what can I say to a family member?

Specialties Geriatric

Published

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?

Specializes in Medical-Surgical.

I disagree...I'm not advocating sobbing all over the place all the time, but sometimes, you get overwhelmed, and being human, sometimes we cry. She went into a supposedly private room to try to get herself together...OP wasn't crying in front of patient or family.

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Specializes in critical care/ Hospice.

I think you are wrong. Very wrong......there is a need for "limits" on invasive care with re: end of stage diseases...and for persons in their 90's with multiple comorbidities....selfcare deficit, mult cva's, MI, non compliant IDDM, obesity, cancer with mets, COPD, dementia, parkinsons, chronic falls, chronic aspiration...the list goes on, and believe you me I have had a single pt with all the aformentioned process's at the same time, at many times. There needs to be a limit.

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I have been a nurse for 25 years and still I have not developed "thick Skin." I have a hard time watching family members say goodbye to their loved ones, many times having to fight back tears and have even let them come when the family is crying. I apologize but they seem to understand and appreciate, that their loved one, and them are cared for. We are nurses, but we are also daughters, sons, mothers and fathers. We have also suffered loss and know it is not an easy time for anyone.

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Specializes in Gerontology, Med surg, Home Health.
I think you are wrong. Very wrong......there is a need for "limits" on invasive care with re: end of stage diseases...and for persons in their 90's with multiple comorbidities....selfcare deficit, mult cva's, MI, non compliant IDDM, obesity, cancer with mets, COPD, dementia, parkinsons, chronic falls, chronic aspiration...the list goes on, and believe you me I have had a single pt with all the aformentioned process's at the same time, at many times. There needs to be a limit.

I don't disagree that people need to be realistic about the outcomes of treatment and their quality of life, but it isn't up to YOU, ME or especially the Government to decide how much is enough. First they will deny treatment to really old people and then perhaps to someone who is not so old but perhaps who is mentally challenged. My family knows what I want when it comes to end of life care and I think they will do what I want (no pain, no thickened liquids or puree, and a glass of wine at the bed side). I do not need the government to step in.

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Specializes in critical care/ Hospice.

It's just that I have too often seen pt's wishes not carried out, and extreme measures instituted against pt wishes...disgusting...and the flip side; a pt clearly circling the drain and he/she "wants everything done" when the best thing to do is hang a MSO4 gtt! an exercise in futility, painful, degrading and unecessary.

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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

How does crying in a med room help? It can allow a good nurse to discharge a build-up of emotion (that she will address later when there is time) in order to go back into the difficult situation. It can give her a moment to gather her wits about her so she will be able to redirect her energy toward her patient and the family. It can help her to strike a balance between being human and becoming insensitive to life's unpleasant realities and their effect on patients.

It isn't unprofessional to have feelings on the job if they are proportionate to the situation if they are managed properly. Taking a few minutes in a private place to regroup can actually improve performance and capability.

Nobody wants a weepy Winnie hiding out in the bathroom every time she sees a patient suffering, but hard-hearted Hannah isn't a good alternative either. We aren't appliances. There will be experiences that affect us for a variety of reasons. Acknowledging our own needs and taking care of our patients doesn't have to be mutually exclusive, and one can even enhance the other.

That "thicker skin" will come with time and seasoning. But take care to avoid the occupational hazard in which the thicker skin leads to a hardened heart that can end in burn-out. The trick is to hang on to your humanity (which means you might cry from time to time) while developing a practical protective shell that allows you to function efficiently--a tough balance to find and maintain, but one which is well worth the effort.

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Specializes in cardiothoracic surgery.

I agree that the government shouldn't intervene in end of life issues, but I strongly believe that we try to treat people that should be in hospice. Why? Is it because we have the technology to prolong people's lives when this may not be in their best interest? Is it because doctor's aren't straightforward about the patient's prognosis? Is it because society views death as something terrible, when in fact everyone has to die at some point in time? Or is it because patient's and families don't understand the illness and prognosis and demand everything be done no matter what? I work on a cardiothoracic floor taking care of CABG's. One too many times, I have seen patient's have surgery and then their obituary in the paper 2 months later. Now, maybe their death had nothing to do with the surgery but it makes me wonder. Is it ethical to do a CABG on an 85 yo with other cormorbidities? I think a lot of times the patient just thinks "well they are going to fix my heart and then I will feel better" I sometimes think they have no idea what they are getting themselves into and are not aware of the possible consequences. I remember a patient, in her 80's, and her family pretty much talked her into having a CABG. She died a few months later from complications. Patients and families are undereducated when it comes to these issues. Just some thoughts, I could go on and on, but I am getting off topic.

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Everyone has gotten off track here. No, one has answer her question. . . . . What can I say to a family member??? It is a valid question . . . how about . . . I care for your father. I feel frustrated that I am unable to control your father's pain and help him breath more comfortably sometimes releasing a bit of stress allows me to think more clearly and come up with alternative plans to help my patient.

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Specializes in critical care/ Hospice.

again...will they honor your wishes??? TOO often seen person's wishes completely ignored...assault if you ask me.....just be sure your HCP has the balls to standup against family that are out of control.

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She had no business in the med room. I'm tired of family members who think they have any business behind the nurses station, in the med room, in the break room etc. Do they go to hotel lobbies and start poking about behind the desk, to shops and fumble around behind the register?

I would have told her if she ever went in the med room again I'd call the police and have her for trespass............OK, maybe I want to keep paying my mortgage too.

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Specializes in LTC, Hospice, Case Management.
How does crying in a med room help? It can allow a good nurse to discharge a build-up of emotion (that she will address later when there is time) in order to go back into the difficult situation. It can give her a moment to gather her wits about her so she will be able to redirect her energy toward her patient and the family. It can help her to strike a balance between being human and becoming insensitive to life's unpleasant realities and their effect on patients.

It isn't unprofessional to have feelings on the job if they are proportionate to the situation if they are managed properly. Taking a few minutes in a private place to regroup can actually improve performance and capability.

Nobody wants a weepy Winnie hiding out in the bathroom every time she sees a patient suffering, but hard-hearted Hannah isn't a good alternative either. We aren't appliances. There will be experiences that affect us for a variety of reasons. Acknowledging our own needs and taking care of our patients doesn't have to be mutually exclusive, and one can even enhance the other.

That "thicker skin" will come with time and seasoning. But take care to avoid the occupational hazard in which the thicker skin leads to a hardened heart that can end in burn-out. The trick is to hang on to your humanity (which means you might cry from time to time) while developing a practical protective shell that allows you to function efficiently--a tough balance to find and maintain, but one which is well worth the effort.

Beautiful!:heartbeat

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Specializes in Med-Surg, LTC.

Thank you healer65, that was so eloquently put. I am a caring person, that's why I became a nurse in the first place. I also understand the need to be professional, which was why I went to somewhere private, which turned out not to be. I appreciate that this forum is here to get some other opinions and advice on how to handle situations.

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