Denial

[SuesquatchRN, BSN, RN]

Same one I've had trouble with.

Loved one in end-stage cx. Mets everywhere. Intubated a few weeks ago. Finally a DNR. Not eating, not voiding.

POA had us stop the MSO4 because that's why the loved one isn't eating.

[CapeCodMermaid, RN]

"Please don't give Mom (Dad, auntie, sis,,,) pain medication. It makes her too tired to talk to us."

Doesn't it fry your nose (thank you Mumbles Menino) when selfish family members care more about their needs than the needs of the sick person?!?

[SuesquatchRN, BSN, RN]

POA still does. not. get it. DYING. We can't cure mortality, people.

[NotFlo]

This is one of the worse, most heartbreaking situations I face at work. It disturbs and upsets me more than anything else.

[Jolie, BSN]

OMG!

Can you legally refuse to comply with this request (which is clearly NOT in the best interests of the resident) while you await the arrival of Adult Protective Services?

Please, Dear God in Heaven, help the staff to help this precious soul.

[ObtundedRN, BSN, RN]

All I can say is to continue being the best patient advocate that you can be. And make sure you get the MD on the same page. When you talk to the POA, make sure that you don't sugar coat anything. Use the blunt words that many people find harsh. Many times people just don't get it until you use the cold blunt words. They are going to die soon. They should be made comfortable.

Good luck with your situation. I hope the POA comes around and lets their loved one die comfortably like everyone should be able to do.

[SuesquatchRN, BSN, RN]

I have used the blunt words and am thankfully on another unit. Their response about me? "I can't talk to her. All I ever get from her is that xxx's terminal."

They have retained permission to use it in certain instances.

I can do no more. Without getting detailed, the matter has become official, although we have not been found lacking.

[SuesquatchRN, BSN, RN]

Oh, the MD has been trying desperately to get through. And documenting as much as the nurses.

[tewdles, RN]

sad cases...and until we change the way we talk to people about dying and the reality of having life limiting chronic illnesses in the months and even years before death is inevitable, we will continue to deal with this phenomenon over and over and over.

There is a reason that the last 6 months of an elderly person's life are the most costly in terms of medical care...and the ability of nurses and doctors to talk realistically with patients and families about these issues is a big part of the reason.

[JB2007, ASN, RN]

OMG!!! Now I am banging my head against the wall! This is the kind of thing that just makes me want to shake the crap out of some of these resident's family members! I just want to tell them that I know they love their loved one, but the best way to show that is by letting the loved one go comfortably. GRRR...

[nhelkhound]

As a board certified hospice RN I have come upon similar situations many times. As the late Dr. Kuber-Ross has written, each individual works through their own stages of grief at their own pace. Sadly, many family members have not completed this grief work as the patient is actively dying. Is Hospice involved with this case? There is more work to be done here than one or two individuals (or disciplines) should or can handle. I have found in my practice that TONS of education is a key in helping the families make informed decisions. As for dealing with our own thoughts and emotions, as difficult as it is, we must keep in mind that ultimately it is the patient and family's choice how to face the end of life.

My thoughts are with you.

[Copper4]

Is that something that can be detailed in a living will? i know I need to put my desires in writing, my husband will totally not get it. Good luck with this case. We have a resident with very debilitating MS, they were just able to extubate her , again, spouse just cannot let her go... so sad.