Ever had a family overdramatic with dying patient?

gypsyatheart · Jul 21, 2005

I would hate to think what the staff at the ED thought of my sister-in-law less than 3 weeks ago as she wailed over the sudden and tragic death of her 16 year old son throwing herself on his lifeless body that laid still and bloodied on an ED guerney. After reading some of the responses in this thread, I wonder now what the staff thought of her kissing his feet and legs and begging God to send him back.
I also wonder what some people would think about my nephew's grandma screaming loudly upon her first viewing of my nephew's body at the funeral home: "How could he do this to us?" "How could he hurt us so bad?!?"
What's worse? The intense and debilitating display of grief suffered by my brother and his wife in the ED? Or was it the party atmosphere of the ED staff right outside their room? :angryfire
HOW DARE anyone sit in judgement anyone else's grief. Until you've been there, until you experience FIRST HAND a grief that has no word in a human dictionary to describe it, I beg you all to please accept people's reactions and coping mechanisms no matter who has passed away and no matter what it looks like.
Reactions to the OP in this thread are especially disturbing given the fact that we are the very professionals that those in a death/dying situation look to for normalizing feelings and behaviors. There is no right or wrong, acceptable or offensive. What they are is what they are.
Please, those who stand in judgement (and you may not think you are, but you are) of the family that is the subject of this thread, educate yourselves not only for the benefit of your patients and their families, but for a greater understanding of the grieving process for yourself, your loved ones, and your friends who may one day need that understanding.
Leslie, you dear, sweet woman. I don't know if you've ever mentioned the passing of your daughter before, but if you have, I missed it. I am deeply sorry for what has undoubtedly changed your life forever. And I want to acknowledge the grief you still suffer and will suffer for the rest of your life.
Have you ever heard of The Compassionate Friends? I contacted a representative of this organization a couple of days following the death of my nephew and hopefully my sister-in-law will attend her first meeting tonight. They are wonderful (I cannot express this enough), wonderful people.

Your post literally has me crying. I am so sorry for your loss and your family's! I, too, know loss of loved ones very well, it has been 1yr now since I lost my sister,, under very bizarre circumstances, I might add...so thank you for pointing out that none of us should be judging anothers' grieving process.

Perhaps the OP felt the way she did b/c she is human and also, most of us don't like to deal w/grief, death, loss. As if enough of us have not dealt w/it in our own personal lives, we also see death at work...it is constantly there...so when we see people re-acting in whatever way...it can make us feel uncomfortable. I know it is very hard for me, personally, to keep it together when we lose a mom or a baby....

This thread is too sad....compassion, folks, remember, compassion.

gypsyatheart · Jul 21, 2005

whoa, whoa, whoa!!!
since when can you compare a child's tantrum to a personal grieving process? yes, a tantrum does require interventions but loud, vocal grieving is nevertheless grieving and should be treated with the respect & consideration it deserves.
as has been stated, people manifest their grief in a multitude of ways- there is no right or wrong way to do so. trying to comfort a grieving person/family is probably the most appropriate intervention; and maybe closing the door as to not disturb the other pts. but it is not something to be judged or condemned. there is absolutely no room for such harshness as i wouldn't want to be judged if i lost my child, parent, family member- God knows i've been through it already, as many of us have. i went totally nuts when i lost my 6 yo dtr- NUTS! i wasn't even thinking of others' perspectives. it was gutteral, visceral and deeply, deeply heartfelt- my grief. dang, now we're going to start classes in training people on how to grieve? good grief.
leslie

Leslie, I can't even begin to imagine your pain...I, too, am so sorry for this loss. I have lost my father, grandmother and sister....but to lose a child...it tears my heart apart to think about it.

leslie :-D · Jul 21, 2005

I think wht most of "us" mean to express is the frustration at a family that could not express their love to a woman as she lay dying, or even just sit quietly with her...she was alone-with her nurses. Nurses that are HUMAN, by the way, not devine entities of peace and healing sent from the heavens. Humans, that are allowed to be frustrated, ticked-off, uncomfortable or creeped out-if that's how THEY feel.
That was a bad, inflammed situation, let's try to understand what everyone was feeling.

