First "actively dying" experience 6 months in....

[stefkane07]

Im in an accelerated LPN program, 6 months in and graduating in 4 months, I now go to clinicals 4 days a week...this past weekend was my first experience with an "actively dying" patient. HIV pos, multi system organ failure, jaundice (worse than my instructor had ever seen in her experiences)... Basically my patient was "rotting from the inside out"... Her room had a very distinct odor of what I assume to be 'death' she was strictly in the hospital for "care and comfort" only. I am curious to see if anyone else had the felt the same way as me after this experience. The nurse in charge of her care was very un-empathetic and judgmental. The patient was on a PCA ordered 10mg Dilaudid, only running at 6mg, the nurse refused to increase it, telling me the patient was not possibly in pain and insisting I washed and repositioned my patient despite the patient saying she didnt want to be. This patient awakened to stimuli and As I performed personal care she grimaced and "oww-ed" but held my hand as I soothed her. This was extremely hard on me due to the fact the patient was dying and had no family present. In the nurses report she said the patient had 'burned all her bridges'. I know as a nurse I will come cross things like this, but considering these circumstances I feel like this once case has dramatically affected me so far. Just curious to see how other students would deal/cope with a situation like this. I feel the nurse had no compassion for this patient whatsoever and considering the patient was alone I felt the nurse should have put all judgement aside t provide the best care possible for this patient to 'go with,'

[Still Standing]

I agree 100% to what you are saying. I haven't had that experience yet in clinicals but with every patient I make sure that they are aware that I'm there to provide the best care possible according to the state's and facilities standards, and with care and compassion, the way I would want to be treated!

[christyness, BSN]

You will come across nurses like this. Sometimes they are people who should never have been nurses. Many times, they are human beings who have run out of emotional resources.

You have to try to understand what the nurse may be going through whole also advocating for the patient. As a student, you should speak with your instructor first. In the future as an RN, you should speak with your coworker, then your charge nurse, and so on up the ladder.

And one more thing - I can't tell from your description exactly how oriented your pt was. But if you have a pt who is able to make his/her own decisions and that pt does not want to be bathed, it would be assault to bathe that person anyway. If that were the case, you would have to refuse to comply with your supervising RN's instruction.

[Mewsin]

I work in ltc so I have been with people who are passing. We really try and be respectful to those who are passing, we try and respect their wishes as much as possible. If a resident says no bath, or we can see it is causing them discomfort we don't bathe them. We do comfort care as much as possible(pain medications, having someone sit with them if possible, if they are alone).

I am lucky to work with amazing nurses who listen to the aides and are quick to intercede for the resident to keep them comfortable.