I lied...a story of how I outright LIED to patient's family.

[JDougRN]

I got the call on the EMS radio around 5 am. This is the usual time we get calls from EMS responding to nursing homes- The nurses are rounding on their patients to give am meds, and they find their residents dead or in distress. An 87 yo female, febrile, and in severe respiratory distress coming in. Pt is a DNR, but family is very involved, is aware, and will meet them in the ER.

I'm alerted that family is in the waiting room before the patient even gets there. I go out and introduce myself, tell them I will be her nurse, and that I will bring them back as soon as I get her settled in the room.

EMS arrives, and carefully transfers their frail burden onto one of my stretchers. You can see the relief on their faces, that they got her here and are able to hand her off before she dies on their watch. I'm now the proud owner of one very ill person. Temp 102+, Respiratory rate 14 and irregular. HR 50's, sat 84% on NRB, I don't need my Littmann to hear the rhonchi- Other hx is advanced dementia, DM, CHF. Has been in the nursing home for about 6 months- her husband had taken care of her at home as long as he could, but it finally got too much for him to manage, as he was also dealing with his own health problems at the age of 92.

I got her settled, and the Doc comes in- I give him the pertinent info- Not a whole lot we can do at this point other than make her comfortable and treat the infection. Chances are poor that she will make it, and we both know it. Doc moves on to deal with people he can help, leaving me in control of this mess.

I bring her visitors in, including her only daughter in her 60's, and several close friends of the family. I get them settled in and TRY explain to them what is going on. They don't get how bad off she is- I try to explain it to them in soft terms- They share with me who she is- a wife, a mother, a friend.I learn her husband is frail and elderly. I strongly suggest that if he is able, that he come. The daughter tells me she is going to leave to go get Dad. I explain that mom could go at any moment, each gasp she takes could be her last. I don't want them to have to deal with the idea that she died without ANY of her family around. But I REALLY wanted her husband there. The daughter calls her husband, who is dispatched to go get him dressed and here.

In this age of technology, we can keep up with a lot of things. I'm updated that son in law is at dad's house, he's getting him dressed, getting him loaded in the car with the wheelchair. I'm watching my patient brady down, 50's, 40's 30's....The monitor is alarming, and my pt.'s daughter sees it. Husband lands in the parking lot, and the son in law is getting him loaded in his wheelchair.

Then she died, no resps, asystole on the monitor. The daughter asks me- "Is she gone?"

"Not yet" I told her her- I gave her some silly answer- the monitor isn't picking up anything because she is so sick. I mute the alarms, turning the monitor away so she can't see the flat line.. I send 2 of my male coworkers to go out and GRAB the husband, RUN him in.

He arrives, looking a bit baffled at the whirlwind of men running out to snatch him out of his van and deliver him to trauma room 3.

I kneel down and introduce myself. I told him. "I'm sorry, but your girl is dying." He looks at me without comprehension. I took his hand, and joined it with his dead wife's. I told him "Your wife is dying right now- tell her you are here, tell her you love her- these are the last things you will be able to tell her....Tell her it's OK to go-"

He grasped her hand and brought it to his temple. "I love you baby....it's OK to go, I'm here."

I waited a minute and placed my stethoscope to her chest, made a big deal pronouncing her time of death as just then.

I lied- she died without her husband.... but that is something they will never know, but I will live with forever. I know I helped the living, but damn, holding this stuff inside hurts. I tried to explain it to my husband when I got home. He didn't get it. This is something I carry inside.

I know my fellow nurses will understand. Thanks for letting me vent and get this out.

[Christy1019, ASN, RN]

Kind of convenient that this is the only post by that person... I can only hope that the OP can feel our overwhelming support and gratitude that they can ignore the small-minded comments of others.

[AZQuik]

I am so mad I had to log on via computer so I can comment on this article. How dare that nurse make a decision like that, How dare he decide that seeing his wife die is better then seeing her dead. How dare he lie to the family and how dare he think his lie was believed by the patients daughter. Not only did he lie to the husband but he made the daughter complacent in that lie. This is why I am reluctant to ever send our elderly who are close to death to the ER.

This is not constructive in the least bit.

Sent from my iPhone using allnurses

[MDragonfly]

To those of you defending the poster I have this to say I have been in the medical field for 26 years the last 20 of them as a RN with work in acute care, home care, insurance company and long term care settings. From experience people know the truth no matter what we tell them. That poor daughter, she is not stupid, she could see the monitor and the look of her mother. This nurse made her complicit in the lie he told. This nurse with out any understanding of the daughters knowledge level lied to her. He assumed she was ignorant to what was before her eyes. Now if she was aware of what was going on but did not argue with the nurse then she is living with the burden of knowing her mother was dead when her father arrived and that she participated in the lie to him. That in and of itself angered me.

But the worst part of his whole post is he made it repeatedly clear that he felt the patient was a burden.

"EMS arrives, and carefully transfers their frail burden onto one of my stretchers. You can see the relief on their faces, that they got her here and are able to hand her off before she dies on their watch."

"Doc moves on to deal with people he can help, leaving me in control of this mess. "

This is acceptable to all of you? Referring to a dying woman as a mess, a burden? Someone that can't be helped?

This nurse had the chance to do one of the toughest things there is in our profession easing someones passage out of this world and how did he handle it? Lying to the family.

In all my years of experience missing someones last breath is not a bad thing. People tend to hold onto those last images of someone turning colors, getting cold, gurgling and gasping at their last breath for a long time and focus only on that. But have the deceased cleaned and laying nicely in their bed looking asleep and the family can hold that memory.

Come work in my world for a few months and you will have a whole new outlook on dying.