i think we need to be reminded that plenty of family had come aeb up to 20 people in her room and the waiting room becoming filled. it is more common than one thinks, to avoid being with a dying family member. again, i am a hospice nurse and have seen dozens and dozens of families avoid visiting their loved one while they lay dying. so i don't understand why pt's family is being judged so harshly.

i lost my dtr many years ago and i was ripe for im haldol and 4-point restraints- a total grieving, hysterical lunatic.

back to the point vickster, you need to understand the human dynamics of a family member's inability to be rendered incapable of sitting at the bedside of their dying loved one. it happens at least 50% of the time. i've seen every conceivable behavior working in hospice and nothing surprises me (except for that one time the son wanted his mom's body to be kept at the facility over the weekend so he could go antiquing in maine :rolleyes: ). i just don't understand why so many think this family was uncaring? a little compassion and insight goes a long way.

leslie

jansailsea · Jul 21, 2005

I am 50 years old. If some of you are under the impression I've reached this age without personal loss, you must be a young person. By my age, most of us have lost as a bare minimum,at least one very important, beloved individual in our lives.

As an example, twenty years ago, my kind & supportive grandmother died of anaphylactic shock in the hospital. It took 2 days of seeing her lying unconscious in Intensive Care, moaning in pain that was not whispered or hushed but could be heard by anyone who passed by her room if the glass door was open, before she passed away, her last breaths rattling loudly from her lungs as she died.

I still say your grief is your grief. And if I'm nurse to the patients in rooms around you, it will concern me how your behavior impacts their fears & worries for themselves or their family members or loved ones who are having to witness or be impacted upon by your grief. None of us are an island, what we do & how we behave affects others, especially if we do not respect the boundaries of others.

I'm sorry, I just do not think it is inconsiderate to ask people to close the door, express your grief how you must, but let your grief be shared with your family & loved ones, not strangers who are unwilling recipients.

PCloudy · Jul 21, 2005

:melody: that's one of the best terms i have heard lately. definitely could be used in numerous situations.

not to sound too crude on my first posting or anything; but i like to refer to that kind of a reaction as: "status dramaticus" :chuckle

begalli · Jul 22, 2005

I am 50 years old. If some of you are under the impression I've reached this age without personal loss, you must be a young person. By my age, most of us have lost as a bare minimum,at least one very important, beloved individual in our lives.
As an example, twenty years ago, my kind & supportive grandmother died of anaphylactic shock in the hospital. It took 2 days of seeing her lying unconscious in Intensive Care, moaning in pain that was not whispered or hushed but could be heard by anyone who passed by her room if the glass door was open, before she passed away, her last breaths rattling loudly from her lungs as she died.
I still say your grief is your grief. And if I'm nurse to the patients in rooms around you, it will concern me how your behavior impacts their fears & worries for themselves or their family members or loved ones who are having to witness or be impacted upon by your grief. None of us are an island, what we do & how we behave affects others, especially if we do not respect the boundaries of others.
I'm sorry, I just do not think it is inconsiderate to ask people to close the door, express your grief how you must, but let your grief be shared with your family & loved ones, not strangers who are unwilling recipients.

You just don't get it. These are exactly the types of attitudes that grieving people are taught or eventually learn how to deal with. Too bad those who are not directly affected by a death can't be more accepting for whatever grief is for a particular person and save the grieving person the extra and unecessary pain.

I'm not young, maybe youngish compared to a 70 year old. My 16 year old son has more of an understanding of grieving than some people in this thread do. He, along with my two daughters in their mid 20's, have experienced it 4 times in the last 8 months with close family members and we lost my son's 32 year old soccer coach 2 years ago. He was a good friend and mentor to my son. Not only was my nephew my son's cousin of the same age, they were friends since birth.

jansailsea, I think your nursing school has sorely let you down. Was there not at least one class on death and dying? Do your feelings come from having to endure the painful death of your grandmother? Have you ever really dealt with that?

It rips my gut out thinking that this may have been what was going through the minds of the staff in the ED as my brother, his wife and their 13 year old son learned of the death of their son and brother. My sister-in-law did say that when the doctor delivered the news, he was emotionless and made no gesture to try to offer comfort. The only time she felt any kind of compassion is when the nurse handed her a damp washcloth and mentioned that she might want to clean the dried blood off her face that got there by giving rescue breaths to her dead son. They didn't expect to have their hands held, but they did expect some respectful behavior, behavior that was completely inappropriate given the circumstances, from the ED staff.

