Incinsiderate Families

wowohwow · Jul 8, 2016

Needress to say, the family left after that; they had wrecked their damage; other matters to take care of now (I guess more little old ladies to upset or a child or two to run over).
I understand they were upset, too, but the lady has anxiety issues and she's really quite fragile.
I was fuming. I didn't show it or express it, but I was thinking, "You jerks!"

First off, spell check is your friend.

Secondly, what an idiotic comment regarding what the family members actions might have been after they left. "I guess more little old ladies to upset or a child or two to run over" What a very insensitive and callous thing to say about a family who is grieving.

Thirdly, way to go in making it all about yourself and much easier it would be if you have the chance to medicate her before the news. I guess some people are just naturally cold and callous.

sevensonnets · Jul 8, 2016

You're not logical at all. Shame on you.

jadelpn, LPN, EMT-B · Jul 8, 2016

Does your facility have a social worker, a chaplain, hospice counselors?

That would be the next thought I would have as a nurse caring for someone who has lost their spouse.

Pre-medicating will not make the emotional pain any less. Dynamics are such that they were perhaps married for 100 years, your patient more than likely doesn't want to be left alone, and perhaps is used to "taking charge" at home when devastating family circumstances occur.

So get a 1:1 sitter, call whomever the patient would want to help them be it their minister, the church ladies group,hospice, a grief counselor...."Mom needs something for her nerves, her husband just died" "I will medicate her accordingly, can I call someone to be with her like her minister or one o our counselors? I am so sorry for your loss."

But to leave a spouse in the dark about their husband's death until the time is convenient for the nurse is outrageous.

TheCommuter, BSN, RN · Jul 8, 2016

The family members in the original post were being very considerate of their loved one's emotionally charged grieving process, which is why they asked for medication to calm mother's 'nerves.'

macawake, MSN · Jul 8, 2016

The poor lady starts to scream and cry.

the family did not want her coming back to the home

I understand they were upset, too, but the lady has anxiety issues and she's really quite fragile.

I noticed that a few posters think that the OP made the resident's husband's death all about her and that she is being selfish when she expresses being upset by not being notified in advance. I actually think that it's possible to make a more benevolent interpretation of her post. She does mention twice that she would have liked to medicate the resident before she received the bad news. I still don't think it's a suitable course of action but it could be that OP thought that it would "soften the blow" and her motivation could have been concern regarding the emotional impact on the resident from hearing the news. Misguided and an inappropriate intervention? In my opinion, yes. But it doesn't have to be a sign of selfishness.

When I said that it could have been helpful that the nurse be made aware I didn't mean that the family tell the nurse about the husband's death before they told the resident. I do of course think that she deserves to hear it first.

I simply meant giving the nurse a heads-up that the resident was about to receive some very difficult news without specifying the details, would have prepared her to offer support that goes beyond what's probably required on a day-to-day basis. But again, I wouldn't expect it and I don't think it's at all strange or deserving of blame, that the relatives didn't think to or chose not to do it.

OP, not all pain in life should be addressed by pharmaceuticals. In a way the intense shock, pain and sorrow that someone experiences (fragile or not), upon hearing about the death of a loved one is a testament to the depth of the love that they felt for the deceased person. It hurts so much because we have irrevocably lost someone who mattered so much to us, someone who had a big part in our lives and in many ways are part of who we are. We should be allowed to feel this and grieve our loss. I think that it's an essential part of the grieving process and later on; the healing process.

Horseshoe, BSN, RN · Jul 8, 2016

I noticed that a few posters think that the OP made the resident's husband's death all about her and that she is being selfish when she expresses being upset by not being notified in advance. I actually think that it's possible to make a more benevolent interpretation of her post. She does mention twice that she would have liked to medicate the resident before she received the bad news. I still don't think it's a suitable course of action but it could be that OP thought that it would "soften the blow" and her motivation could have been concern regarding the emotional impact on the resident from hearing the news. Misguided and an inappropriate intervention? In my opinion, yes. But it doesn't have to be a sign of selfishness.
When I said that it could have been helpful that the nurse be made aware I didn't mean that the family tell the nurse about the husband's death before they told the resident. I do of course think that she deserves to hear it first.
I simply meant giving the nurse a heads-up that the resident was about to receive some very difficult news without specifying the details, would have prepared her to offer support that goes beyond what's probably required on a day-to-day basis. But again, I wouldn't expect it and I don't think it's at all strange or deserving of blame, that the relatives didn't think to or chose not to do it.
OP, not all pain in life should be addressed by pharmaceuticals. In a way the intense shock, pain and sorrow that someone experiences (fragile or not), upon hearing about the death of a loved one is a testament to the depth of the love that they felt for the deceased person. It hurts so much because we have irrevocably lost someone who mattered so much to us, someone who had a big part in our lives and in many ways are part of who we are. We should be allowed to feel this and grieve our loss. I think that it's an essential part of the grieving process and later on; the healing process.

I agree. I actually edited my original response to the thread after I went back and re-read the OP. It was not actually clear to me that she was framing the whole thing as being only about her own inconvenience. I think one could interpret her post as verbalizing concern for the patient. However, I disagree vigorously that the knee jerk reaction to the knowledge that a patient is about to receive bad news should be medicating the patient prior to delivering the news. I agree whole heartedly with macawake's comments above about allowing the patient to absorb the news without having their authentic reaction dulled by medication. No matter how well meaning, it strikes me as rather patronizing, arrogant, and completely inappropriate.

lifelearningrn, BSN, RN · Jul 8, 2016

If I'm reading correctly, the family came in, dropped the bomb on grandma, then left shortly after? While I agree that it's silly to have expected them to notify the nurse prior to dropping such horrible news on the patient, to do so then just up and leave the poor grieving grandma alone in the facility IS inconsiderate. Sorry, having worked in nursing homes, families can be ridiculously inconsiderate. I can totally see how this happened, nurse, unaware of anything, sees family members that rarely show up walk into patient's room. A few minutes later, sobs are heard from the room, nurse enters, family members are gathering their things to leave and say to nurse, "mom just learned her husband died, she's going to need something for those nerves".. patient begging daughter to let her go home and grieve with the family, daughter saying to nurse as she walks out the door, "please explain to mom why she has to stay here"... family gone, nurse left to pick up the pieces in the middle of her med pass of 30+ patients.

