Ever feel like you've let your pt down?

Jay-Jay, RN · Apr 22, 2003

Oh, geez, you WOULD ask!! Just when I'm on a BIG guilt trip! Had a 47 y.o. mom with terminal Ca. of breast. Very ugly fulmigating tumor, plus pleural effusion. I thought with the tumor being so superficial (skin breakdown confined to the area that was irradiated) she was going to last for quite a few months. Well, on Tuesday she was c/o SOB, as the lung was deteriorating very rapidly. Not such a big deal, thinks I, as the other lung is clear.

On Thursday, she was much worse, so I tried to get her into a hospice, as local hospital was quarantined due to SARS. Can't think of anything worse than being terminal and family not allowed to visit. I got a second visit authorized for the evening, so I could check on her again, only to find she'd already gone to hospital. Guilt, guilt...maybe if I'd suggested hospice sooner she would have been able to get a bed.

She died yesterday. And I never got a chance to talk to her 2 teenagers to try to prepare them. Okay, they were rarely around when I visited. Still..... big guilt trip.

Anyone have any suggestions for how to talk to her kids when I do the bereavement visit?

hoolahan, ASN, RN · Apr 22, 2003

{{{Jay-Jay}}}

I would say no, but I think that would be a lie. I have one pt I felt I really let down. She was 100 years old. I explained to her what Hospice was, just based on her age, and she was sooo happy, and thanked me for allowing her the chance to die in her own bed just like her people did in "the old country."

Never in a million years did I think her doctor would refuse her to be on Hospice!! He needed some educating regarding the fact that the expectation of life at that age alone , coupled w her heart disease, made her a perfect candidate even tho she was not actively dying. We see so many people go onto Hospice at the last minute, it would've been so nice to have her stay home.

Well, we finally ironed out the doctor issue, of course the pt had been so disappointed and frightened by the fact that he may have refused this to her, I think it aggravated her heart. I felt like I had really let her down. Anyway, she finally did go on Hospice, only to breal her hip a week later. Because of her weight and inability to assist w turns, etc, her dtr just could not manage her at home w the hip, and dtr was very high=strung as it is. Anyway, I remember going to see her in the hospital, and she looked so sad, and withered. She opened her eyes and looked at me and was so glad I visited her, but I had to hold back tears b/.c I knew she would not get her wish of dying at home.

So, I think if ppeople go to the hospital, it is letting them down in more ways than one, but we cannot always prevent hospitalizatioon, and for those who are too exictable to deal w emergencies at home, they are best to call 911 and go to the hospital.

Good question. I haven't thought about my Sophie for a while, and she also lived down the street for me. When she turned 100, the preist came to her home and gave her a private mass. She told me over and over how deeply it had touched her.

amesly15 · Apr 22, 2003

Jay-Jay---check http://www.campgoodgrief.com

It's a camp for bereavement for teens and children

I don't know what I would say to teens who's mom just died.

It's so sad that breast cancer is taking out young women.

I am a three year survivor of Breast Cancer but lost a friend who was 37. She left behind a 7 yr. old.

Have I ever felt I let a patient down? Maybe if I'm feeling rushed. I remember one day going to this elderly ladies house. Her grand daughter had left her baby there and they had no food or formula...so I went to a food pantry and brought back formula and cereal for the baby. Took time out of my lunch to make a run....

susanmary · Apr 22, 2003

I wish I had more bedside time to spend with my patients. I try not to feel guilty about it ... sometimes I do ... but I know that I do the best that I can -- I believe this is true of today's nurses. We do the best we can with what we've got.

renerian, BSN, RN · Apr 23, 2003

I only recall one time when I felt guilty over a client going to the hospital. As a rule I don't feel that way..........

renerian

CraftyLPN · Apr 24, 2003

I was just wanting to know your feelings on this..thx!1

Hellllllo Nurse, BSN, RN · Apr 24, 2003

Originally posted by susanmary
I wish I had more bedside time to spend with my patients. I try not to feel guilty about it ... sometimes I do ... but I know that I do the best that I can -- I believe this is true of today's nurses. We do the best we can with what we've got.

These are my thoughts, as well.