Friends say they could NEVER take care of kids who die

realnursealso/LPN, LPN · Apr 15, 2016

Here's an example of how I handled it, or not, it was hard. https://allnurses.com/home-health-nursing/sometimes-you-just-705572.html

Kitiger, RN · Apr 16, 2016

Here's an example of how I handled it, or not, it was hard. https://allnurses.com/home-health-nursing/sometimes-you-just-705572.html

You're right. Sometimes we just don't see it coming. Either way, we love them & care for them ... and sometimes we have to say goodbye.

I've had friends tell me that they couldn't do Peds when their kids were small, but once their kids were bigger, they could handle it.

amoLucia · Apr 16, 2016

...
My goals for these kids are to keep them as healthy as possible, keep them safe, have fun while promoting normal growth and development, keep family life as normal as possible, and help their parents become competent, confident caregivers.
My goal is not to see them grow up to be adults.

(my bold)

As I read your post, I thought it realistic, well-grounded, honest, etc. How I would like to be in your place.Then I read your bio at the bottom of the post. And then I realized why.

Experience explains it all. And lots of experience.

Thank you for your dedication to one of the nsg specialties that I never could have handled. We all have our 'niche' and it seem like you found yours and it is such a good fit. You're doing something right. :yes:

KelRN215, BSN, RN · Apr 16, 2016

I don't talk to people who aren't pediatric nurses about my work. I had three patients die recently (because, you know, deaths always come in threes.) Two were children with progressive genetic/metabolic disorders. Children who were quadriplegic, G-tube fed, TPN dependent, on BiPAP. Children who it was known the day of diagnosis would not live to see adulthood. One of them I remember from many years earlier, I knew him when he could walk and talk. The third was a 19 year old with multiply relapsed leukemia, 2 failed stem cell transplants. There was nothing more to be done. He died on a Saturday night, only minutes after his father arrived to his bedside from the country he grew up in. Reading the note about how his BiPap was removed and he passed comfortably only minutes after his father's arrival, I thought it was beautiful. I had another oncology patient a few months ago who also died shortly after his sister arrived back from a semester abroad.

OscarTheOwl · Apr 16, 2016

I am one of those who say they can't. I don't think I could remove myself from the situations in a healthy way. I've had scary situations with my own child, life threatening health issues that thankfully turned out OK. The nurses were angels, I was a mess. I would not be a good nurse to those precious kids, and they definitely deserve the best of the best.

Kitiger, RN · Apr 16, 2016

(my bold)
As I read your post, I thought it realistic, well-grounded, honest, etc. How I would like to be in your place.Then I read your bio at the bottom of the post. And then I realized why.
Experience explains it all. And lots of experience.
Thank you for your dedication to one of the nsg specialties that I never could have handled. We all have our 'niche' and it seem like you found yours and it is such a good fit. You're doing something right.

Thank you.

Kitiger, RN · Apr 16, 2016

I am one of those who say they can't. I don't think I could remove myself from the situations in a healthy way. I've had scary situations with my own child, life threatening health issues that thankfully turned out OK. The nurses were angels, I was a mess. I would not be a good nurse to those precious kids, and they definitely deserve the best of the best.

I understand. We each find our niche. Nursing is such a broad field.

And when your child had health issues, your niche was MOM. I found out how that works when my Mom was in ER. I was her daughter first and last. I thought as a daughter, so much so that I didn't even see the reason Mom's O2 sats were dropping, not at first. The fact that I was her daughter caused too much static in my brain.

I'm glad your child's issues turned out OK.

