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Be My Friend at the End

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I returned to nursing after having been at home with my children for a number of years. At first, I was apprehensive and uncomfortable. But I had a great team of nurses and a wonderful preceptor and eventually my "deer in the headlights" look gave way to an underlying confidence. I had learned to enter into countless new situations believing that I could learn to handle whatever came my way.

Be My Friend at the End

It was exciting to work on a busy medical-surgical floor. Although I was occasionally overwhelmed, I can honestly say that I was never bored. After I became confident in administering physical treatments, starting IVs, placing foleys, and so forth, I realized that the greatest difficulty was handling complex family situations. Sometimes it seems that as I walked into the room, a certain family member consciously or sub-consciously deemed me the one they would unleash all of their anger upon.

I remember entering a room once when the physician was exiting.

He looked at me and said, "Don't worry. They have already taken everything out on me."

One particular patient and family situation is imprinted forever into my soul. Each time I entered the room to check the n/g tube or answer the call light, the patient seemed tense. At all times, her family was present. Once I patted her hand and asked if there was anything she needed or if there was anything she wanted to talk about.

She smiled and began to say that she knew she was very ill but that her family would not let her talk about it. Three family members were present and immediately came to her side to tell her to be quiet that she would get well and go home. When she did not look at them but spoke only to me, they asked me to leave. I did so. I think that confronted with a similar situation now I would stay and at least try to talk with the family about the patient's needs.

The next day she called me to her room. Her family had left to eat breakfast. I pulled up a chair to sit down beside her and took her hand. She immediately began telling me that she was dying and knew it but that her family would not let her talk about it.

She said she did not have anyone else she could talk to and would I please listen. I assured her that I would listen. She told me she wished she had done certain things in her life instead of just been a caretaker.

She had lived a life to please others and told me of things she wished she had done regarding trips, sailing, and completing her education. She expressed anger that her family would not step in to be with her in a real way as she faced death, but added that she understood they had only learned to use her for themselves and that she had allowed it.

As she continued to talk, she cried some; she thanked me for listening to her, deeming my listening as a gift. As the family entered the room to observe us holding hands, both with tears in our eyes, their anger erupted onto me. They asked me to leave the room and to not return. I was reported to the nursing supervisor as having interfered in their family life.

Although I was gently admonished by management, it was acknowledged that perhaps I had done a good thing. The next day the physician, a very business-like gentleman, came up to me, gently put his hand on my shoulder, and said, "You did the right thing."

I am glad I did the right thing in spite of having been reported by the family and being gently admonished by management. I think that I did help the lady have a better death which added to her quality of life.

Trying to be an RN again. I have taught piano and subbed as a secretary in the local elementary and middle schools.

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15 Comment(s)

They probably couldn't stand to see her pass away because it is always so awful to lose your slave.

josh1974, LPN

Specializes in LTC/Subacute.

That's what we do.

CABRN55

Specializes in PACU, HIGH RISK OB, EARLY CVTRANSPLANT.

Regardless of how management or the family viewed what or how you did your job, your actions epitomize "patient advocacy". Bravo! And Thank You!

Unfortunately, denial is one coping mechanism that families employ. The woman was lucky to have you in her corner. You did a great service for her.

We just said goodbye to my dad this fall after 2 months with hospice. Happily, we were all on the same page, discussed all kinds of end-of-life issues, personal and medical. That communication was priceless.

Nurses are healers. You were a healer in every sense of the word that day. Well done.

That level of caring is what makes a 'real" nurse. How sad for that family. I work in an ICU, we see that same lack of caring, concern, understanding (or whatever) from family members way to often. Our society does not accept death as a part of life, but as an enemy to fight as long as possible.

lamazeteacher

Specializes in OB, HH, ADMIN, IC, ED, QI.

Children blame themselves for everything that happens in their young lives - parents' dicorces, even the death of a loved one. To a less obvious extent, adults do the same, especially during stressful times; and sometimes that fact is hidden deep down, hidden even from themselves. That is self protection from that horrible realization - and that others, while deeply effected by self judgment have yet to open that "Pandora's box".

As nurses we experience patients and families' aberrant behavior, yet we have to resist judging them and realize that coping measures have been well established before we entered their lives. Knowing where they stand enables us to work with them; and reflect back what they say and do, for their own edification.

It's a technique called active listening, which has been found extremely effective in dealing with children and adults. It can be presented to adults as a, "Let me see if I got that right......." statement, and then review the point they made. Believe me, they'll correct you if you get it right, ammending their stance to a more favorable aspect.

In the situation presented in this thread, a nurse faced with a family such as the one portrayed, could say to a family member who is less aggitated, kindly, "Do you think (the patient) can't deal with knowing her situation?" Or ask the leader of the response to your action, if he/she might like to step outside the room for a moment, and then review what they want you to do, as if you really don't understand it and want to improve in their eyes. Being humble goes a long way in communication.

Monday morning "quarterbacking" is insightful, and it helps one deal with the next situation where the situation comes up again, which it will.

Listening to what a patient wants to say especially when no one in the family can is what nursing is about. The time you spent with her hopefully gave her some peace. Knowing that another human being had heard what the family could not hear is truly the greatest gift you could have given. Bless you for taking that time.

HeavensNurse

Specializes in Hospice. Has 14 years experience.

You did a GREAT job listening to what your patient's NEEDS were. I have worked hospice for about 20 years and helping someone at the end of their life with closure is very important. It is sad when families turn a deaf ear to their loved one's needs. As a nurse we are advocates and at times become friends. This can happen very quickly. I truly believe what you did for her was one of the biggest gifts she had received in her life. You may want to consider Hospice as your calling. God Bless!

I actually earned a divinity degree and became a chaplain. I work in a University Medical Center with at Level I Trauma Center. Thanks to all.

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience.

I actually earned a divinity degree and became a chaplain. I work in a University Medical Center with at Level I Trauma Center. Thanks to all.

Are you doing this now instead of nursing or as an extension of nursing?

For 3 years I worked part-time as a nurse and part-time as a chaplain. For the last 3 months I have worked only as a chaplain -so I am doing this instead of nursing. I did not want to move away from bedside nursing and it was becoming too difficult for me physically as well as not being able to keep up with the mounting customer service demands. I feel I provided good customer service but have noted it was never enough and I began to feel I was going to miss something clinically being nurse, technician, and, increasingly, a customer service representative.

FineAgain

Specializes in ED; Med Surg. Has 7 years experience.

I have always told people that I believe helping a person ease out of life is just as much a privilege as helping a life come into the world. I became a nurse after my mother died; I will always remember the nurses being there for the whole family and helping my Mom as she went on her last adventure. I try to do the same for my patients and their families. This made me cry -- thank you for doing that. Hugs.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 41 years experience.

Sometimes you need to love someone enough to let them go.....