I have been a rn for almost 9 years, i have always worked cardiac and seen alot of codes and my share of dying patients. I know all people respond to death differently and i try not to judge people but last night experienced something so bizarre.
We had a patient that was infarcting since saturday, she refused intubation and made herself a dnr but will allow chemical code. Our cardiologist told her she needed a heart cath to determine the damage, totally refused everything. Family from everywhere came, even as far from tennesee was there yesterday, they were aware of her decision and how the doctors felt.
At one time i swear there were 20 people in the room and more filling up the waiting room. They left about 5pm and i told them one or two may stay with the patient if she liked them to, they left saying to call if she needed them. About 830pm patient was having hallucinations, confusion, o2 sat at 95% on 2liters. I told respiratory to give her a treatment that was due. She was crying for her family to come. I called her son, asked them to come in to stay perhaps for a few hours. They were reluctant, and said the son would come to stay for a hour or so...They lived 5 minutes away, he never showed.
At 1005 patient went into vent tachcardia and after all means to resucitate patient allowed per protocol patient went into v-fib and asystole. One of the nurses called the family and told them of a perhaps lethal arrythmia happening to the patient, they said fix the arrythmia and call them in the morning. When the family was made aware by the cardiologist she was gone, they all came in and was screaming, throwing thmselves on the bed
I cried all the way home, i know as a nurse we did everything we could legally allowed to us. Why do i feel so bad?
Specializes in Med/Surge, Psych, LTC, Home Health.
I was thinking the same thing as RN4NICU... strange that it seemed like the family couldn't be bothered with anything until the patient died; THEN they showed all that intense, dramatic grief. But, like someone else said, maybe they were just in intense denial until the very end. Still, strange.
When I was still a tech (thank goodness, NOT this patient's nurse), I helped care for an elderly African-American gentleman who was dying. The patient was a DNR; the family had agreed to make him a DNR, etc.. Well, when the end came, his daughter panicked and demanded that we do something, save him right away! Well, with the house supervisor's consent, (and after she quickly spoke with the family) we did end up coding him, but he ultimately died. The daughter screamed, cried, threw herself around, all of that. Then she kinda calmed down and seemed to accept the situation.
Sometimes guilt accentuates grief. Various cultures display grief in various ways. We just had an experience last week where we had to pick family members up off the floor and call for help with managing the crowds.
I'm trying not to judge here too, but what a bunch idiots.,to stop her care or prevent the ability to try and save=then act as if. as if they did everything they could,maybe they had to act like they cared so much by acting like they cared more than they did. how awful
I have been a rn for almost 9 years, i have always worked cardiac and seen alot of codes and my share of dying patients. I know all people respond to death differently and i try not to judge people but last night experienced something so bizarre.
We had a patient that was infarcting since saturday, she refused intubation and made herself a dnr but will allow chemical code. Our cardiologist told her she needed a heart cath to determine the damage, totally refused everything. Family from everywhere came, even as far from tennesee was there yesterday, they were aware of her decision and how the doctors felt.
At one time i swear there were 20 people in the room and more filling up the waiting room. They left about 5pm and i told them one or two may stay with the patient if she liked them to, they left saying to call if she needed them. About 830pm patient was having hallucinations, confusion, o2 sat at 95% on 2liters. I told respiratory to give her a treatment that was due. She was crying for her family to come. I called her son, asked them to come in to stay perhaps for a few hours. They were reluctant, and said the son would come to stay for a hour or so...They lived 5 minutes away, he never showed.
At 1005 patient went into vent tachcardia and after all means to resucitate patient allowed per protocol patient went into v-fib and asystole. One of the nurses called the family and told them of a perhaps lethal arrythmia happening to the patient, they said fix the arrythmia and call them in the morning. When the family was made aware by the cardiologist she was gone, they all came in and was screaming, throwing thmselves on the bed
I cried all the way home, i know as a nurse we did everything we could legally allowed to us. Why do i feel so bad?
I agree that there is probably some guilt about not visiting when she needed them. And family dynamics are so complex - you often never know all the little things that make families seem dysfunctional in their grief. They may have had other recent losses - grief tends to build up. Other past issues - like abuse, for example, impacts families grieving.
One of my most dramatic death events as a hospice nurse was the elderly lady who threw herself on top on her husband, screaming to me "bring him back, bring him back!" This went on for about 30 minutes - seemed like an eternity. I would never have expected her to do that, and it was made more difficult because there were adult grandchildren present whom I had never met and knew very little about hospice. Naturally, they wanted me to perform CPR and call 911 - and were very upset at their grandmother's condition. I focused with them on what the patient wanted - he chose to die at home - he didn't want to be resucitated because he had terminal cancer and simply couldn't continue to live with any quality even if we managed to resucitate him. What made this normally rather private, quiet lady go off the deep end? I think it was because his death meant that she had to sell the house they lived in - she had no means to continue living there. She felt she was in immediate financial peril. The hospice social worker was helping her with these difficult issues, but the death came before things were worked out. She needed him to live longer and that was how she expressed it. I sat next to her and the patient, touching both of them and talking to her in quiet tones. I never removed her from him. She eventually calmed down and got up. She needed to do what she did and not be made to feel it was wrong.