[mrssunday, BSN, RN]

Read the story and can't help feeling what this nurse felt at this situation. I'm currently an ER nurse and love what I currently do. I worked in different nursing settings for the past 5yrs (home health, hospice, med surg, ICU, and Nursing Home) and I can't help but feel sad on what this nurse has to do for the patient's family.

Its hard to take care of this kind of patient, I know that there are different opinions about this situation but have you been an ER nurse to judge her so fast? Have you experience a person dying in your care and all you have to do was help them ease their pain to help them rest forever? What will you do if you are in this position?

I think judging the people base on their actions are definitely a bad example to do. We don't know what does EMS people are thinking of whenever they brought in this patient. They have to respond to every call there is at night and can not stay in the hospital because they need to see other people too. As well as the doctor, he/she can't just stay with the patients till their last moments. We became a nursing advocate for patients, we take care of them make sure everything is okay. As an ER nurse, you take care not only the patient but the family as well.

In my opinion, you did a great job doing this. Family needs to know that you did everything to their family until her last breath. Lying to the dad is a white lie that we have to do to help them ease with the guilt of not being there in time for his wife's death. Easing the family's pain is one of the burdens that we do as a nurse. They said doctors are the one who are suppose to do this but let me tell you, if you work in a busy place, you can not just drop every patient that you have just for one patient. I salute you for doing the right thing for this patient's family. I also believe that the daughter knew about what you did and probably understood that this is needed for the sake of the patient's husband.

[MDragonfly]

@mrssunday I have been involved with 8 deaths of the elderly in the last month. I had to have some very tough conversations with some very distraught families. I never once kept any of the truth from them and in every one of those times I have seen and heard the gratitude for being honest with them.

@ all posters: I came across this when my daughter who is not a nurse shared it on Facebook. She and several non-medical friends of hers were mortified that the nurse lied to the family.

[mrssunday, BSN, RN]

@MDragonfly That's one of the task we have to take and have to endure in our profession. I think some people just didn't know how hard it is to face a family member and tell them that either their family is not going to make it or their family member is not here anymore.

[Lunah, MSN, RN]

Mdragonfly, the uses of "burden" and "mess" were used not in the literal sense. I read that in a totally different way than you did. Have you ever worked in the ER? It is a totally unique beast (and I don't mean "beast" literally ), but having been an ER nurse for a decade, I get why she did what she did. We see a lot of death and dying too. A lot, and by virtue of it being the ER, it's not usually what the patient chose. Just last week I had a pediatric trauma arrest that didn't make it, and this kid's father beat himself up for not being there when his son died. It was heart-wrenching. I wish I could have changed it for him, but I couldn't. I get why she did what she did.

In any case, Mdragonfly, for what it's worth - welcome to Allnurses! Look around, there are many forums that may benefit from you years of experience. :)

[JDougRN, BSN, RN]

MDragonfly- How dare I? I dare because I have been doing this for 22 years. I dare because I care about each and every person I nurse, I dare because I personally know what it feels like to sit with a spouse as they take their last breath. I believe you are either a very new nurse who has no clue or understanding of what that feels like, or you are, as I suspect...just a troll who has nothing better to do with their time than to be mean and hateful. This situation broke my heart- I felt so powerless and sad for the family, even though death is a part of life. My reason for writing this was not to ease my guilt over lying-I would do what I did again in a second. It was to touch bases with my fellow nurses, and to relay to them that they are not alone when they carry this sadness home. Shame on you for having nothing better to do than to try to make people feel bad.

[MDragonfly]

I will be as quick as I can because you obviously don't really want any constructive discussion and won't believe what you read so no sense wasting much of my time.

1-I have 25 years in health care the past 20 as an RN in acute care, home care, longterm care and insurance nursing. No I have never worked in an ER but my mother who was an ER nurse for at least 20 of her 50 years in nursing was and she also felt that what you did was wrong.

2-I only came across your post because my daughter and her friends, none of whom are in the medical field, were completely mortified about you choosing to lie to the family.

3-Your aggressive reaction speaks strongly to how you actually feel about what you did.

[JDougRN, BSN, RN]

I will be as quick as I can because you obviously don't really want any constructive discussion and won't believe what you read so no sense wasting much of my time.

1-I have 25 years in health care the past 20 as an RN in acute care, home care, longterm care and insurance nursing. No I have never worked in an ER but my mother who was an ER nurse for at least 20 of her 50 years in nursing was and she also felt that what you did was wrong.

2-I only came across your post because my daughter and her friends, none of whom are in the medical field, were completely mortified about you choosing to lie to the family.

3-Your aggressive reaction speaks strongly to how you actually feel about what you did.

RIIIGHT- Because NOTHNG you posted addressed my points- Thanks so much. Now run along while the grown ups and those of us who actually HAVE any experience in dealing with patients talk about grown up stuff- you just proved my points. Shoo now, and please try to understand that when dealing with death and families.....It's NOT about you.

[JDougRN, BSN, RN]

And BTW- Citing concern by children who see this post on FB, most of which have never SEEN a dead body, let alone have ANY frame of reference as to what nurses go through on a daily basis isn't a big concern to most of us. I never placed this post on FB- That was a decision made by those who run this site. ANd I'm sorry, I very much doubt you are truthful with your assertions about your mother- Again, I think you are nothing but a sad troll who has no understanding of what us real nurses go through- how dealing with families rips our hearts out on a daily basis. If you were really a nurse, you WOULD understand how important it was for that poor man to be there for his sweetie- If you are a "NURSE" and feel the way you claim- You are pretty darn cold hearted and nasty, I SO don't want someone like you caring for my family.

[MDragonfly]

I wont resort to the childish behavior that you are resorting to. Just two more points. My daughter is a 26 year old woman, not a child.

Second point, you lied. EOD