Today I had a weird moment and I'm in bed right now and I can't help but think back on it and kind of feel like i didn't handle the situation properly. I have a quadriplegic patient and he is fairly young and due to his tumor on his spinal cord he is in this situation. I think he has a fairly good outlook on things but I think he gets bad days which is okay. The family is fairly present and every time I come in the room, they always ask me what the medications are, which can become annoying after a while since they are always the same but expected as they are concerned. Today, I brought him the Pro-Stat, he hates it (like most of my patients) and he asks me what is it for. I tell him it is a protein supplement and encourages healing. Then he says, will it get rid of my tumor? I was shocked that he asked that and I blurted stupidly no. Mom was at bedside and she said why did you tell him no, it could diminish the size or encourage healing or something. She insisted that I should have said it will help the tumor. I was in a bind at that moment, I tried to backtrack. I said it is a supplement, it won't heal him but it allows him to remain healthy, keeps albumin at a good range and all that stuff, but I couldn't say it would affect the tumor because that would be a lie. I tried to direct the conversation away from the topic but I drew a blank. The family and the patient weren't overly upset or anything. They don't seem as if they're lingering on the topic as I interacted with them throughout the day. But I just can't let it go. It might seem like something small but I felt like I was really insensitive to say no like. It just won't let me sleep tonight. I mean did I make an already hard situation worse for someone?
thoughts are welcome. Sorry for the extreme length, I just needed to talk about it, I guess.
You sort of left off the qualifier she expressed at the end of the sentence. This is her complete sentence: " The family is fairly present and every time I come in the room, they always ask me what the medications are, which can become annoying after a while since they are always the same but expected as they are concerned." We all have dealt with patients/families that have annoying but understandable behaviors. Finding them annoying, in and of itself, isn't us making it about us it's just a normal reaction. How we respond to it makes the difference. I'm having a hard time seeing where, in her interaction with the family when she was caught off guard, she made it about her. It sounds to me like she was simply being honest about the medication without giving false hope but also without publicly calling them out on their denial either. Lying to patients and families isn't giving them emotional support and certainly will destroy the trust relationship when the lie comes out. It certainly sounds to me like she was supportive in a very difficult situation. As for advocating for the patient. We really don't know that that wasn't already done or at least in the works and it isn't germane to the discussion about lying to patients. I'm interested in hearing why you feel the OP made it about them because I just don't see it.
The "qualifier' of expected does NOT change the fact that OP is "annoyed".
A nurse that is ANNOYED with questions, whether or not they feel that gave the right answer... is making the issue about them.
A nurse can't be "annoyed"? I confess to regular feelings of being put out, annoyed, peeved, ticked etc as well as being joyful, grateful, sad, and all the other emotions that make us human.
What is so wrong with a nurse focusing on her own emotional needs and pondering important questions after work?
I just re-read and this time around it doesn't sound like a genuine question but more of a type of defeatist sarcasm. I'm not sure his age but maybe he wasn't looking for the answer he already knew.
I didn't mean annoying as in I mind, maybe a different word could be used. I don't mind answering questions. It's a little much if i'm having the exact same conversation every single day. I guess i did make it about me but honestly i mostly felt guilty about the conversation and that i answered him too harshly.
Thanks you are right. I think he has a serious understanding of his disease process and he was just joking. I think the problem was with me and me feeling bad about his situation and being awkward about it. He is young and its really my first time interacting with someone so upbeat and still so sick. It was a weird moment that i couldn't get out of my head.
"they always ask me what the medications are, which can become annoying ".
The family is seeking emotional support. The reason you can't sleep is because you made the issue all about YOU.
Instead of forcing something on the patient that he hates, advocate for him and discuss alternatives with the physician.
I didn't mean annoying as in I mind, maybe a different word could be used. I don't mind answering questions. It's a little much if i'm having the exact same conversation every single day. I guess i did make it about me but honestly i mostly felt guilty about the conversation and that i answered him too harshly.
You gave the correct answer. The moment you lie to the family and they find out about it is the moment that family loses faith in you as a nurse.
Sometimes we can't give our families what they want to hear, but we tell them what they need to hear. It helps them work through that grief process, and that can be just as healing. Getting them to the point where they can accept what is happening allows them the ability to plan for the future.
Don't overthink it. You did your job as a nurse.
Thanks. I think its a problem with me I tend to overthink things and worry over my day. I'm told that its being on the fast track to burning out but i can't turn it off. I worry about what i could have done better and i try to plan for the next day to avoid making similar mistakes. I honestly think it was me being taken off guard about being asked that question. I think he knows more about his disease process than i do and that he has accepted it but to me as a fairly new patient of mine, i feel like our interaction are filled with minefield since i'm not sure where the emotional triggers are since they aren't the obvious ones you would think in such a situation.
Overthinking and worrying is pretty normal in a new nursing career; just be sure to think about the things you did right, the times you felt competent and in control, in short, give yourself credit for doing a good job! The many correct things that fill up your day will far outnumber the one or two gaffs you think you might (!) have made.
1. Nobody died!
2. I got all my meds done in a timely manner.
3. I held somebody's hand when they needed it
4. I helped a coworker.
5. I noticed someone in pain, and helped relieve it.
6. I got someone some snack/juice/food they liked.
Get the idea? dwell on positive stuff!
And your original response was spot on... no to the tumor yes to good health.
You did absolutely the right thing in not lying to the patient and his family. You were able to explain correctly what ProStat is and why it was prescribed. The only possible thing I think you could have done differently is to suggest taking to the caregiver that prescribed the ProStat to explore alternate options if the patient hates the taste that much.
Honesty, although not always pretty, is usually the best policy (unless your best friend is asking if this outfit makes my butt look fat - then lying is okay). This patient's mom may be okay with lying to her son, but you are a medical professional. Imagine if the patient told other staff you said it would get rid of his tumor? What then?
Mom sounds like she has much to come to terms with. This is her dilemma to deal with, and it's a lot. Some people can be inappropriate when facing down the Big Bad under pressure. I can't always say I have handled insurmountable events with aplomb and grace - even if I wish that were so. This has nothing really to do with you my friend.
I know family can complicate patient care at the worst of times, but you answered honestly, then added some tactful - and truthful addendums. You saved a sticky situation with intelligence, and it sounds like you satisfied everyone with your response but yourself. We can't always please everyone as you already know. You didn't mess up. Give yourself a break.
Just gotta say I wish I had the emotional control of some of the other posters here. I can't seem to control whether I get annoyed or not. I wish I could I'd be a much happier person and I'd like being a nurse a lot more. I spend at least 60% of every shift being annoyed about something, and some nights, it's a lot closer to 100% of the shift. I get exhausted being annoyed all of the time, not to mention the constant shoulder pain from tensing my shoulders all night.
...I still get the "You're such a wonderful person and so kind!" compliments from the EXTREMELY annoying family members at least once a week, though, so I guess I hide it well.
OP - you handled the question the best you could. You can only do what you can do, or as I like to say to my coworkers often, "But what do I know? I just work here." We can't fix patient/family communication with physicians. We can't fix denial - and sometimes the denial is so strong it makes me want to never go back in the room, knowing what I know. All we can do is be honest about what we are doing, and try to keep our pretty smiling actress faces on so nobody knows how frustrated we get dealing with everyone else's emotional stress as well as our own.
Been there,done that, ASN, RN
7,241 Posts
The "qualifier' of expected does NOT change the fact that OP is "annoyed".
A nurse that is ANNOYED with questions, whether or not they feel that gave the right answer... is making the issue about them.