Hardest things we tell family

[sjalv]

I've only been a nurse for a few months now, but working in a CVICU, I've been in some very somber situations. I knew I would be experiencing this as a critical care nurse, so it's not like it has come as a shock to me, but it doesn't make it any easier. Twice this week, I've had to tell the families of patients that their loved one has suffered an anoxic brain injury and has an extremely slim chance of ever recovering. Did the neurologist tell them that? Yes, but you know families always ask the nurse who is there for 12 hours what they think. At least, that's been my experience.

It's somehow easier to tell someone that their loved one has died rather than, as we stand on either side of the patient, say that they will never be able to breathe again on their own, or feed themselves, or know what's going on, while they look on at the patient's baby-doll eyes. It's even more heart-wrenching to hear family discuss amongst themselves how they can't believe it's happening, how it isn't fair, how there might still be hope.

Again, I knew I would be faced with these situations as a nurse, especially in the ICU, but nothing can prepare you for how emotionally taxing it is. I'm pretty good at separating work and my emotions, but even the most detached personalities are affected by the despair that some families feel at their most desperate times. Compounded by that is the fact that as a new nurse, I'm not yet jaded or hardened. It doesn't keep me up at night, but it makes one's heart heavy.

Thanks for reading what probably should have been a blog post.

[pamiesuejt27]

Not all nurses get jaded or hardened. You having these feelings, probably means you are good at your job. We see people, our patients and their families, in their most vulnerable states. That is both terrifying and taxing on our naturally empathetic souls! Sometimes you just have to say what you feel, sleep it off, and do your next twelve hours the best you can.

[Lev, MSN, RN, NP]

It's normal and natural to have these feelings. I work in the ER and fortunately don't have to have these conversations too often. Hats of to the ICU nurses. One thing that's keeping me away from the ICU - the deaths. When patients die in the ER its usually because they came in cardiac arrest and didnt make it. Not because we did cpr and they made it and family gets all hopeful and now we have to explain to the family that they will never wake up.

[AnArtist]

Thanks for writing your thoughts... I've thought about ICU when I graduate, and then I wonder how ICU nurses work with this issue. Does it change how you view life?

[shugamomma]

Thanks for writing your thoughts... I've thought about ICU when I graduate, and then I wonder how ICU nurses work with this issue. Does it change how you view life?

Yes. ICU does change how you view life.

[sjalv]

Thanks for writing your thoughts... I've thought about ICU when I graduate, and then I wonder how ICU nurses work with this issue. Does it change how you view life?

Yes, I would say so. I already had a clear distinction between 'quality of life' and just living before even becoming a nurse, but seeing what some families put their loved ones through, and what we in the healthcare field do to prolong the life of those who are basically vegetables, is ridiculous. I've seen people with stage 4 pancreatic cancer with mets to every organ system you could think of come in for respiratory failure, and the family's at the bedside screaming "do everything you can for her!!" It's all you can do sometimes to not say things like, "Why isn't she at home on palliative care? Why are you doing this to her? Would YOU want to live this way?"

I am just 21 but working in the ICU motivated me to get a detailed advanced directive and get my brother established as my durable medical power of attorney. I have been taking care of a patient these past few days who is relatively young and whose estranged husband is making her medical decisions because he's still her spouse, legally. He gave consent for a trach and PEG and she's on her way to an LTACH for the rest of her life, because some man who may or may not give a **** about her is saying "do everything for her".

[heron, ASN, RN]

The hardest thing I've had to tell families? "Your son/daughter died". Not fair, not fair!

[HouTx, BSN, MSN, EdD]

Great thread.

"Moral Distress" is very real for nurses and other clinicians. It's important to recognize it and seek/provide support for one another when it occurs.

Although it is sometimes difficult, in the end it's a job for us - but patient families will be re-living and dealing with these defining moments for the rest of their lives. It is something to keep in mind.... we will be part of their personal 'history' by virtue of our participation in those terrible (or wonderful) moments.... very humbling.