Palliative care clinical- how to deal with...

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Hey guys!

So I am finally here. I'm finally starting clinicals in a week. Exciting, right? One problem- palliative care unit is the one thing that scares me to death. It's not the idea of patients with incurable diseases or the fact that they're dying that scares me (all of that I am fine with), it's what to do/tell the family after a patient passes away. I've always been terribly awkward around people mourning the loss of someone close to them and it's pretty bad (for example, when one of my parents' co-workers suddenly passed away of a heart attack a couple of months ago I found myself rattling off the reasons for a sudden heart attack to my deeply upset mom- bad idea. I'm pretty sure I only scarred her more.) You guys get the picture... So my question is how do you deal with a family that just lost a loved one? How do you seem sincere about being sorry for their loss without being too emotionally attached? Any advice would be greatly appreciated!

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Specializes in Infusion.

"I'm so sorry for your loss." You don't need to explain how the death happened or anything. That's the doctor's job. If you stayed with the patient at the very end, you might want to say that you were with their loved one. If the family has been at the bedside the whole time, ask if they want some privacy.

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Specializes in Med Surg - Renal.
So my question is how do you deal with a family that just lost a loved one? How do you seem sincere about being sorry for their loss without being too emotionally attached? Any advice would be greatly appreciated!

Most families are really just appreciative of your help. And that is what you are there for - to help.

Your lesson with your co-worker was a good one; you don't want to do that.

Keep an eye on the family. Your job is to find out what they need and provide it. "Is there anything I can do for you?" "Do you have any questions?" Let the family set the tone for your conversations. They are very good at that.

Don't try to look sad or overly maudlin. Make good eye contact with a positive, but not goofy, expression. Be professional.

Sometimes they look to you for strength because you are the only person in the vicinity who is not an emotional wreck.

Provide it.

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Sometimes, saying nothing is best. Just be there for them, stand there in the room with them for a minute or two. Hold the patient's hand to show the family that they're not really some "cold, stiff corpse". Make sure the room is tidy, the sheets are straightened, there are tissues available, places to sit, and offer a cup of water. Let them know you'll be right outside if they need anything at all, and then make sure they have some privacy with their loved one. For me, dealing with the families is infinitely more difficult than dealing with a dying patient; but, it's amazing how you'll just sort of sense what to do for the family. Also, a nurse from the unit will most likely be there with you to help take care of things if a patient dies. Watch that nurse and model their behavior, nurses on units like that do a great job with families.

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My grandfather, who helped to raise me, passed away a month and a half ago. The nurses were really great. They called when they realized that his breathing changed and suspected that he was nearing the end, gave my grandmother and I a brief update when we got there, and then dimmed the lights in his room and gave my family our privacy. After he passed away and I buzzed the nurse, she simply came in, said "I'm so sorry" and gave me a hug. Short and simple, and it was the best way she could have handled it.

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You sound just like me a year ago at this time... only I was just starting my first CNA job. Lucky for me, I "got" to take care of a dying resident in my first week. It was the most amazing thing, really.

#1 If your patient is palliative care, the family ALREADY knows this is going to happen.

#2 The nurses will probably be able to notify the family in time to be there for their loved one... there are lots of signs as I am sure you already know.

#3 just say I'm sorry for your loss. Tell them it's ok to talk to the person as they are dying or even after they have passed. Seriously, I talked to my resident the entire time I cleaned him up- telling him every step just like he were alive. The other CNA thought I was crazy but it made me feel better!

#4 If it comes as a complete shock like the pt had a MI or something and died sooner than expected just be there for the family. Ask them if there is anything you can get for them. Make SURE the room is clean. The last thing you want them to think is that their loved one died because he/she wasn't getting proper care. An unkempt room can be mistaken for untaken care of patient.

#5 it is ok to cry. Probably not all out blubbering but a tear or 2 will only show the family you care. If you feel like you aren't going to be able to control yourself, take a bathroom break, get yourself together and try again.

Get the first one under your belt and you might surprise yourself! Good luck!

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Thanks everyone for the advice! Makes me feel less nervous about the upcoming semester :)

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