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Nurses General Nursing

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A recent illness and death in our family is one of the reasons I have chose to go into the nursing field. I know what I *want* to do, but I'm not exactly sure what area this would fall into. Here's an example:

When the immediate family was faced w/ doctors, getting updates on patient condition (especially since this was so touch and go all the time), it seemed every time we turned around, the doctors were saying, "we don't know.. we don't have all the information yet...". In those moments when talking to the doctor, I know that all the family really wants to hear is "he'll be okay", and the many questions usually don't come until AFTER the doctor has left. I know that our family would have a ton of questions about possibilities of different things, but all the nurses would say about it was, "you'll have to talk to the doctor when he returns tomorrow".. well, by tomorrow, there was a whole new set of questions, or we were getting other information and just trying to absorb that and nobody ever asked the questions. This left me to come home at night, and log on to the WWW and try my best to find information. And, lo and behold, I did find that information.. and by printing it out, and highlighting the areas in question, we were able to start asking and getting answers to questions. One of these questions was, "How on earth could this person have been misdiagnosed for so long when the s/s should have been so obvious? Of course, to that question, we'll never have the answer.. he's gone. But, by nursing, and researching the illness and finding the information for families that gives them a foundation for their questions, I feel like I can do *something* in his memory.. perhaps if I had felt this way a few years ago, he'd still be here... but I doubt it.. it was his time, and I know this..

Anyway.. can anyone give me any idea of what kind of position this is/would be? As much as I would love the hands on of working w/patients, I would so much also love the ability to be there for the families and give them the information that they so desparately need, but oftentimes are not getting b/c of the fear/shock of being in a critical care area and trying to keep faith that their loved one will be okay...

Specializes in LTC,Hospice/palliative care,acute care.

I think I understand what you are saying-at times of high stress it is very hard to concentrate on the info you are being given and by the time you have and are able to formulate some questions no-one is available to answer them.And sometimes you just have to hear something a few times before you really HEAR it....The kind of info you are talking about should come straight from the docs-not through a social worker because that makes it open to their interpretation.Social services and the nursing staff can always re-enforce info-Nurses can teach families how to ask their questions and get the answers-the patient and loved ones have to take responsibilty for gathering the amount of info they are comfortable with....I always encourage people to keep a notes-list all of their questions and if they have to they can call the doc and make an actual appointment to meet ....write your questions out and insist on asking each one-have another family member write the answers-ask and ask again for explanations of anything you don't understand...I also encourage them to appoint ONE family member as the contact person....In my experience most critical care areas are well staffed with ancillary support but it is not and cannot be 1 to 1 and sometimes info has to be disemminated and then staff has to back off and let families work through it..and even if there was one person available at all times for this kind of support it still would NOT be enough-because when the worst if happening NOTHING can stop it...No amount of info or lengthy explanations will ever change the outcome...Nursing or social work may be for you- we all have to accept that sometimes there are no answers and we can not fix everything....but we can make a difference....Maybe someday you will publish a booklet in your nephew's name to be given to families in the position yours was in.....In your nephews case often adults have complications yrs later from radiation they received when young and they are sometimes fatal---I am sure the possible complications were listed for the family those many years ago but -again-you often just don't HEAR that kind of info...Some adults are not completely forthcoming regarding the full range of their symptoms and some people just can not clearly communicate their problems....that hinders an accurate diagnosis..I feel that patients and other "consumers" in the health care system have to bear a certain amount of responsibility for educating themselves-we do it when we buy a car or an television...Anger is one stage of the grief you all are feeling-I am sorry for your loss and hope you find peace....

Specializes in NICU.
However, I just want to explain something that most of you are hitting on... the telling the family everything is going to be okay. That is not at all what I'm suggesting. I'm saying that is most often a families state of mind... nobody sitting in a waiting room wants a doc to come out and say "I'm sorry.. we did all we could".. that is just not what you want to hear. I'm not saying to TELL them anything, neither good nor bad, it was simply a statement made regarding state of mind of families in the critical care arena.

I suppose this is where I keep getting confused? What is it you think we should say in situations like that? Whether the family wants to hear it or not, we have to give them the information. What is wrong with saying that we did all we could? Or that it doesn't look good? I am very confused as to what you think we should say in that situation. We need to be honest.

Not trying to be annoying, just trying to understand so that I can better serve my patients' families in the future.

I suppose this is where I keep getting confused? What is it you think we should say in situations like that? Whether the family wants to hear it or not, we have to give them the information. What is wrong with saying that we did all we could? Or that it doesn't look good? I am very confused as to what you think we should say in that situation. We need to be honest.

Not trying to be annoying, just trying to understand so that I can better serve my patients' families in the future.

I believe you should tell the truth about the situation. I have said over and over, I do not think anyone should just tell a family "it's going to be ok" if that isn't the truth. I'm simply stating that's what is in their minds.. that's what they want to believe more than anything else.. I'm not suggesting to lie to anyone, and I agree wholeheartedly in being honest. My whole issue here is that because a family has this type of mindset most of the time, it's hard for them to grasp the actual reality of it sometimes. Nine times out of a ten, a family is going to hold tight to anything positive the doctor has had to say and let the rest of the info fall by the wayside for a bit. I don't see anything wrong with telling a family either of those things.. the truth is the truth. I'm just saying that sometimes, as a family with a loved one in a critical situation, it's hard to wrap your mind around the total truth when it's presented to you and not all of the information you are given "sticks". I have a lot more respect for those doctors who DO shoot straight from the hip when it comes to telling things how they are. I've learned over the years, after being in the critical care waiting area more times than I care to remember, to stop a doctor in mid sentence if I have to in order to ask a question. I get all my questions asked as they come to me -- but, at the same time, I've seen many families who speak w/ a doctor and say "thank you" after the doc says his part, only to have them sit down and talk to family and when they are asked something, it's "I don't know, I meant to ask that, but...."

Again, I'm not badmouthing doctors or nurses or anyone else. I was simply stating what I've seen happen over and over.. it's a mindset.. not a fault of the medical community at all.

And, while I agree that the medical science is still much a gray area, I'm not going to beat a dead horse here.

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