How do you keep from getting too close?

[bellehill, RN]

This past week I had a patient, a 55yo with an inoperable brain tumor. This pt was someone who was very aware of what was going on while still inappropriate. His main concern was that he was he was dying and couldn't stop the progression of the disease. I talked to him, offered support, spoke honestly and openly about his treatment course. At the end of my shift he lost control and went psychotic (from the tumor or steroids). It was terrible to watch the desperation in this patient's eyes as he described his desire to live while knowing he was going to die. It broke my heart.

How does everyone else deal with this? I talked it over with my husband who is a good listener but really doesn't understand the emotional toll this takes on a person. Do you have some type of program at your hospital to talk these situations out, maybe with a counselor or someone on the unit? The response from the nurses I work with is "get a good antidepressant". That isn't how I want to be able to do my job. Any ideas?

[RaggedyRN]

My mother died from a brain tumor 5 years ago. It was because of nurses like you that I went into nursing. Know that you do make a difference in the lives of your patients and their families. Continue being the caring compassionate nurse you are :) I do hope your hospital has support services set up for their employees...check with your HR department.

God Luck to you. God Bless,

Chickey

[papawjohn]

Hey Bellehill

I'll never forget one Pt I had soon after I started NeuroTrauma. Young man, close to my age, thoracic spinal transection, s/p MVA. We had interests in common (outdoors, fast cars) and had quite a warm relationship.

The night before he was going to be transferred from ICU I was doing routine StraightCath, that kind of thing. "John," he asked me "when do they think I'm going to start getting better?"

I looked him in the eye and realized that no one had told him he had permanent paraplegia, that he would NEVER get better. For days, he'd assumed that he would recover.

I told me as gently as I could that his condition was forever.

We cried and cried and hugged and hugged. I feel my eyes burn and a lump in my throat right now, remembering him that night.

That's what Nursing is like, honey. We have that kind of pain and privilege when we do this work.

Grieving

Papaw John

[bellehill, RN]

Papaw John,

Thanks for sharing your story. It is a privilege to be able to help these patients when they are so vulnerable.

[sored]

Hi, and thank you for caring. It may hurt to see pain. You call it being close and I think it is better called empathy. Thank you for that. If you think caring hurts imagine how bad not caring would feel. You are strong enough. Listen to the senior staff around you that you respect. It is alright to ventilate. Your feelings are normal. Please remember it is better that you are there. The real stuff is painful. You are brave and capable. I know.