Knowing the worst and not saying a word.

umcRN, BSN, RN · Nov 11, 2011

Yes I have. Working in a NICU I've had plenty of patients come up diagnosed with this, that and another strange/rare/fatal diagnosis. When the parents come in all I can do is give them updates for the day and say the doctor will be in to talk to them shortly. I will stay while the doctor talks and make sure to have a few cartons of tissues in the room ready

nerdtonurse?, BSN, RN · Nov 11, 2011

I had a patient that was just wonderful. He was a Montagnard, and was a true hero to a lot of our GIs during the war in Vietnam -- the doc told me he'd known the guy for years socially, and if he ever went back to Vietnam there was a price on his head, and that in a righteous world, he'd have gotten a Presidential Medal of Freedom. FYI, 50% of the Montagnards, or Vietnamese mountain people, were executed by the Viet Cong; they paid a horrible price for helping GIs and rescuing downed airmen. My patient was very body shy, but I was able to see he had scars consistent with being shot and what looked like beat with a piece of barbed wire. The scars on his back took my breath away.

Being an Army Brat, this made him royalty to me -- if that man had wanted anything in the hospital, I'd have gotten it for him. I'd grown up hearing stories of how wonderful these people were, how many people they'd saved. But he was "yes, ma'am" and "no, ma'am" and "thank you, ma'am."

He'd come in for something relatively simple -- gallbladder or kidney stones. Had done well and was going home the next morning, and they did a x-ray to make sure that what they'd done had worked. Except this particular x-ray went just a little higher in the chest than the prior films, and he had a 6cm nodule in the middle lobe of his lung. The report spit off the printer, I looked at it (anticipating nothing wrong) and was floored. He had lung CA. And I couldn't tell him. He talked all night about what he was going to do do with his grandchildren that summer, how he and his wife were going to NY because he'd always wanted to see Lady Liberty, etc.

And I'd been on the phone to the big teaching hospital in the state capital, getting him an appointment for a bronch with biopsy.

When I went in the next morning, he'd made his bed neatly, and was sitting at the foot, dressed and putting his shoes on to go home. I told him he didn't get to do that until the doc came by and wrote discharge orders, and that he had to have one more of our wonderful breakfasts before he left. And I started home, pulled over in the McDonald's parking lot, and cried.

When I went back to work that night, he'd been transferred. I never saw him again. But I know that at least for one night in my career, I looked after a true hero.

Traum-a-Rama · Nov 11, 2011

Wow...I'm wiping tears away after reading your story. This really touched me, especially on Veteran's Day (there are so many unsung heroes out there). Thanks for sharing.

Whispera, MSN, RN · Nov 11, 2011

What a touching story, nerd. Thank you for sharing it.

Jenni811, RN · Nov 11, 2011

had a patient, 47 y/o, life-long smoker. Had 2 kids in high school. Had part of a lung removed. Tests came back positive for lung cancer.

I knew it, and the patient kept saying "Im just hoping i don't have cancer. I promise i will stop smoking. i just want more time with my children"

hard to sit there and listen when i knew. Physicians eventually told her while she was in the hospital, it was off my shift so not sure how she handled the news. but i don't like knowing and not being able to say anything.

roser13, ASN, RN · Nov 11, 2011

What a touching story, nerd. Thank you for sharing it.

Did a double-take at this sentence - had to look at the OP to realize who you were calling a nerd:D

Whispera, MSN, RN · Nov 11, 2011

I had a friend who went to the hospital for indigestion. After a long time they diagnosed cancer plaques throughout her abdomen. I worked there so I knew about it. I couldn't tell her even though I knew the prognosis, until she brought it up...

