Medical staff rude to my brother;complicated;advice please

shoegalRN, RN · Nov 30, 2009

While we are not certain that the medical staff meant harm, we are not certain that they did not mean harm either. It could go either way. I do think an apology for their behavior is called for and hope that my brother gets it. Those nurses were the professionals here and more should have been expected from them. I know that ,as a future nurse, there will be times that I will have to be quiet and do my job. That is life. Snidely calling my brother a "candleholder" and sharply handing him a piece of paper with the name of the local funeral home printed on it was not advocating for a patient in a positive or helpful way. All I can say is that if I had been there to witness that, I would have raised holy hell.
I am glad that the end came as well. I mean, I don't want anyone to suffer. I can tell you that after the emergency surgery and once the LW was clarified, there were no heroics after that. She had adequate pain meds. Everything was on the "up and up" so to speak.
And yes, Leslie, I am hoping to is dancing with the angels...I do, however,take offense to your description of her as a person "trapped in a crippled bodyform". She was more than that....she was a person who loved children and animals, enjoyed trips to the beach, had a friendly smile.... she was truly more than just her CP.

And how was that gonna help the situation? I can tell you from being an ICU nurse, there are plenty of family members who "rasied holy hell" when told that Granny or Nana was not gonna make it, and while their feelings were noted, security was called in a couple of situations. It's not fair to the pt or the other pts or their family members to "raise holy hell" because you heard something you didnt want to hear.

Just my opinion.

PostOpPrincess, BSN, RN · Nov 30, 2009

While we are not certain that the medical staff meant harm, we are not certain that they did not mean harm either. It could go either way.

You need to explain this sentence. YOU obviously did not trust them.

THAT is the bottom line. If there was no trust established, everything could've been done properly--but your brother, and even you may not see it as such.I also do not have the HCPs side. Only your brother through you. I would also like to hear what they have to say, as I am sure they have explanations for their behaviors. I'm not saying they weren't rude, but at the same time, perhaps your brother was too.

I truly hope that your brother and even you, will find peace. And To be honest, you will have to address your expectations of HCPs as you learn to be a nurse. They are somewhat unrealistic at this time.

Scrubby · Nov 30, 2009

How awful it is that a person has to suffer because someone is too wrapped up in their own selfishness to listen to reason.

As an operating room nurse I see so many patients who are terminal, elderly and are having major surgery that will only prolong their suffering, will not cure them and will only make their last days painful and without dignity because their families insist on it. There are times when I truly feel ashamed to be a part of the surgical team and would love to just scream at these family members that they are just so wrong.

I'm going to be brutally honest here. I too find it difficult to believe that someone who was a caregiver for such a long time was not aware of this patients wishes. I wouldn't want someone who would not honour this to be caring for any of my loved ones.

For the sake of future patients I would hope your brother reflects on how his decisions have impacted on this poor patient and hopefully will not do this to another person, or just get out of the industry for everyones own good.

As for rudeness, well all health care workers need to be professional, but we are NOT here for the patients relative and friends benefit we are here for out PATIENTS.

TheCommuter, BSN, RN · Nov 30, 2009

While I can appreciate all of the points made-and agree with most of them-nothing warranted the fact that a)the doctor raised his voice to my brother b) the rude comments made by the nurse and social workers. I understand that they might have been frustrated but they needed to remain professional. Their behavior was not professional; it was rude. And to that end, an apology from them will be made when everything is said and done.

I will very respectfully opine that the deceased lady is the one who truly deserves a heartfelt apology because she was robbed of the chance to ever have her final wishes honored. She endured traumatic emergency surgery, unrealistically heroic measures, futile treatments, questionable pain management, barbaric rescuscitation efforts, and four days of needless suffering before death. Although your brother has perceived the words and actions of the hospital staff as rude, he is not necessarily entitled to a formal apology from these people who were entrusted to tell him the blunt truth about the situation.

litchi · Nov 30, 2009

I agree with pretty much everyone else that's posted here. I just wanted to add one thing in response to this statement:

3) I think the fact that his friend had CP is important here. Sad to say but a lot of people do not believe that handicapped people should be allowed to live. My brother felt that they were pushing her to die because, in their eyes, her life was not as important as, say, a young teenager or a father of three....the language that was used "Her life was horrible before and it will be horrible now"direct quote from the DR.

I don't think the fact that she had CP had anything to do with it. I think the bottom line was that they knew she had terminal cancer and they wanted to make her comfortable, not put her through a lot of pain and suffering in the end. It doesn't take an oncologist to know that some cancers are terminal. The fact that everyone was suggesting hospice indicates that they already knew the prognosis.

I can understand your brother's feelings and wanting a second opinion from a specialist.. He's human. A friend dying is very hard to deal with. I'm sure he was just hanging on to hope that an oncologist would say that something else could be done. Deciding that all the doctors and nurses felt like she didn't deserve to live because she had CP is just an easy way to displace his anger on them for the situation. The truth is, they wanted to do all they could to make her comfortable because they knew she was dying. The fact that she had CP was completely unrelated and did not make her unimportant to them.

