I don’t know what to say ???

[JenMH88RN, BSN, RN]

I have recently decided to remove myself from the float pool (I simply became tired of floating) and become a med-surg/oncology nurse. Yesterday, my patient’s (who has pancreatic cancer) was crying and saying “I just don’t like to see him in pain”. Later into the day, he has a room full of relatives/friends who were all crying and praying. I DID NOT KNOW WHAT TO SAY/DO ?, and I felt bad for not knowing what to say and also for saying nothing at all. Any advice on what to say/do for a grieving family or a patient who is grieving for him/herself would be greatly appreciated.

[Davey Do]

Showing empathy, verbal listening, e.g. "I know it must be difficult to see him in pain", your knowledge and support, and just being there. Silence is good- let them fill that silence- they need to express their pain.

My first LPN instructor told us, "If you can do nothing else, just be there".

The very best to you, Jen.

[NurseCard, ADN]

Just be there.

Just listen.

Often that is all that is really needed.

I mean, sometimes family members will have questions that you will learn the answers to as you go along in your new job. They will want to know signs that the end is near. You will gently be able to answer such questions.

Other times, all you need to do is be there to listen. Or, to simply allow family members to gather and pray.

[CharleeFoxtrot, BSN, RN]

Sometimes no words are necessary, use you body language to convey that you are "present" and supportive. For example, enter the room with a calm neutral expression (hardest part IME), make brief eye contact, slight nod of head "I acknowledge you and your feelings and am here with you ". Do what needs to be done, sweep the room with your eyes again and quietly exit.

I love this video on the very important difference between sympathy and empathy, it was a part of a lecture I attended on therapeutic communication.

Brene Brown's video on empathy vs sympathy

[inthecosmos, BSN, MSN, RN, APRN]

Being present and attentive is more than enough.

[AceOfHearts<3]

I do all of the above and I quietly tell a family member or two to let me know if they need anything- water, tea, etc. I offer to call the chaplain if they want someone to sit with them. I make sure there are tissues in the room, etc. I also quietly peek in from time to time to see how everyone is doing so they know I haven’t forgotten about them.

[VivaLasViejas, ASN, RN]

Sometimes the best thing to say is...nothing at all.

Like others have said, words are not always necessary. Your presence in the room and the good care you give show the patient and their loved ones that you're there for them. You can also offer them comfort in the form of food and drink, or call their clergyman/woman of choice. I know when my own husband was dying of pancreatic cancer, it meant a lot to me that the nurse remembered to ask if she could call our priest to have him come out to perform the last rites. I was so distraught I'd completely forgotten.

You're doing fine. As you learn your job, you'll develop instincts as to what to say, and when you need to listen more than anything. This is hard work, but it can be so rewarding even though you deal with a lot of sadness.

[zoidberg, BSN, RN]

Providing great care in situations like this is nursing at its best. Round frequently, advocate if more/different analgesia is needed, explain things to the patient and family so they understand what is happening, make sure they know what options are available (comfort care, hospice, surgery, chemo, etc) palliative care teams are a great resource if you have one available.

[Caprica6]

I used to ask families how much they wanted to know...and then provide that information in a caring, compassionate way. It allowed them to have some control over an uncontrollable situation.

Look up mindful listening...there's quite a bit on that topic. Practice the techniques because it can be hard to simply listen...we often want to jump in and say something(anything) when the family/patient just need us to hold the space for them.

Kudos to you to looking to improve your practice...I'm sure you're doing fine and will continue to provide compassionate care!

[Workitinurfava, BSN, RN]

Med-surg oncology nursing is a tough area of nursing, in fact it is one the easiest to burn-out in. You will really need to look up this area of nursing. It is a rewarding area of nursing but the patients will be at their lowest and some will be knocking on deaths doors so don't be shocked if they are upset and down right nasty towards you. You may want to run from this job but stick it out if you can, please get chemo certified and than so many doors will open for you. You will be able to work in places with a slower pace. I worked at major hospital in Washington, D.C. while I was a oncology med-surg nurse.

[buttercup9, ASN, BSN, MSN]

People have given great advice so far.

Being present and listening is huge I think. Sometimes you don't have to say anything. If there is a chair available, sit down and listen. (Also make sure the room has a lot of tissues). The chaplain is a great idea.

When I was on the floors (in ED now) we were able to get a "courtesy cart" from the kitchen. It was basically a cart with cups, a hot water carafe/ canister/ pot, coffee carafe, creamer and some cookies. We were only able to get it when there was a family vigil for the actively dying patient but they always appreciated it. We never told them we'd get it, it just showed up.

Another thing I would suggest is asking for a palliative care consult. They are wonderful and can help with pain management and a chaplain is often on their service. They can help set up all the things that may fall through the cracks.

[RNfaster]

Many posters above have some great ideas, e.g., presence, chaplain, etc... I also agree with the pain/palliative consultation.