sapphire18 · Nov 11, 2011

I had a patient that was just wonderful. He was a Montagnard, and was a true hero to a lot of our GIs during the war in Vietnam -- the doc told me he'd known the guy for years socially, and if he ever went back to Vietnam there was a price on his head, and that in a righteous world, he'd have gotten a Presidential Medal of Freedom. FYI, 50% of the Montagnards, or Vietnamese mountain people, were executed by the Viet Cong; they paid a horrible price for helping GIs and rescuing downed airmen. My patient was very body shy, but I was able to see he had scars consistent with being shot and what looked like beat with a piece of barbed wire. The scars on his back took my breath away.
Being an Army Brat, this made him royalty to me -- if that man had wanted anything in the hospital, I'd have gotten it for him. I'd grown up hearing stories of how wonderful these people were, how many people they'd saved. But he was "yes, ma'am" and "no, ma'am" and "thank you, ma'am."
He'd come in for something relatively simple -- gallbladder or kidney stones. Had done well and was going home the next morning, and they did a x-ray to make sure that what they'd done had worked. Except this particular x-ray went just a little higher in the chest than the prior films, and he had a 6cm nodule in the middle lobe of his lung. The report spit off the printer, I looked at it (anticipating nothing wrong) and was floored. He had lung CA. And I couldn't tell him. He talked all night about what he was going to do do with his grandchildren that summer, how he and his wife were going to NY because he'd always wanted to see Lady Liberty, etc.
And I'd been on the phone to the big teaching hospital in the state capital, getting him an appointment for a bronch with biopsy.
When I went in the next morning, he'd made his bed neatly, and was sitting at the foot, dressed and putting his shoes on to go home. I told him he didn't get to do that until the doc came by and wrote discharge orders, and that he had to have one more of our wonderful breakfasts before he left. And I started home, pulled over in the McDonald's parking lot, and cried.
When I went back to work that night, he'd been transferred. I never saw him again. But I know that at least for one night in my career, I looked after a true hero.

Wow, this story brought tears to my eyes, thank you for sharing. :heartbeat

carolmaccas66, BSN, RN · Nov 11, 2011

I know this sounds hard hearted, but try to stay out of it all, though you can still remain professional and empathetic.

I have worked hospice and seen nurses who get too involved with patients, and ended up getting dragged into fights with other nurses & family members. I even saw a nurse who got involved in a dying person's will - the dying person wanted to leave money to the nurse, family were against it - it caused a WHOLE heap of trouble, fighting, tears, arguments, etc. I think it even went to court.

I know it sounds awful, but trust me, it will save you a lot of grief in the long run. Some advice also for new nurses too.

Ahhphoey · Nov 12, 2011

About 6 years ago I was caring for a young Hispanic woman in the ICU who had become critically ill with some type of respiratory issue. She was about 30 or 32, an immigrant, and spoke no English. The docs were baffled at what had made her so sick since she appeared the picture of health and from the limited history we got from her friends, she had no medical history other than 3 pregnancies. She had no family in the states; her family, including her young children, were all in her home country. A slew of tests were ordered to try to figure out what was going on with her, one of which was an HIV test. Needless to say, it came back positive.

The first day I had her, which was about 4 or 5 days after she first came in, she was on a ventilator, but had significantly improved and was about ready for extubation. With the help of a Spanish-speaking respiratory therapist, I was able to communicate enough to let her know what I was doing, such as drawing blood, turning her, doing mouth care, etc, and ask if she needed anything. What I remember most is that she smiled a lot, despite the tube down her throat and lines all over the place. She couldn't talk, but her smile was almost constant when she was awake. It was that day that the results of the HIV test came back.

Early the next day she was finally extubated and able to talk. Fortunately, the same Spanish speaking RT was there and helped with a lot of the translation. But when it was just the two of us, with my limited broken Spanish and her limited broken English and a LOT of hand gestures, we actually conversated about her children and how much she missed them. All the while I kept thinking about that HIV diagnosis and how it would change her life. It may not be a life sentence anymore thanks to advances in treatment, but its still life altering. Plus, this was a woman with very limited resources who only saw the doctor in the past to give birth.

Later that day I sat in the room at her bedside while the physician and a translator informed her of the diagnosis. The wails that came from that woman were almost unbearable. The only thing I could do was rub her back and sit with her while she cried, and thats what I did for the next hour (fortunately my charge nurse was able to watch my other patient during that time). She sat there and cried and talked and cried some more during that time...I felt horrible that I couldn't understand most of what she said but it obviously wasn't the time to leave her to get someone to translate or use the translation phone, so I just stayed with her.

It seemed liked she just shutdown after that. She barely talked for the rest of my shift and the next day she was equally quiet. She wouldn't make eye contact and answered questions with a simple yes or no. I transferred her out to stepdown in the middle of that last shift and just felt helpless when I left her in her new room curled up in the bed facing the wall.

Sorry so long, but that is a patient that really sticks with me especially how she looked when I last saw her. I still think about her from time to time and wonder what became of her.

Whispera, MSN, RN · Nov 12, 2011

Another very touching story...thank you, lovelylpn.