So..the doctor raised his voice to your brother and even said her life would continue to be horrible. The situation was stressful for everyone, doctors and nurses included. Who knows how long this lady suffered with cancer before it was diagnosed? Your brother was extremely distraught and probably not thinking clearly when all this unfortunate information just came at him from left field. Neither you nor I know if the doctor's statement was taken out of context or not. I have a feeling that most of the statements that your brother felt to be inappropriate were, but I cannot say for sure.

I'm guessing that since she passed away, your brother has realized he probably should have listened to what the staff had suggested regarding her treatment. On top of his grief, he's probably also dealing with a massive amount of guilt that she was put through everything unnecessarily. I think the best thing that he could do, rather than focus on trying to get an apology from the hospital staff, is make peace with knowing that he and the doctors and nurses only wanted what they felt was in her best interest. They might have disagreed and butted heads, but she was what mattered most..to both sides.

allnurses Guide · Nov 30, 2009

This past week was a difficult one for my brother. After caring for a lady with cerebral palsy for 14 years(She lived in), she died. It started on the 21st when he brought her into the ER due to stomach pain. After doing a scan, it was determined that she had terminal cancer and had to have surgery to assess/remove the tumors.
Before the surgery, two surgeons sat down with my brother(who had POA). One doctor was fine, explained the procedure and was very compassionate. The conversation with the other doctor and my brother went like this:
Brother: I want everything to be done for her.
Doctor: You have to think about her quality of life (He was referring to the fact that she had CP and that if she survived the surgery, her life would not be that great anyway)
My brother took offense to this as he felt that her CP should not matter and that the best care should be offered.
The same doctor also raised his voice to my brother when my brother requested that CPR be done if needed, telling my brother that her ribs would most likely be broken and "did he really want that to be done to her?"
Anyway, she made it through the emergency surgery. The doctors and nurses began to pressure my brother, telling him to call hospice as she was terminal. This was on the 22nd, a Sunday, He said that he would call but that he wanted to see an oncologist about her prognosis first. He knew that she was terminal but just wanted these questions answered. He also wanted her to have pain relief but not so much that she could not communicate.
On Monday the 23rd, the breathing tube was removed( her liviing will stated that she did not want life support). By this time, one nurse in particular was acting in a very odd way. Two examples a) A doctor noticed that the lady's oxygen had been removed and the nurse told the doctor that my brother requested that it be removed. He did not. and b) When they transferred the lady to another room, the nurse grabbed the wheelchair away from my brother and said, "I will push the wheelchair and you can be the candleholder". Now, I am not a nurse yet and maybe that is nurse-ese for something, but that comment just sounds off.
By Wednesday the 25th, she was still hanging on. My brother had still not seen the oncologist. Doesn't this seem weird? She has all of these major tumors but an oncologist could not swing by? So my brother stays with her and comforts her. He has still not called hospice. At 4pm, the social worker from the ICU floor rudely hands my brother a piece of paper with the name and number of a local funeral home on it, shakes her head and says in a snotty tone,"I am leaving. Call this number if you have issues. It's too bad you could not have called hospice" . My brother's friend died about four hours later.
I feel that the the first doctor, the nurse and the social worker acted inappropriately. Can I please get some insight from all of you? Were these people acting normal in their world?

It would be really odd that all these people would happen to be rude, snotty, and grabby. In fact, the more I read it, I see that failure of communication (your brother's perceptions) probably account for most of it-- so before you demand an apology on your brother's behalf, just some stuff to think about. (btw why can't HE demand an apology? Unlike you and I, he was there)

1. Surgeon #2 stated that "you have to think about her quality of life" and that "he was referring to the fact that she had CP". Are you sure that's what he is referring to? Is your brother sure of that? Because if she has a belly full of cancer he already knows her time on the earth is so short he is not going to consider what is the quality of life long-term. That very likely is a mis-perception on your brother's part. "Did he really want that done to her?" That means he is as compassionate as the compassionate doctor. The reason he said that is because he wants to alleviate THE PATIENTs pain, not your brother's. Turning him in to the authorities would be really unfair to him.

2. Nurse "Odd"--and the O2- "a doctor" was it the lady's doctor? If not, docs don't generally go around noticing things on patients they don't take care of. How did your brother even know about that convo? If he was there he would have just told the doctor himself that the lady was DNR-- not doctor-nurse-brother-sister-allnurses telephone game. As far as "you be the candleholder" most likely meant that it's against policy in some places for friends/family to push the chair, so she gave him somthing to carry or hold up for her. It's as simple as that.

3. An oncologist can't just "swing by" The swing by is the tip of the iceberg. The real work of the specialist is done behind the scenes- it takes time and it aint cheap.

