Without getting into too much detail, I had a patient arrive by EMS last night. Very SoB, working hard to breathe, "one word dyspnea" (i.e. "I... can't...breathe... help... me" etc.) No other complaints. Was just recently discharged from the hospital (post DVT). Lungs sounded like the proverbial washing machine. Couldn't literally see the lungs on the CXR - so massive was the cancer mets. I mean, cancer everywhere....
Couldn't get access other than an itty bitty 22g.
Something about the patient strikes me as vaguely familiar and family updates me - pt. was in the ED not too long ago and I had taken care of the pt. That's when the whole story hit me like a slap in the face. I had this pt. barely 3 weeks ago and pt. was in MUCH better condition than pt. presents now. I mean, pt. was talking and cracking jokes and moving around ....
ED doc is consulted. Doc, ED nurse (myself), patient and family collectively decide to not pursue aggressive treatment - no more IVs, no more lab draws. Comfort care. Make pt. as comfortable as possible. Await primary MD assessment/consult for in-patient hospice and eventual home hospice per family request.
That's kinda when it started.
Some of the family members are having trouble 'coping' with the change in status.
Which is understandable - according to family, pt. was dancing at grandson's wedding barely 2 months ago... and now pt. is barely able to move limbs or speak. Apparently pt. has deteriorated.... FAST ... and family is having a hard time coping with it.
Now normally, I'm pretty good at this. This isn't my first dead/dying patient and associated family. Helping others to cope is one of my strong suits.... always has been (even before I became a nurse).
But for some reason last night, I just couldn't "do it." The human in me wanted to reach out to the family through the nurse in me... but for some blessed reason, it just didn't happen last night. There was no "connection" - it felt like I was just 'going through the motions'.
I feel like a rotten nurse. I feel like I let the family down.
None of them complained ... on the contrary, both patient and family were very appreciative of my efforts - but that just made things worse. Made me feel that much more guilty and ashamed. Like I cheated them out of something...
*sigh* I suppose this is a 'confessional' of sorts.
Have y'all experienced what I'm talking about? If you have, any suggestions/pointers? I mean, how do you deal with it?
Like I cheated them out of something...