Have you ever had a family accuse you of killing their loved one?

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Specializes in Corrections, Cardiac, Hospice.

I DID TONIGHT! I work at an inpatient hospice facility. Had a new patient with a hx of breast ca with brain mets. She had been restless at home for 3 days. The oncall nurse didn't make a visit, but called the sister at work and asked her if she could send her to us. What the sister HEARD was that she would come for 2 or 3 days and get her pain under control, although having just dealt with her I doubt that was what was SAID. What has happened is the woman came in with horrible terminal restlessness and is now comatous. The sister shows up after work, HYSTERICAL because she won't answer her. I spent about 4 hours of a twelve hour shift explaining the disease process, the terminal restlessness, the s/s she had been showing over the last couple of days that indicate this was coming (as per her discription.) She didn't believe me and said, I know whatever it is your doing to my sister is killing her. You can't fool me. Then acutally asked the aide if I hit her sister on the head:uhoh3: Now, I know what your all thinking, psych right? Nope, this woman is a TEACHER for crying out loud. She just kept saying, my sister isn't dying, she is getting better. I don't know who your talking about, but I know my sister is going to wake up. Ummmm, HELLO, HOSPICE!!!! Her mother was sitting in a chair the whole time saying, now come on. Listen to the nurse, she is trying to tell you what is going to happen next. At one point she even said, I just don't understand all this, I am not a medical person. I said, Well, I am, please let me guide you through the process, so that you can make it easier for BOTH you and your sister. Her mother said, my baby is dying, nothing you can do will change that, then the sister looked at me AGAIN and said, I know that the medicine your giving her is killing her. I even offered to shut the morphine off, thinking that if she SAW how terminal restlessness affects people she would understand. It is AWFUL to watch a loved one strip and flash their bare bodies to all those around. All the while crawling out of bed and hollaring in pain, YIKES! The mother asked me not to turn it off, because she completely understands what is happening. I just feel like this:banghead: :banghead: :banghead:

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Well to me it sounds like you have more than gone above & beyond to help this family member understand the facts & situation. Some people just can't

deal well with death. The sister is more than likely projecting her own grief & regret onto you. You sound like a well informed, caring, & patient nurse. Just keep your head up, and try not to take this personally. :loveya:

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Specializes in ICU, telemetry, LTAC.

Yeah, relatives in denial can be like that. I had a patient that I babysat her whole family one night. Talked them through the whole process, individually and in groups. How did I know their mother was dying, what are the physical signs and symptoms, how did I know she could not get better from that point, etc. They saw the pain she had been in, and all agreed that the morphine was good for her. I walked them through the process of monitoring her resp. status because the one dose I gave her, knocked her down to two, yes two breaths a minute for the next 12+ hours and explained to them everything I was doing, thinking, assessing, etc.

They were a wonderful bunch. It was great getting her son from the point of wanting to "shake mama" to wake her up, to the point of acceptance that she was going to heaven really soon. He wasn't okay with it, but he had a little more peace knowing what was going on. I bonded with the patient's oldest daughter somewhat and have seen her several times since for admissions... apparently her life fell apart a bit after her mom died. Once she told me that her baby sister had been making a lot of trouble in the family by telling people that the family "let the nurse kill mama with the morphine" and such. I remember that sister... she didn't have a big neon sign on her that said "substance abuser" but I thought that she might have been, she had a lot of symptoms. I took the same kind of care to explain things to her, that I had with the rest of her family. It didn't get through.

People will believe what they want to, and sometimes all the education in the world isn't going to reach someone who doesn't want to hear it. You did a great job with your patient.

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Specializes in Nephrology, Cardiology, ER, ICU.

What a compassionate nurse you are. Thanks for being there. It takes someone with more patience than I possess to do hospice. Please take care of yourself.