4. Rude social worker-- well, yeah- turn her in and demand an apology.

Junebugfairy · Nov 30, 2009

"those nurses were the professionals here and more should have been expected from them. i know that ,as a future nurse, there will be times that i will have to be quiet and do my job. that is life."

i am in nursing school right now, finishing up my very first year, yay for me..

we are taught to be patient advocates! we are taught to speak up if something does not seem right, we are taught to use our education and skills to ensure that the patient's well being is the #1 priority.

i have seen doctors prescribe a drug that interact with a patients current rx meds, and a nurse had to mention something quickly.

as a nurse it is your job to always look out for the patient's best interests because often enough the family will not!

Junebugfairy · Nov 30, 2009

"i understand that they might have been frustrated but they needed to remain professional. their behavior was not professional; it was rude. and to that end, an apology from them will be made when everything is said and done."

telling someone that a patient will die is not pretty. sometimes you have to be blunt, lay it out there, and explain that this lady is dying a painful death and she deserves better.

there is not an easy way to tell someone that their loved one is going to die, but it makes it more difficult when someone will not listen.

a doctor is a doctor. you do not really need an oncologist in this situation. chemo will not help, there is zero hope of recovery, and any treatment will be agonizingly painful.

i am 27, but all i can say is that i am glad my wishes are in plain writing and my entire family, including my husband, knows what i want. this is another case which shows the importance of not only telling caregivers your wishes, but having them in writing, and talk about it every once in awhile/

burberrylover · Nov 30, 2009

I do have one question: This lady died within 5 days on the onset. Honestly, could hospice have been set up during this time, keeping in mind that two of those days were Sat and Sun?

burberrylover · Nov 30, 2009

I am 100% supportive of HCPs being straight and honest. Had the nurse told me brother, "Your friend is going to suffer if you do XYZ" that would have been one thing. Instead, she resorted to namecalling like a two year old.

burberrylover · Nov 30, 2009

it would be really odd that all these people would happen to be rude, snotty, and grabby. in fact, the more i read it, i see that failure of communication (your brother's perceptions) probably account for most of it-- so before you demand an apology on your brother's behalf, just some stuff to think about. (btw why can't he demand an apology? unlike you and i, he was there)
he is going to ask for the apology. i never said that i was.
1. surgeon #2 stated that "you have to think about her quality of life" and that "he was referring to the fact that she had cp". are you sure that's what he is referring to? is your brother sure of that? because if she has a belly full of cancer he already knows her time on the earth is so short he is not going to consider what is the quality of life long-term. that very likely is a mis-perception on your brother's part. "did he really want that done to her?" that means he is as compassionate as the compassionate doctor. the reason he said that is because he wants to alleviate the patients pain, not your brother's. turning him in to the authorities would be really unfair to him.
i don't think anyone is going to turn anyone into the authorites....who said that? i did ask my brother to clarify and he did stress that the doctor was referring to her cp being a detriment. the doctor raised his voice as well. there is no place for yelling from either side.
2. nurse "odd"--and the o2- "a doctor" was it the lady's doctor? if not, docs don't generally go around noticing things on patients they don't take care of. how did your brother even know about that convo? if he was there he would have just told the doctor himself that the lady was dnr-- not doctor-nurse-brother-sister-allnurses telephone game. as far as "you be the candleholder" most likely meant that it's against policy in some places for friends/family to push the chair, so she gave him somthing to carry or hold up for her. it's as simple as that.
so why didn't the nurse say, 'i will push the empty wheelchair. it is against policy for you to do that". she handed him nothing to carry.
3. an oncologist can't just "swing by" the swing by is the tip of the iceberg. the real work of the specialist is done behind the scenes- it takes time and it aint cheap.
well she had insurance.....
4. rude social worker-- well, yeah- turn her in and demand an apology.
i don't quite get your snideness here...can you explain?

morte, LPN, LVN · Nov 30, 2009

i am pretty well disgusted at the general tenor(sp) of the responses here. Handing someone the address of the local funeral home was utterly unforgiveable. The "candleholder" crack i am not sure what that idiot even meant.

and i dont see defensiveness in the op's response, i do see firmness of purpose, and refusal to back down....obviously some posters didnt not read through the thread before making their observations. why two docs with obvious diverse opinions? and why wasnt social work called to help with that.....i didnt go back and reread the SW comment, so cant comment on that, or was that where the FH address came from? the pain med issue, has anyone stopped to think that maybe he needed to confirm something with her, and given that opp. he would have no problem with any and all pain med after that??? again, i am aghast at the general mood of the responses here. Especially those aiming to demean the OP about her emphasize on her brother rather than the woman involved....that is the QUESTION she was bringing us, not a question about the woman's care.

edited to add: the only defensiveness i have seen on this thread is from those insisting that the brother HAD to be wrong.