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.

[Sixtyseven]

Well, we're damned if we do and we're damned if we don't. You made the best judgment call you could at the time, and it was done out of kindness. Let us not judge you.

[Roses101]

According to research, when a person dies the hearing is the last to go. Could she have heard her husband's voice? Then you wouldn't have lied!

[jvman]

Doug, you did a heroic thing, what you did was have compassion for the living and allowed them to feel peace to start the grieving process.. "we've" all had something similar within our scope of practice... Let's hope more Nurses seize the opportunity to be as thoughtful, insightful, and compassionate. Well done, no lies, just an opportunity to "do the best for your patient and family"

[RNCCMMS, RN]

The patient didn't know what was happening, but you provided the husband and family with very much needed closure.

We don't just take care of the patient. Families are always affected by illness and they need our support. You did what nurses do-care and comfort.

[Roses101]

According to research, when a person dies the hearing is the last to go. So is it possible she could have heard her husband's voice? You wouldn't have lied then! You are a kind wonderful nurse who is being to hard on herself but I know how you feel.

[sadiecookie]

You absolutly did the right thing. I remember when I worked in a Dr.'s office, an elderly man and his wife walked in he was ill. I did an EKG and knew immdediatly the man was dying even though he was still very alert and oriented. (His only complaint was server dizziness) While waiting for him to be transported to the ER I stayed with him and his wife and teased him the entire time about differnt things. I had him and his wife laughing knowing the entire time he was dying. I debated about being honest but just kept up the banter with the couple. He did die on the way to the hospital. I went through a phase, should I have done this, should I have been more honest so they could say their good byes? Several months later the wife had an appointment when I placed her in the room she hugged me and said, " I want to thank you so much, my husband's last moments were spent laughing because of you. This meant a lot to both of us." I know I did the right thing even though at times I question myself still. YOU DID THE RIGHT THING BE PROUD!!!!

[Mat/rnm]

Thanks for sharing with us, at least the next time I am in the same situation I will remember this. As students we are inspired by the caring nurses like you. You got the 'nurse's heart'.

[Wendysplace68]

I remember when I first started nursing and I was a nursing student in a large hospital setting...I sat with this elderly gentleman late at night on the pm shift....we noticed that his condition was deteriorating and felt that he was going to pass away...we contacted his wife and family and I sat waiting with him hoping that they would arrive before he passed away...I was probably 19years old at the time...I still remember the moment when he took his last breath or sigh and I could even imagine the soul leaving his body...I remember the feeling I had, that his wife and daughter would not make it to say goodbye to him....it was not my responsibility at that stage to let his family know he had passed it was the nurse in charge....but I remember them all sitting in a private room for support once they arrived..there is nothing you can do about the time of death it is totally outside of our hands....I have heard stories of some patients who just last long enough to say goodbye.....

[Sharon M RN BSN, BSN, RN]

You did the right thing. It was compassionate and merciful.

[gunny48]

"Do no harm" - You didn't. That also needs to apply to you. We use words every day to help our patients. Perhaps saying "You look better" when they don't just to give them hope and the will to fight on. You gave this family a release from the guilt of "not being there". You are what they needed - a Nurse. Thank you.

[martinb216]

You were very brave and compassionate. You did entirely the rught thing - doesn't make it any easier though

[once-a-nurse]

What you did was a kindness. I applaud you!