How to Respond When Family Blames You for Patient Dying

[CaliRN2019]

What is the appropriate response when family blames you for the patient dying, even if you did nothing wrong and death insists on taking its course? We have had so many Covid situations lately where patients are DNR/DNI  but are in respiratory distress and family refuses comfort or hospice. Such a slow and awful death. The other day a spouse was fixated on the fact that we had not been feeding her husband ( Sp02 70-88%, lethargic, ALOC) and insisted I take off the non rebreather to give him his PO meds and feed him to "save his life". She continued to scream at me ( over the phone) that I was killing him. It feels so unfair to watch a patient slowly suffer and die without relief due to patients own specific parameters and then get blamed for it. 

[Andy 12, MSN, NP]

I haven't been on the floor since January, but my experience is in ICU, Hospice, and ER. I agree with those who are saying that there is not much nurses can do, except educate. Some families handle grief differently, but education has alot to do with it.

Hospice families would thank you for for being so good to the pts, because they had the education to know it was coming.

ICU families sometimes blamed the staff, but many times they took it better if they were prepared.

ER was usually the worst because the pt was usually fine the day before. They don't have time to prepare themselves.

We need remember that the first two of the five stages of grief are denial then anger. When it was slower, families were closer to acceptance. With covid, pts are sometimes declining so rapidly that there is no chance for families to move towards acceptance.

[PaulL]

While it is quite emotionally taxing to be berated by family members, people will grieve in their own ways. However, there is no reason for you to be subjected to threats or overly aggravated behavior. Consider calling the chaplain's office and other end of life resources to comfort family members if they are available to you at your facility.