Kitiger, RN · Apr 16, 2016

I don't talk to people who aren't pediatric nurses about my work.
Yeah, I don't bring it up. It makes them too uncomfortable. We know how to look for the good. and we hold precious memories. Some of those memories are about kids who cram a whole lot of living into a few short years. And some of those memories are of kids dying comfortably, well-loved, in the presence of family.

elkpark · Apr 16, 2016

Your friends say that because, as we all know, they're right, they couldn't ever do it. My specialty is child psych, not med-surg pediatrics, but I've had similar experiences; when I talk about the kind of horrific situations I have worked with professionally, most people's response is, oh, I could never do that. I've taught psych and peds nursing over the years, and I always cringe when students say (v. cheerfully), "I want to work in peds (or child psych) because I really love kids!" It takes a lot more than just "loving kids" to be able to function effectively in peds or child psych; in fact, I often think that "really loving" kids is a handicap (makes it too easy to get emotionally overinvolved).

Kudos to you, OP, for being able (and willing) to function effectively in such a challenging environment and role. In terms of parents "wanting answers," in situations in which we can't provide answers, the best thing we can do is offer empathy, and make sure the parents feel that they are being listened to and understood (not in the "I know how you feel" sense (which is always a bad response), but in the "old school" therapeutic communication sense of really listening and dialoguing with them until you do understand, as well as possible, how they are feeling).

KelRN215, BSN, RN · Apr 16, 2016

Yeah, I don't bring it up. It makes them too uncomfortable. We know how to look for the good. and we hold precious memories. Some of those memories are about kids who cram a whole lot of living into a few short years. And some of those memories are of kids dying comfortably, well-loved, in the presence of family.

I one time went on a date with a guy who asked what I did for a living. At the time, I was a visiting nurse for pediatric patients, primarily oncology patients. I specifically remember talking about a child I was seeing for G/J teaching and weight checks who had hypoxic ischemic encephalopathy from prolonged shoulder dystocia during delivery and realizing at that time that my work was completely horrifying to the average human being.

https://allnurses.com/pediatric-nursing/when-others-ask-760841.html

Kitiger, RN · Apr 16, 2016

Your friends say that because, as we all know, they're right, they couldn't ever do it. My specialty is child psych, not med-surg pediatrics, but I've had similar experiences; when I talk about the kind of horrific situations I have worked with professionally, most people's response is, oh, I could never do that. I've taught psych and peds nursing over the years, and I always cringe when students say (v. cheerfully), "I want to work in peds (or child psych) because I really love kids!" It takes a lot more than just "loving kids" to be able to function effectively in peds or child psych; in fact, I often think that "really loving" kids is a handicap (makes it too easy to get emotionally overinvolved).
Kudos to you, OP, for being able (and willing) to function effectively in such a challenging environment and role. In terms of parents "wanting answers," in situations in which we can't provide answers, the best thing we can do is offer empathy, and make sure the parents feel that they are being listened to and understood (not in the "I know how you feel" sense (which is always a bad response), but in the "old school" therapeutic communication sense of really listening and dialoguing with them until you do understand, as well as possible, how they are feeling).

You are so right. Still, sometimes the question isn't why, but when. Should they take that big vacation in 2 months, or should they hold off? (Said vacation was not for the child; it was meant as a respite vacation for the family.)

Obviously, no one can say exactly when, but the need to know is still there.

Sometimes the question is code or no-code. I can help them explore their thoughts/feelings to a point, but I sometimes feel that they see me as an authority, when I'm not. And I tell them that I'm not. OK, I do have experience, but I do not have specific training in psych, and I'm not a doctor.

I need to know whether they still want to pursue a full code. When gently asked, they usually go for a "partial code". No compressions, but do help them if they can't breathe. One family started giving a sedative when he struggled, but still kept him as a full code. As long as he was calm and comfortable, we did not intervene. (He was not on a pulse oximeter, and I did not suggest it.) One night, near the end, I asked again about compressions. The mom said, "He's been through so much! We don't want to prolong it. Let him go." With her permission, I called the doctor, who approved the no-code, and I notified my office. He died within the week.

Some families will never be ready to say no-code. A traumatic full code feels right to them. (Everything that can be done, will be done.) I accept what they say; I don't argue with them.

I wonder how hospice nurses handle that. I know they will come and talk to the family before taking the case. Perhaps the fact that the parents have asked about hospice shows that they are already thinking along those lines.