end of life, please??

We are as honest and consistent with our information as possible. When that fails we move on to declaring medical futility. Families actually handle a finding of medical futility pretty well most of the time, I think in some situations it helps to take the responsibility and associated guilt of withdrawing care off the family's plate.

How does declaring medical futility differ from end-of-life?

I have struggled with the same feelings, nursbrooklyn. The physicians that I work with will use the futility term also with families who are struggling with making a decision. They usually phrase it as "mom isn't going to get better no matter what we do. Right now they are suffering. We need to change gears now and focus on making mom comfortable. We are going to start some medication to make her comfortable, and won't torture her with more tests. Once your family gives us the ok, we are going to remove her breathing tube."We take the decision and guilt out of their hands.

First. . . I can totally relate to your feeling of helplessness in such situations. Heck, I just simply don't like watching people die. I don't think I'll ever get used to it, or to the pain the family feels when their loved one leaves them behind.

Our hospital has "Comfort Measures Only" and, when the physicians check all of the happy little boxes on his or her computer screen (we've recently gone near 100% computer for everything. . . which is a topic all by itself!!!), the patient is cared for with "comfort only" measures (apologies for the redundancy). And, I believe, that our facility does a very nice job supporting the patient and the patient's family through this obviously difficult time. With all of that said, not all of our hospitalists does a thorough job (quite frankly) explaining to the patient's family the idea behind the concepts of "graveness" or "poor prognosis" or "futility". One of the hospitalists does. She seems savoy enough to explain to the family, without forcing their decision, the process behind dying and what prolongs the inevitable. She's wonderfully respectful but she's explicit.

Still. . . there are families that just don't want to put their loved on on "Comfort Measures Only" (although that seems rare now-a-days). It breaks my heart to see the slooooooooow and prolooooonged journey for the patient. I guess I just continue to focus on giving the patient as much comfort as possible (in addition to the IV fluids and the G-tube feedings, etc.), and continue to support the family. In the meanwhile. . . WE need to vent our sorrow and our frustration, or it WILL get to us. It has to me in the past. I'm in a better place with regards to watching the process (sometimes the slooooow process) of dying. But I don't think I'll ever get used to it.

Good thread. . . sad subject. . .

Check out this thread that was just started. It is tackling the same "ethics" issues that you are having difficulty with.

https://allnurses.com/general-nursing-discussion/when-care-equals-676484.html

Thanks for all the comments --- good links, especially in the other thread posted by EMSnut45!