what can I say to a family member?

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Specializes in Med-Surg, LTC.

I recently had a situation with a gentleman who was a full code and in respiratory distress and an obviously enormous amount of pain. Because of various decisions by the family and the MD we couldn't get him enough analgesia and we couldn't help his breathing. I was upset by the situation and went to the med room so that no one would see me crying. The patient's daughter barged into the med room, saw me crying and walked out, but a little later, once I had recovered and was talking to her, said to me, "You know, I know you have a hard job, but maybe in a few years you'll develop a thicker skin". I didn't say anything. Now, what I wanted to say was, "I think that the fact that I care about my patients makes me a better nurse". Would that have been an inappropriate thing to say to a family member?

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Specializes in Gerontology, Med surg, Home Health.

She was inappropriate to come into the med room and I wouldn't have hesitated to tell her that. I would refrain from the other comment however. She doesn't really care about you or the kind of nurse you are with anyone other than HER family member. For your own sanity, you need to develop a thicker skin. You can't save everyone...you can't fix everyone...there is not always something to 'do'. Sometimes doing nothing is the best. Good luck with this.

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Specializes in Pulmonary, MICU.

It is a great thing that you care for your patients, but thicker skin is necessary. The problem wasn't with her and her family member...the problem is with a society that is too attached to their loved ones, afraid of death/dying/abandonment, and simultaneously undereducated in terms of health care and physiological processes. While it seems like it's just that family member with that patient...it's most family members with most patients, and one person can't change the health care problems that are inherent to society. A paradigm shift is needed and that's only going to happen at the political (mandating uniform limits of care based on age/comorbidities) and the cultural level. If you want to make a change in our system, nursing is a good background for it but clinical nursing is not the place to do it. Politics and/or activism and speaking. Informing the masses, not informing one family member at a time.

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First of all, you may need to develop a thicker skin to be in nursing. I certainly had to. Are you a relatively new nurse? If so, you will develop that thicker skin in time. One of my nursing school instructors told us in our first semester that you can't take anything personally in nursing. I really try to remember that if I have a difficult family member or patient (or doctor!) to deal with.

Second, why the heck do your patients families have access to enter your med room?? :uhoh3:

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Specializes in Med-Surg, LTC.

I guess I don't understand what's meant by thicker skin. I don't want to see someone suffering and NOT care about it. Hopefully one day I won't cry about it (this was more of the icing on the cake, so to speak, it was a horrible weekend, someone died unexpectedly, etc). but I never want to not be affected by someone else's suffering.

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Specializes in Cardiac care/Ortho/LTC/Education/Psych.

You know, I would say yes and no to getting thicker skin. I am working in Critical care floor and these situations are all the time there. Do I sometimes cry for my patients? Yes, I do I am human and I want to stay human. Do I sometimes take it as it is and try not to steer more than it is already steered and just watch and observe - Yes I do.

But, being nurse is not something that can be judged by one family member, or one manager or your friend - It is what you are getting from it and what you are putting into it. I cry and I am proud of it. I eat and talk about the wound I dressed and I am proud of that. I look into my patients' eyes and trying to read their light and their soul if I can not hear them talking - and I am proud of that. As long as your human reactions do not make you incapacitated you are safe, regular human being who is caring for other human being. I wish you can be my nurse when I need one.

:heartbeat:icon_hug::prdnrs:

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Specializes in Telemetry.

I have been a nurse for 1 yr and 10mos. I have yet to see a nurse cry about a pt. I don't see how you sobbing over a pt makes you a better nurse. No one wants to see a pt suffer. There is only so much that can be done. So, how does you crying in a med room help? You should be tending to your pt's and not sobbing in a med room. I think that it is totally unprofessional. jmo

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Specializes in cardiothoracic surgery.

I know nurses on my floor who have cried when they were super stressed out. They are not bad nurses and I don't think it means they need to develop "a thicker skin." Our floor can be absolutely insane at time and if crying helps to relieve some of the stress, then so be it. I myself have been near tears at times, usually when I am so swamped that I don't even know what I am supposed to be doing! I know we have to learn to not take things personally, but if the day ever comes when I stop caring about what happens to my patients then I don't want to be in nursing any more. I understand we can't save everybody and I agree with Be Moore that society doesn't understand death and that everyone has to die at some time. Sometimes I think people think their parents should live to be 110 and if they don't it is our fault! As far as that family member in the med room, how rude and inconsiderate! She was way out of line.

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Specializes in Gerontology, Med surg, Home Health.
It is a great thing that you care for your patients, but thicker skin is necessary. The problem wasn't with her and her family member...the problem is with a society that is too attached to their loved ones, afraid of death/dying/abandonment, and simultaneously undereducated in terms of health care and physiological processes. While it seems like it's just that family member with that patient...it's most family members with most patients, and one person can't change the health care problems that are inherent to society. A paradigm shift is needed and that's only going to happen at the political (mandating uniform limits of care based on age/comorbidities) and the cultural level. If you want to make a change in our system, nursing is a good background for it but clinical nursing is not the place to do it. Politics and/or activism and speaking. Informing the masses, not informing one family member at a time.

I am a patient advocate and don't like to see people suffering BUT...if ANYONE tries to 'mandate uniform limits of care based on age and comorbidities' I will march on Washington. What a horrible thought. NO ONE has the right to tell me or my family members we can't choose to keep treating what ever disease we have. End of life issues are very personal and DO NOT and SHOULD NOT be legislated.

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Specializes in critical care/ Hospice.

Thank you for such an elegant way of expressing how I feel, but could not quite express it as well as you. I would like to print your reply and post at work if you'll grant me permission. Thanks again:smokin:

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Specializes in Medical-Surgical.

It's unprofessional to have feelings? How callous.

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Specializes in Gerontology, Med surg, Home Health.

It's not unprofessional to HAVE them but could be to SHOW them.

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