I would like to know what you would do, however, If you had a patient who was dying and suffering and you aren't allowed to clock in early and the family is sitting there begging you to make their father comfortable. No night shift nurse. Hospice had nothing in their lock box. This was a special circumstance. I'm not going to stand in front of a family and say "oh sorry you'll have to wait 20 minutes until I clock in".