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Discussion

How do you know what to say?

Hello everyone,

Im a new grad and this is my first job in the hospital and its my first time dealing with people who are terminally ill,etc firsthand. When I was an LPN I worked with chronically ill pediatric homecare cases, but none of my patients were terminal or anything. Yesterday was my first day on the floor. I woke up in the middle of the night and couldnt go back to sleep bc I was thinking about the patients I took care of yesterday and their families.

My heart goes out to patients and their families to the extent that physically/emotionally I feel their pain. Maybe it is more severe now bc I just lost my dad a few months ago-his health was going downhill, but he has always been known to bounce back--then suddenly he had a massive heart attack and he was gone at 54. Whether the patient is 90 years old and lived a full life or they are young and diagnosed with Cancer,etc....it is so hard to let someone go and accept their condition. I have no problem with offering comfort as far as holding someone's hand, giving them a hug,etc...that comes natural to me. What doesnt come natural is finding the right words to say when someone is going through something like that. I know sometimes, just being there is enough...but I feel like Im reaching for words to say and I cant find them.

It also pulls my heartstrings badly when there are elderly patients who dont have anyone and are so lonely/depressed...and it brightens their day just to have someone pay attention to them, talk to them, keep them company. I know when Im off orientation I wont have a lot of time to spend with them and Ill struggle with that...there was a lady I kept going back in to see bc she was just so lonely...I felt so bad to leave her and I must have gone in there 20 times. She would say "oh, there you are!" everytime I would come back. She went from being really withdrawn to where I wasnt sure she was oriented at the beginning of the shift to telling me her life story by the end.

I know this post is random...but I would just like to know what types of (non-cliche) things you like to say to people to offer them comfort. Am I the only one who is often at a loss for words?

Featured Replies

Each person is different.

I have taken care of terminally ill nurses who loved to talk about the process they were going through from a nursing perspective.

I have taken care of people on the cusp of a new heart after years of waiting who just wanted a hand to hold.

I have taken care of newly diagnosed heart failure patients in their 40's, on their way to the heart transplant list who wouldn't talk to anyone unless they were direct and realistic.

I have said nothing to a sad and withdrawn patient, but have felt the sigh of contentment over a little bit of lotion on their back and a fresh cup of ice water.

I have talked about life, love and opportunity with a 55 year old colon cancer patient as he sat on his last days of life. (My hero, my inspiration Rick I won't ever forget you).

Each case is different, individual, special, and generally I let the patient dictate what they need. Just open your heart, empathize don't sympathize (you haven't been there, you don't know, even if the case seems similar to something you have been through), and remember a little bit of you can go a long way with a patient, but too much can bring you down as well.

There will always be a few patients that will stick with you, and that is a wonderful thing, it makes us better for having been there, just remember to move forward and enjoy your days with family and friends even more.

Best of luck,

Tait

  • Experts

You are SO not alone! I've been around dying children for more than 2 decades, first as the parent of an oncology patient and then as a PICU nurse, and there are times when I just... don't know what to say. And sometimes just being present is enough. But when you find the silence uncomfortable it's natural to start groping for something - anything - to say.

I might say something like, "This is so hard for you. Is there anything I can do to help?" Or if it seems like it's appropriate, I might say something positive about the child, like, "Bonnie has such beautiful (fill in the blank), did she get that from you?" or I'll comment on the cards and gifts in the room and say, "Seems like Bonnie's got a lot of people who love her. That must make you feel proud." If the parent seems to be willing to talk, asking questions about what Bonnie is like "when she's well" makes them feel that you truly care about their child. You can adapt these suggestions to adults, of course.

Another way to provide emotional support is to include the family in the patient's care. I often suggest that Mom wash the child's face and hands, or brush their hair. It's a caring and comforting act for both and keeps them connected. And the parent is DOING something, which is important in relieving some of that helpless despair of just sitting and waiting. I ask them to help me with comfort care and make it obvious that I want the child to be clean and comfortable, no matter how much more time there is. Chatting about what we're doing is the sort of distraction that they need.

A couple of years ago, a coworker of mine (not a nurse) who I didn't know well had a stepchild in our unit. He was estranged from the child's mom but was still involved with the child. When the results of all the tests were in and we knew the child was not going to survive, there was an outpouring of love and support for the mom and her family, but my coworker was ignored. If they could have pushed him out of the room they would have. He and I were sitting by the door while the rest of the people in the room comforted each other. After several minutes of indecision I put my arm around his shoulders, not sure how it would be received. He didn't stiffen or pull away, so I left it there. After a little while, he relaxed against me and we just sat for about an hour. We've never mentioned that night to each other but there was a change in how we interact after that night. It was worth the risk!

luv4nursing

Could you please tell me how to go about going into an lpn program and taking pre reqs at the same time to become an RN like you are now? Thanks

:redpinkhe:redpinkhe:redpinkhe:redpinkhe:redpinkhe

I dont know what to say either. This has caused me a lot of anxiety. Wish they had a class on what to say.

What to say is never the same thing. And its never really enough. If the goal is to make you feel better about your discomfort, etc, it will elude you. The goal is to comfort the patient. And sometimes that is the arm around the shoulder, the sip of ice water and lotion on the back, and sometimes its being very realistic... it varies. Show them that you care, and that you want to help, and yes - HOW CAN I HELP YOU is never out of line. Even if they dont know what to tell you at least they know you want to help.

Im so sorry. I know it must really hurt. Its so unfair.

After a death I find that often families appreciate a chance to chuckle, even a little... comments about the one who has passed on and what they would have said, or how they would have reacted to something... or that they made a grand exit, or a quiet one... gets more positive reactions than you might think. The KEY to all of this is to focus on THEM and what they need and not spend time feeling helpless and unsure. It will come with time, Good luck.

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