At first, I wanted to share what I've personally been through with the death of loved ones in the past 8 months. I thought it would be helpful and cathartic coming to allnurses and writing it all out in it's own thread and reading the responses of some really great people/nurses. I thought for sure that I would find understanding and compassion here - maybe even a similar story. While the good far outweighs the bad here, I just don't want to have anything to do with this anymore. Like the death of my nephew has pushed me over the top, so has this thread.

Maybe I have personalized my posts too much. But it is personal.

I'm taking a break from allnurses, probably from nursing for a while too.

g'daymate · Jul 22, 2005

You are a feeling, thinking human being first, and a nurse second. No one of us knows when one is gong to influence the other.When you stop feeling over things that happen at work, its time to leave and get a job at Walmart.

God Bless and keep up the good nursing care.

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?

jansailsea · Jul 22, 2005

Dear "you just don't get"...you see, I think you are the one who just doesn't get it:

How can you forget or ignore there are other patients on the floor with family members & loved ones who themselves may be confronting the issues of death and dying as well?

Are their boundaries to be run roughshod & trampled over so someone else may display thier grief loudly & even flamboyantly?

Must they be tortured & tormented by someone else's verbal tirades when they may be trying to confront their own loss of life?

Do they not have the right to peace?

Do they not have the right to come to terms wth their own situation without distress being piled upon them by a stranger?

Evidently not. For the life of me, I cannot comprehend why it is inconsiderate to have the door closed?

How you elect to grieve is your own personal affair...I would not presume to tell you how you feel about your grief.

However, that does not give you the right to impose your situation on someone else, particularly other patients on the floor.

All I am saying is, there are boundaries. Boundaries are about respect & consideration, without which no civilized society can exist, all becomes chaos.

PCloudy · Jul 22, 2005

I almost think this hostile thread needs to be deleted. It seems most are trying to out do the others.

I am very pro-death and try very hard in my job to allow family members and the patients the decency of having death as conducive to their wishes as humanly possible.

For those of you that need an example, the first one that comes to mind is a man that I took care of for weeks in the ICU last year. He was septic, MSOF, ESRD on CVVHD and was on everything that would fit in the room short of a vent (at that time he died - he had been on one earlier that admission). There was no hope of his recovery and he was well aware of that. His family wanted him to be a full code but the pt disagreed. To make a long story short, I had to (over several days) get his team of doctors together, involve pastoral care, get his family in (some from out of town) and make plans to allow him the best possible death in the hospital setting.

His wishes were to die outside under the trees while he heard the birds singing. That had never before been done at our hospital and I met up with incredible resistance. I planned with him (as close to down to the moment as possible) for two days. The morning that he decided that he wanted to die, it took several hours to get his family in at that time, turn off the CVVHD and get cardiopulmonary and pastoral care that I would need their help. He would need several O2 tanks as he was on a NRB needing >10L flow.

Well, after two dry runs with two different stretchers (had to find one that would fit through the courtyard door), coordination with the OR (since we had to go down that hall) and L&D (they were the other side of the courtyard), he was ready to make his final journey.

We planned to leave the pressors on outside until he decided that it was time to turn them off (knowing that he'd last only a few minutes after that) so we had to take several triple pumps outside as well.

We got him out there, placed him under the large tree that he had selected from the ICU room, watched the birds, went through several O2 tanks, visited with his family, looked at family pictures, ate ice cream (that his son went to get at a local Baskin-Robbins which was closed but they opened the doors just for this occasion) and prayed. I stayed with him the entire time and was on phone contact with the unit, RT, etc so that he could have his needs met.

After nearly two hours in the blazing heat (Central Texas), he decided that he was ready and asked me to turn off the IV's. In less than 30 minutes, he took his last breath with his family all there praying over him. A remarkable event after they sat and told me repeatedly that they just don't understand why he wanted everything to end that way. I had lengthy discussions with them after which they thanked me endlessly for making their loved one's last wishes happen.

