Dealing with families and dying patients

[Faust09]

Hi, I'm a new RN. Today, I had a dying elderly patient to look after and the family was in the room. As I passed in the hallway, the daughter of the resident called me and asked if her mother (the patient) will make it through the night (I was doing nocte shift). She asked if the patient is going to die soon as she plans to go home to look after her young son. But she also wants to stay with the patient's side so she can be with her mother while she dies. The thing is, I remember in my BN course study that one should not to make such opinions, especially about whether a patient is going to die or not, to families. I only told her "I'm sorry, I'm not sure. I wish I knew. I can't really tell. It can be unexpected." To make the story short, the daughter decided to go home eventually, but I can tell her face that she's really worried.

I wasn't really sure what I was answering. I felt 'blank' at that moment. The daughter kept asking the same question, but the only thing I can think of is "I don't know" - eventhough I feel that the resident can die any time in my shift.

How do you answer if a family asks such question?

[amoLucia]

You knew the right answers. This is one of those grey areas for nsg staff to deal with. It is so hard to talk with families at this time. They want concrete answers and have such a hard time handling the non-specific.

I would NEVER, EVER say this to someone but I always think that the pt could just as easily pass away when the family leaves to go to the bathroom. There's just NO way of telling.

Sadly, I have had pts pass away just minutes after the family scoots home for a quick shower or family details. The pt was otherwise status quo - no inclination that they would pass just right after family left.

Even though I had no control, I feel so sorry (and guilty) for the family. That's why I never commit.

[loriangel14, RN]

You gave the right response.I always tell them there is no way of knowing the answer to the question they are asking.

[Pangea Reunited, ASN, RN]

There really is no way to know. If the family feels guilty about "running home" for a bit to meet other obligations, I let them know that I will check on their loved one very frequently. It helps if the family doesn't see the patient as being left "alone".

[jennycRN]

You did the right thing--- you had no answer and did not pretend to. I took a class in palliative care which helped me a lot with communication with families. So I definitely do (gently) let families know that their loved one could pass while they are in the bathroom! I tell them something like... 'If your mom needs you to be with her when she passes, she will wait until you come back. If she needs for you not to be at her side, she will wait until the one moment when you leave the room.' And then of course I add that I will be checking on their loved one frequently.

I have seen dying patients pass when even very attentive family members leave for just minutes to meet their own needs. I feel like if I can prepare families for this possibility in advance, it can help them feel a little more at peace with the outcome if they are not present.

[Faust09]

Thank you for the responses. I guess the daughter was kinda guilty that she have to leave her mum dying. There was no way of telling when a person's going to pass away indeed. Thinking back, I wish I could have said something better. Nevertheless, the answers provided me insights on what to do/say next time when such event happens again. Cheers again everyone!