Parents both died in hospice care...should I switch to hospice??

[newtelenurse]

Hello all.

I currently work in tele/ICU step down and have for 3 years. My father died at 55 of esophageal CA and my Mom at 59 of breast CA. Both had a short stent (

Hospital in our rural town is in the process of getting a hospice program up and running, currently the home health nurses are doing both. My girlfriend is one of them. She said that they don't like to hire hospice nurses whose parents have died within the last year. It's been 2+ and 1+ at this point.

In hospital setting I deal with dying pts. quite often. But everything is in such a fast paced atmosphere it is hard to give them and their families the "extra" I feel that they deserve. I do what I can to make a point to sit on their bed at least once a nite, look them in they eye and let them lead me in a conversation.

My problem is... sometimes I see my Dad or my Mom there and the feelings at times are that of a daughter, not a nurse. I had a pt. who was end stage COPD. Respirs 45. Wanted me to call daughter for him. This is 1:30 in the morning. He asked her to come in and she refused...yes I could hear both ends of the conversation...Now let me tell you that this was X-mas eve. I heard her say "Dad it is 1:30" and he replied, "yeah, it's 1:30 here too."

After he hung up he looked at me and said "would you do that to your Dad?" Maybe I should've come up with an excuse for her to make him feel better. I couldn't do that, I was right there with my Dad for the entire week he lay unresponsive. I could've NEVER told him I wouldn't be able to make it. So I looked him straight in the eye and told him "No. I wouldn't" If I could've reached thru the phone I believe I would've slapped her myself! Does that mean it is too soon for me to consider hospice nursing?? Or will I ever be able to keep my own feelings on the backburner?? Or are those feelings/experiences what will help??

Wow, went in a little deeper than I intended. So if you're still reading what do ya think?? Make the change or give it some more time???

Thanks!

[CANRN, MSN, RN]

I also had both my parents die on Hospice as well as my younger sister. What these experiences have done for me, it has helped me to better understand the families as well as the patient (to a certain extent, I can not understand them totally of course, not experiencing this for myself). Personally, I would not have said what you said to the patient related to what his daughter said. Maybe you would have better served you patient if you would have allowed him to express his feelings more instead of confirming that his daughter was "wrong" for not coming. You have no idea what his daughter was dealing with in her personal life or what her feelings were related to her father's illness. I am a nurse for pete's sake, and when my father, mother and sister were in their last days, I certainly did not think like a nurse, I thought like a daughter and a sister losing someone very important to me. Denial can be a wonderful survival mode. Our responsiibility as hospice nurses is to gently guide or allow the families of our patients to get to the 'accepting" point in dealing with a very life altering situation. There is no rule book or time constraint for this, some get it sooner or later and others just don't.

Yes, there have been many times I have wanted to "reach out and slap" someone who is acting selfish, but you have to understand, they are hurting inside, their pain is very deep and to the core, they are losing someone they love and they are losing 'control'.

I believe that if you examine how you felt, and use that experience to help your patient's and their families you would make a very good hospice nurse. Just remember, things are not always what they appear to be.

Cindy

Hello all.

I currently work in tele/ICU step down and have for 3 years. My father died at 55 of esophageal CA and my Mom at 59 of breast CA. Both had a short stent (

Hospital in our rural town is in the process of getting a hospice program up and running, currently the home health nurses are doing both. My girlfriend is one of them. She said that they don't like to hire hospice nurses whose parents have died within the last year. It's been 2+ and 1+ at this point.

In hospital setting I deal with dying pts. quite often. But everything is in such a fast paced atmosphere it is hard to give them and their families the "extra" I feel that they deserve. I do what I can to make a point to sit on their bed at least once a nite, look them in they eye and let them lead me in a conversation.

My problem is... sometimes I see my Dad or my Mom there and the feelings at times are that of a daughter, not a nurse. I had a pt. who was end stage COPD. Respirs 45. Wanted me to call daughter for him. This is 1:30 in the morning. He asked her to come in and she refused...yes I could hear both ends of the conversation...Now let me tell you that this was X-mas eve. I heard her say "Dad it is 1:30" and he replied, "yeah, it's 1:30 here too."

After he hung up he looked at me and said "would you do that to your Dad?" Maybe I should've come up with an excuse for her to make him feel better. I couldn't do that, I was right there with my Dad for the entire week he lay unresponsive. I could've NEVER told him I wouldn't be able to make it. So I looked him straight in the eye and told him "No. I wouldn't" If I could've reached thru the phone I believe I would've slapped her myself! Does that mean it is too soon for me to consider hospice nursing?? Or will I ever be able to keep my own feelings on the backburner?? Or are those feelings/experiences what will help??

Wow, went in a little deeper than I intended. So if you're still reading what do ya think?? Make the change or give it some more time???

Thanks!

[leslie :-D]

i agree w/candy's post.

and for this reason, i believe you need more time.

i would not have validated dad's question by answering as you did.

one of the hardest things in hospice, is not being judgmental.

you're going to see many family dynamics that make your hair stand on end.

and you need to remain neutral.

how are you going to respond when you know a family member is stealing mom's morphine/dilaudid?

or how will you bring a family together, where there has been a hx of incest?

there will be a million situations, that ea and every one, demand neutral intervention.

i would suggest you give yourself more time to heal.

during this time, you can read up on hospice and all of its dynamics.

only then, will you make an objective decision in what you will be able to handle.

wishing you the very best.

leslie

[Em1995]

I agree with everyone. Take your time and read and think a lot. I became a hospice nurse 3 months after my mom died of breast cancer. My dad had also died a bit earlier before my mom, along with my aunt(12 weeks later) and we nursed all of them at home. But, I was able to step back and can be objective with my patients and families.(I'm also a psych nurse, so that education/experience plays a big factor). Also, being a former ER nurse who is used to chaos and drunks swinging and spitting at me...well, let's just say, I can easily step back and be objective after all these years!Families deal with dying in many varied ways, some which you will like and some which appear very strange to you. But, it's their gig.Family dynamics can get very complicated and if you're not astute, they can "pull you in" and before you know it, you're "taking sides" and some even end up staff or family splitting.

So, take your time. Read a lot and hang out with us!

All the best!