Need advice on helping your own family let go

Nurses General Nursing

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Sorry for the rant in advance, I just need a knowledgeable sounding board.

My family has always turned to me (like every other nurse) for medical issues. My uncle was diagnosed Stage 4 Lymphoma in Jan. Hgb below 100, hypercalcemia, weak and comprimised. His family is in complete denial with diagnosis, he's still a FC. Two weeks ago he finished his last round (6 total) of chemo. Extreme weakness, Hgb still in his boots...but I know this is expected...they expect him to be at the cottage this weekend.

Fast forward to last Thurs., diagnosis of pneumonia- feeding tube inserted, intubated and sedated. Family still in denial, pt remains FC in ICU.

This morning I received a call asking what I thought of them doing a bronchoscopy to isolate the bacteria in his lungs to use a more effective antibiotic. I do not agree with their efforts, although I understand why they are pulling out all of the stops.

I guess my question is, how do you help people understand just because we can doesn't mean we should? I have no issue working through this with my hospital pt's but this is family and I feel the need to tread a little lighter. I've attempted to explain what happens in a code, it's not like TV. I've asked what my uncle wants for end of life care, if any arrangements have been discussed. This has always ended up in my cousins being hysterical and my aunt saying it's not time for that yet.

I feel like I'm failing them and him. Any advice would help my heart.

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Specializes in LTC, Hospice, Case Management.

The best you can do is accept that they can't accept what's happening. It honestly sounds like you've done/said all the right things. No doubt someone on that ICU team is also trying to guide them towards acceptance. They are not ready and unfortunately some never get ready. As a a hospice nurse, this was always one of the most frustrating things for me. I always felt like a failure. I wasn't a failure and neither are you. Just love them in the space they're in.

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Thank you for your kind words, and you're right, it is just so very frustrating. I'm not sure of how their conversations with the docs have gone, they seem to want to treat aggressively. I love palliative work, I just seem to be better at it with non-family :(

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Specializes in Oncology (OCN).

I don't know how close you are to your uncle and his family but there have been times with family I have had to set boundaries. Just a little over a year ago I lost my mom to liver cancer. My sister, my dad, and my mom all looked to me for answers. (My experience is all in oncology.) I wanted to give them information (and I did) but it was completely stressing me out. At a certain point I had to remind them I wasn't a nurse in this situation, I was a daughter dealing with a mom who was dying of cancer and they needed to let me be just that. Don't be afraid to set limits with your family if you need to.

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I'm sorry for the loss of your mom

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Specializes in CMSRN, hospice.

It's frustrating when family seeks your expertise but doesn't use what you offer them. It sounds like you are being very patient with them and giving them all the information to make good decisions, which is exactly what you should keep doing. Remember to take care of you and respect your own boundaries, as other posters already said.

I'm really sorry that you and your family are in this place. I feel like it's hard for us because we can't help reacting as both a family member and a nurse. My uncle is also experiencing a serious illness right now, and I'm being reminded of what it's like to be one of the people waiting for answers. Good vibes to you all as you navigate this awful situation.

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Specializes in Ambulatory Care-Family Medicine.

I was in your spot a few years ago. My husbands grandmother had stage 4 metastatic breast cancer. I'm the only medical person in the entire family so I got a lot of phone calls asking all kinds of questions. She was in the ICU for almost a month before passing. Anytime I would bring up hospice the family would all freak out and break down in tears. The night before she passed her husband finally accepted that she was dying and made her a DNR.

It's hard but the most you can do is provide information and let them make an informed decision. Just because you would want to be DNR at this point if it were you doesn't mean that your uncle or his next of kin would. That was a very hard pill for me to swallow but once I accepted that it wasn't my decision to make and my only job was to support my husbands grandpa at the worst time of his life things got a bit easier for me.

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