Yeah- maybe I can see how the OP may have been a bit put off.

kbrn2002, ADN, RN · Jul 10, 2016

I can sympathise with your difficulty dealing with her normal reaction to the news that her husband just died, but don't you think that just maybe it is inconsiderate of you to expect a grieving family to tell you before they tell his wife?

morte, LPN, LVN · Jul 10, 2016

frankly, i think the family should have told the nurse first, even if it were no explicit, just the fact that bad news was coming, and please medicate mom, for MOM's well being. We are not talking about snowing some one, this patient had a documented anxiety issue, why do you want to drive her up and over that wall?

macawake, MSN · Jul 10, 2016

frankly, i think the family should have told the nurse first, even if it were no explicit, just the fact that bad news was coming, and please medicate mom, for MOM's well being. We are not talking about snowing some one, this patient had a documented anxiety issue, why do you want to drive her up and over that wall?

I'm not sure who the "you" is that you're directing this post at?

As former law enforcement I have delivered more death notifications to unsuspecting, unprepared family members than I care to remember. As in knock, knock on their front door, followed by "it's my sad duty to inform you.." Finding out that a loved one has died, hurts. Deeply. It's supposed to. As I already said, it hurts because we loved. No doubt some of the strangers I had to deliver terrible news to were mentally/emotionally robust, while others were no doubt more fragile. Despite that, as far as I could tell, the news was devastating to all individuals that I delivered the news to.

Are you sure that medicating the resident prior to delivering the bad news would really have been beneficial for her? I have my doubts if a benzodiazepine or two would really have much effect, you'd probably have to give various meds in doses close to what I administer on a daily basis (surgical anesthesia) to completely dull the reaction to the news. But.. Imagine that you do manage to neutralize some or even most of the reaction by medicating, how is that beneficial? How does a person feel and process the fact that they just heard news that drastically altered their life, news that they know should be very painful, but their only reaction to it is; meh... What's the plan after the initial news was given? Just keep medicating away to try to keep any manifestations of grief at bay?

No one wants to drive her up and over that wall as you put it, but how does a person ever heal, if he or she is not allowed to mourn?

morte, LPN, LVN · Jul 10, 2016

it would appear you are purposefully misconstruing my post, why that would be, escapes me. I clearly stated not enough to "snow" the patient. We know that with sufficient anxiety , news is not taken in at all. keep that state up for extended periods of time, they family may well be dealing with another death. so, have at it. the puritans would be happy.

I'm not sure who the "you" is that you're directing this post at?
As former law enforcement I have delivered more death notifications to unsuspecting, unprepared family members than I care to remember. As in knocitk, knock on their front door, followed by "it's my sad duty to inform you.." Finding out that a loved one has died, hurts. Deeply. It's supposed to. As I already said, it hurts because we loved. No doubt some of the strangers I had to deliver terrible news to were mentally/emotionally robust, while others were no doubt more fragile. Despite that, as far as I could tell, the news was devastating to all individuals that I delivered the news to.
Are you sure that medicating the resident prior to delivering the bad news would really have been beneficial for her? I have my doubts if a benzodiazepine or two would really have much effect, you'd probably have to give various meds in doses close to what I administer on a daily basis (surgical anesthesia) to completely dull the reaction to the news. But.. Imagine that you do manage to neutralize some or even most of the reaction by medicating, how is that beneficial? How does a person feel and process the fact that they just heard news that drastically altered their life, news that they know should be very painful, but their only reaction to it is; meh... What's the plan after the initial news was given? Just keep medicating away to try to keep any manifestations of grief at bay?
No one wants to drive her up and over that wall as you put it, but how does a person ever heal, if he or she is not allowed to mourn?

macawake, MSN · Jul 10, 2016

keep that state up for extended periods of time, they family may well be dealing with another death. so, have at it. the puritans would be happy.

Yes really morte, hastening the demise of little old ladies is something I do for funsies.

it would appear you are purposefully misconstruing my post

I don't think that I have.

I clearly stated not enough to "snow" the patient.

And I responded by telling you what I thought would happen if the resident was administered her regular (likely relatively low) dose, namely not much at all. I added that it's my belief that if you were to get a more pronounced effect from her regular meds, reacting abnormally (lacking emotion because of the meds) to her husband's death, might actually be detrimental.

The state of being "snowed" isn't a medical term. The criteria of exactly when a person enters the "snowed" state aren't clearly defined. Neither you nor I know how various dosages of a specific benzodiazepine will affect the ability of a specific individual to absorb and process bad news. What exactly is it that you are proposing? Are you aiming for a certain plasma concentration of the anxiolytic? You are proposing to alter brain chemistry by enhancing the brain chemical GABA because, I assume, you think that the hard news will be easier to hear that way.

We'll have to agree to disagree. I stand by my belief that attempting a preemptive strike designed to inhibit the natural reaction to a loved one's death, is ill-advised.

You didn't answer the questions I asked. I am curious what you think it would do to a person's mind when they experience a clear dissonance between what they do in fact feel and how they know they ought to feel in that situation? Their loved one is dead, and they don't really feel much of anything?