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It is really frustrating sometimes dealing with the family of a dying person. Denial is a strong tool for easing your pain. I was shocked when my own dad was dying. I work in LTC et deal with death everyday. I have sat with families who deny their loved one is dying et thought, "Why can't they see what I am seeing?" But when my dad was dying of cancer, I looked at my best friend (who also is a nurse) et said, "I am not sure if he is going to be here by Thanksgiving." She said, "Leslie, he is not going to make it through this weekend." He died the next night. It was really weird looking back at how I was making plans on how we would do Thanksgiving with him being there sick et if he could tolerate all of us being there or if we would disturb him. He died November 3. That is how bad he was but I was planning for Thanksgiving. I guess when it is your loved one, even the most educated people can be in denial. Now I no longer get frustrated with families who are in denial about things. Too bad I had to learn the lesson the hard way: by experience. Kudos to you for the compassion et patience you have for families. Hospice is hard work! Thanks to all of you hospice nurses. You really do help families out. Even the educated ones!! I know from personal experience.

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Specializes in Case Management.

God bless all you hospice nurses out there who deal with death and dying and the psychological ramifications and sometimes skewed family dynamics. It is hard to be caring and compassionate when the family is causing you more grief than you already have, when all you see every day is the process of death. I could not do your job, but I am so glad there are great hospice nurses out there who are able to do this very difficult job.

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Specializes in Corrections, Cardiac, Hospice.

Thank you all for your kind words. My frustration was increased by leaps and bounds by my fatigue, I am sure:lol2: I was up almost 21 hours when I typed that post, and knew I had to be up in 2 hours to get my dd to school. I am off back to bed, just had to suck in some support so I don't toss and turn for the next 20 minutes rehashing the night like I did this morning in bed;)

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Well to me it sounds like you have more than gone above & beyond to help this family member understand the facts & situation. Some people just can't

deal well with death. The sister is more than likely projecting her own grief & regret onto you. You sound like a well informed, caring, & patient nurse. Just keep your head up, and try not to take this personally. :loveya:

I agree. Sounds like you did everything right.

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Specializes in cardiology-now CTICU.

it can be so hard to cope with people's denial when they project it aggressively on you. in that situation i find it helpful to remind myself that these people are hurting very much because they love their family member. it sounds like you were doing all you could for your patient.

i have been in the situation of family members in denial threatening to sue, verbally attacking me, etc. (this was a family who had fired half the floor and completely disrupted other patients care btw) just be very careful to document not only your care for the patient and their responses but be very careful in your documentation of education to the family and their response. if possible try to have a witness with you for your interactions with the family (your charge or NM ideally) and involve social work.

in this case i would avoid at all costs any contact with these family members after the pt leaves your facility (celestial discharge or otherwise). i would hate to be in the "good nurse" role for a staff splitting family only to find the tables turned on me and be named in their malpractice suit.

people in grief are unpredictable. you can only give the best care to your pt, and educate the family. keep up the good work.

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You sound like you went above and beyond the call of duty. Please be sure to document, document, document every detail of your actions and the family members statements. I am sure this sister is in denial, mixed with anger and grief, but she could cause lots of trouble with her accusations.

Get some rest, you deserve it.

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I wasn't accused personally of killing someone, but the facility was, and I was involved. A baby was brought in for fever and vomiting and was given an Abx for OM. The mom didn't fill it and over the next few days made several trips to both the ER and the clinic with the same complaints, saying Baby was getting worse. Never filled the Rx even though with each visit she was told to. On the last night the mom found the baby unresponsive, she and grandpa jumped in the car and went up the freeway to the next hospital, an hour away. Stopped en route at a fire station, who coded the baby. Baby was long dead, we think she had a febrile sz and aspirated. Mom blames my ER for letting her baby die. She has had another child since then and comes in every once in a while. If she isn't seen right away she starts making noise about how all we do is let sick babies die.

Some people, in their grief, just cannot accept the truth. In my case, the mom could not accept that she had a hand in her baby's death. In yours, the sister cannot accept that no one can help her sister.

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Specializes in cardiac med-surg.

shay

i'm sure that was a tough shift

bless you and all hospice nurses

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