She ended up moving in with a daughter in another state. Her house was on the market for a while, but finally sold.
Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
Perhaps what was so bothersome to the OP (it was to me when I read it) was that the family apparently couldn't be bothered while the patient was still alive - AEB: staff calls to let family know pt was asking for them and they didn't come in, even though they said they would; they were notified of a very serious dysrhythmia and they pretty much blew it off (fix it and call them in the morning?!); QUOTE]
That could've been denial more than uncaring attitude, though.
i think it was my mom (who is a nurse) who told me she read in a sociology book that in some cultures the louder the screaming/fuss you make after a loved one passes...it is supposed to signify exactly how much you loved them and are grieving. could this be what happened? the family may not have been upset with your care...it was just their way of showing how much they loved this woman.
i hope this helps!
I think in ancient Greece they hired "cryers" to scream, pull their hair and beat their chest to make the families feel better.
I have been a rn for almost 9 years, i have always worked cardiac and seen alot of codes and my share of dying patients. I know all people respond to death differently and i try not to judge people but last night experienced something so bizarre.
...She was crying for her family to come.
...he never showed.
... perhaps lethal arrythmia happening to the patient, they said fix the arrythmia and call them in the morning.
...I cried all the way home, i know as a nurse we did everything we could legally allowed to us. Why do i feel so bad?
Jane,
I am sorry for you. It is no surprise to me that you feel so bad. This family put on the display of care and meaning yet, when it really mattered, REALLY mattered they showed the true depth of thier concern.
This is very sad. The patient and family knew she was dieing, she only asked for their companionship as she died and they snubbed her!!
Crocodile tears? For display.
I agree that meaningful deeds are done versus just for display.
Sorry for this patient that the family could only put on the front of care.
I also understand that yes, some cultures have passing customs that involve much display yet, this poster was talking about the sadness of a patient who had to die without the comfort of her family, which she saught and the declined, (yet, lived five minutes away?)
If one of my parents, children etc. died I think I would have the exact same reaction. I think it's the one time you're allowed to act out. Grief is so personal, I don't see how someone's reaction could be "overdramatic".
I think you felt bad because you witnessed such raw emotion at the loss. Losing a patient, no matter what the circumstance, never gets easy.
I think she classifies this reaction as overdramatic becasue of the fact that the family didn't seem to give a crap that the patient was dying until she was dead... If their family member was so important to them, why did they seem indifferent when she was going downhill? This family's reaction might seem normal if they had seemed to be concerned at news of the patients worsening condition. I don't think she is saying the reaction in and of itself was overdramatic, but that it seemed over the top given the family's previous behavior.
I think she classifies this reaction as overdramatic becasue of the fact that the family didn't seem to give a crap that the patient was dying until she was dead... If their family member was so important to them, why did they seem indifferent when she was going downhill? This family's reaction might seem normal if they had seemed to be concerned at news of the patients worsening condition. I don't think she is saying the reaction in and of itself was overdramatic, but that it seemed over the top given the family's previous behavior.
I read through her entire post and she stated that family came from as far away as Tennesse to see this patient when they learned how sick she was and that at one point, "as many as 20 people filled the room". That indicates to me that they in fact, DID care. It was only in the end that she called the son and he didn't show in a timely manner, for what reason we do not know but I think it is a leap to assume that he did not care. It is quite possible that he did not understand that this really was it. I have been in the room with patients and their families, I have heard physicians explain to them that the chances of them recovering are less than 30% and I have seen the families turn to each other and say "Did you hear that? He said Mom has a chance of beating this thing!" The point is that you can't judge people by a few hours that you spend with them out of a lifetime and we do not know that this family did not care for Mom so it's wrong to look down your nose at them just because they did not act in a manner in which you approve.
NurseCard, ADN
2,850 Posts
I was thinking the same thing as RN4NICU... strange that it seemed like the family couldn't be bothered with anything until the patient died; THEN they showed all that intense, dramatic grief. But, like someone else said, maybe they were just in intense denial until the very end. Still, strange.
When I was still a tech (thank goodness, NOT this patient's nurse), I helped care for an elderly African-American gentleman who was dying. The patient was a DNR; the family had agreed to make him a DNR, etc.. Well, when the end came, his daughter panicked and demanded that we do something, save him right away! Well, with the house supervisor's consent, (and after she quickly spoke with the family) we did end up coding him, but he ultimately died. The daughter screamed, cried, threw herself around, all of that. Then she kinda calmed down and seemed to accept the situation.