He was a 1:1 pt because of the CVVHD but it should be noted that my manager ran up to me as soon as I returned the blood and turned off the CVVHD stating that "Good he's not a 1:1 anymore." All she was concerned with was staffing issues. Nevermind what was best for him. I told her that he'd continue being a 1:1 until he died which could be in 1 hr, 5, or 10....

I am VERY sensitive to the dying issues and the fighting that appears to be going on here on this thread is getting old.

Before I close, yes, I have personally experienced death far too many times as have my children. I held the hands of two grandparents and a best friend as they died. My kids father committed suicide when they were 8 & 7. My oldest daughter lost her 2nd grade science teacher to an accidental drowning as well as a close friend from suicide when she was in the 7th grade. My daughter's beloved kindergarten teacher that we had remained friends with, died of breast cancer that had mets to the brain less than one week before she graduated from high school. Her former teacher wanted to live to see her graduate. My brother's best friend lost his 5 year old sister when they were in high school - she drowned in their backyard swimming pool. I can go on here - there are several others but you get the idea.

Try not to judge and to take comments so personally. Everyone has a different level of experience and exposure. I'm not proud to say that I have experienced way more than my share of death nor am I condemning of those that haven't. The death rate on Earth is 100% - always has been, always will be. Those that have not experience death as yet, will eventually.

Lets move on to something else, shall we?

Roy Fokker, BSN, RN · Jul 22, 2005

Wow.

Yes, I agree that in some places in the world - expression of grief is a very "open" affair. It doesn't always have to do with 'how loudly you grieve shows how much you respect or loved the person' --- it just is (a very open affair). That is how some cultures 'grieve'.

Just thought I'd share my perspective :)

Roy Fokker, BSN, RN · Jul 22, 2005

For those of you that need an example, the first one that comes to mind is a man that I took care of for weeks in the ICU last year. He was septic, MSOF, ESRD on CVVHD and was on everything that would fit in the room short of a vent (at that time he died - he had been on one earlier that admission). There was no hope of his recovery and he was well aware of that. His family wanted him to be a full code but the pt disagreed. To make a long story short, I had to (over several days) get his team of doctors together, involve pastoral care, get his family in (some from out of town) and make plans to allow him the best possible death in the hospital setting.
His wishes were to die outside under the trees while he heard the birds singing. That had never before been done at our hospital and I met up with incredible resistance. I planned with him (as close to down to the moment as possible) for two days. The morning that he decided that he wanted to die, it took several hours to get his family in at that time, turn off the CVVHD and get cardiopulmonary and pastoral care that I would need their help. He would need several O2 tanks as he was on a NRB needing >10L flow.
Well, after two dry runs with two different stretchers (had to find one that would fit through the courtyard door), coordination with the OR (since we had to go down that hall) and L&D (they were the other side of the courtyard), he was ready to make his final journey.
We planned to leave the pressors on outside until he decided that it was time to turn them off (knowing that he'd last only a few minutes after that) so we had to take several triple pumps outside as well.
We got him out there, placed him under the large tree that he had selected from the ICU room, watched the birds, went through several O2 tanks, visited with his family, looked at family pictures, ate ice cream (that his son went to get at a local Baskin-Robbins which was closed but they opened the doors just for this occasion) and prayed. I stayed with him the entire time and was on phone contact with the unit, RT, etc so that he could have his needs met.
After nearly two hours in the blazing heat (Central Texas), he decided that he was ready and asked me to turn off the IV's. In less than 30 minutes, he took his last breath with his family all there praying over him. A remarkable event after they sat and told me repeatedly that they just don't understand why he wanted everything to end that way. I had lengthy discussions with them after which they thanked me endlessly for making their loved one's last wishes happen.
He was a 1:1 pt because of the CVVHD but it should be noted that my manager ran up to me as soon as I returned the blood and turned off the CVVHD stating that "Good he's not a 1:1 anymore." All she was concerned with was staffing issues. Nevermind what was best for him. I told her that he'd continue being a 1:1 until he died which could be in 1 hr, 5, or 10....
I am VERY sensitive to the dying issues and the fighting that appears to be going on here on this thread is getting old.

That was a very touching story.

Thank you for sharing.

URO-RN · Jul 22, 2005

Like others have said, everyone grieves differently. Screaming, thrashing about is just another way of showing grief. Not everyone, cries silently or privately.