In your experience.......when a seemingly "stable" patient tells you they are

MassED, BSN, RN · Jul 30, 2008

Going to die........how often are they right?
A "stable" patient last night, said she was going to die, there was nothing that was out of the ordinary with her.......
but she did die - 4 hours later....
So, in your experience, how many patients have been right with their feeling of "impending doom?"

always trust what is told to you when it comes to that term "impending doom" - that, and the hair going up on your forearm - that's another non-scientific gauge of impending doom (for me).

nerdtonurse?, BSN, RN · Jul 30, 2008

The runner up to that one, especially with a patient that's been circling the drain, is either the patient saying, "I feel better today than I have in a long time" or the family saying, "Gee, mom's more at her self than she has been in years." Yup, they're getting "better" enough to die.

MassED, BSN, RN · Jul 30, 2008

I used to take care of a "regular" ER patient, a nice guy who would go into V-tach and he had an implanted defibrillator. He would come in, screaming (usually be EMS) saying "stay back" when his defibrillator was about to fire... the darndest thing. That was the nicest and most appreciative patient I have ever taken care of. One night, he was in as a visitor with his girlfriend and he made this off-handed comment after I asked him how he had been doing... he says "oh, same 'ol same 'ol, some chest pain, but no big deal." I said "you better get that checked out because I don't want to be working when they roll you in - in a bad situation." A few days later, EMS rolls in with CPR in progress.... my guy on the stretcher. I had a feeling it was him when the call came in - my heart broke. So sad.

nerdtonurse?, BSN, RN · Jul 30, 2008

On the original post, I had a patient, a guy dying from prostate CA that had mets'd all over. We bonded over his 3 week stay, and every morning when I went in to tell him I was going off shift, he always said, "see ya tonight, right?" This time, he reached up and took my fingers and mouthed "Bye." I told him I'd be back that night, but he smiled and shook his head. I told the nurse coming on that Mr. M thought he was about to go. He passed about 2 hours later.

ilstu99 · Jul 30, 2008

The runner up to that one, especially with a patient that's been circling the drain, is either the patient saying, "I feel better today than I have in a long time" or the family saying, "Gee, mom's more at her self than she has been in years." Yup, they're getting "better" enough to die.

Absolutely! My MIL just passed away. The day before she died, my SIL called and said that she was "feeling great," and flirting with the staff, telling jokes....and pain free. Um. This is a woman with end stage pulmonary fibrosis, and such horrible degeneration of her vertebra that her L2-5 were like dust. I put my husband on a plane 2 hours later. The next morning, she told them she was going to die, and began speaking to her dead mother, sister and son. I mean....conversation. She died at 5 minutes to midnight.

TLCinCICU · Jul 30, 2008

You can chalk me right up there with the crowd. I've had several patients make a comment about dying soon and then have it happen within hours.

I've also developed something of a "sense" or strong "gut feeling" (or perhaps an overactive imagination) of when "nobody's home" in a patient who is s/p arrest - or about to arrest.

lifecycle1898 · Jul 30, 2008

I've worked in Psych for years and heard that hundreds of times. Hasn't happened yet.

liveyourlife747 · Jul 30, 2008

It can happen! My grandmothers best friend was found dead in her home last week. My grandmother had pleaded for her to go to the ED because she had been having s/s of pneumonia and she was diabetic. My grandmaw told her that she "didn't want to come in a find her dead," and the lady said, "it can happen." And sure enough, it happened the next day, right before her dr appt, and after some one had talked to her less than 2 hrs earlier. So sad. But, it can happen!

suespets · Jul 30, 2008

Had a stable geriatric man come to the nurses desk, sev. times ,saying he would be dying "tonite".I reassured him all was well, even took all his vitals,to prove such. He kept telling me he should be buried in ......, and to tell his galfriend he loved her.He died w/I hr's!!!! real embarrasing when galfriend showed up very soon after, expecting to visit. I was a new nurse & stunned.Some time later, I wondered if he saved a bunch of pills & offed himself(someone would have noted them in his drawer,though.)So, yes, I take them seriously,but not much can be done other than monitoring, as I had. sue

Transplant Nurse, BSN, RN · Jul 30, 2008

I've had some look green and I did what I was trained to do, they were intubated usually in the next shift or sooner and got better since it was caught. I wondered the same thing how frequently they are right. They just don't stick around to tell us about it!

Babs0512 · Jul 30, 2008

I trust the patient. That doesn't necessarily mean they will die on my shift, but I've never had a patient who said this that didn't die withing 24 to 48 hours.

I will pay closer attention to the patient with these feelings, encourage them to talk about their feelings, and try to assist them, when necessary, with final arrangements ie: calling loved ones to come for a visit, or old friends, a minister etc... I let them know I believe them, but that they cout be wrong. Seriously though, psyc cases aside, I've never known them to be wrong.

Kind of errie, but true.

Good luck

Transplant Nurse, BSN, RN · Jul 30, 2008

That is exactly what I did also, called the family and told them she was requesting their presence and "change in status/breathing problems." Patient was a smoker and post amputee. This was the onset of her sepsis, and though we saved her that night and she would survive past extubation, she still would need to beat the odds to make it long-term. Last I knew she had no family to support her to go home, and relatively young 50's. Very sad. I am a night nurse and the worst thing for me is when a family leaves and tells you to take good care of them and they tank through the night.