Hospice and Families

[ParrotHeadRN]

When I was in school, it was my intention to eventually work for Hospice. I have been working med/surg now for about 1 1/2 years. At times we get hospice patients and I always take them if I can. I recently had an experience with a family that has made me question my goals.

I work 12 hour shifts and for the first 9 hours, all was fine. The pt's wife was there and we got on fine. I told her what I was doing and medicated her husband every time she asked. We seemed to get on well, although we weren't buddy buddy. There were no problems, though.

In the evening, the daughter came in and all hell broke loose. I wasn't doing anything right, her father was not being medicated enough, I was changing the dressing wrong, etc. etc. When I performed care, the daughter was LITERALLY right at my elbow, telling me what I was doing wrong. This went on for 3 hours, not to mention the fact that I also had four other patients to care for. By the end of the night, I was a physical and mental wreck. I was questioning everything I had done that day, and feeling I was a terrible nurse. I was SO angry at the daughter, and then felt guilty for feeling that way, as I totally understood what was going on. Then during report, she interrupted us, wanting care for her father. I assured her we would be there very quickly. She immediately went back and got ANOTHER family member and brought them out to bring us back. The oncoming nurse went back and by the time she came out of there, SHE was sick. I felt guilty leaving her there with that family! When I got home, I just cried I was such a wreck.

Now I am questioning my career path. I don't know about my ability to care for my patients with family members reacting that way. I LOVE end of life care, nothing makes me happier than to keep my patients comfortable and I am very good at it. Could it be that it was different because it was a hospital setting? Do family members often react this way? I have to say I never gave that much thought.

All that being said, I think I am having an interview with hospice soon as I need to bring in a little more income and I thought this would be the perfect way to get an intro to hospice. Is this something I should talk with the nursing director about?

AM I just a terrible nurse who should be nowhere NEAR hospice?

Any feedback, positive and negative is welcome.

Thanks.

[cargal]

I was removed as case manager from the pt whose husband expected hospice to "come in and take over everything". He told my supervisor it was because I wouldn't commit to a four hour time period 2x a week. He told me he needed hospice there at the same time every day because he ran his own business and he needed to take his handicapped son to work and back . I hooked him up with the volunteer co-ordinator and gently suggested some outside help. This has been very demoralizing to me.

[waves]

cargal-well doesn't that beat all? a sucker punch. hope your supervisor treats it as a people fit issue. ideally there should be someone that will fit each situation. even if the next case manager tells him the same thing, in the same way he may react completely in a different way. it's almost primal scents or something that set some people off. don't take it personally, maybe you'll be the saviour in another tough case!