Faust09

Hi, I think you need to elaborate more. You said some diagnosis, but I'd like to know the evidences for it. Also, sounds like you're stuck, I suggest that the family needs to be interviewed some more.

I can totally relate you. I'm also a new grad nurse. I've only got 3 orientation: one nocte, one am, and one pm shift. So it was my first time alone as the only RN, and it was my first ever shift. I was doing nocte. There were some discrepancies in the medications that were prescribed. Also, one of my patients died (he was already dying and not for resus). What was troublesome is that there are no after hours doctors. And I couldn't find where the main doctor's contact is. I phoned my clinical manager and my fellow nurses. Mind you that it took me about 5 hours to finally contact one of the nurses and my clinical manager. They told me what to do, where the papers, death checklist and doctor contact are kept. Just imagine those 4 hours of no RN support - I was totally anxious and lost; but I thank my team (CNA's) for being supportive (they too didn't know what to do at that time). To make story short, I finally sorted out some things and the next RN duty did the rest. It was draining and exhausting indeed. So I learned from that experience and since then, I always orient myself during my free time - like checking where the papers are kept, where the emergency equipments and meds are placed. I also think of questions relevant to my work after I get home from work and then ask them to appropriate staff when I get to work. Also, I try to remain positive and keep the morale of my team intact. Although I was nervous and lost during that time, I just smiled, kept my calm and remained collected so my team/ CNA's wouldn't worry too.

Hi, I'm a new RN and it was my first time to look after a dying patient in a resthome. She was an elderly patient and she hasn't been eating/drinking well. She's dehydrated and having aspiration pneumonia. But despite those, she's not for resuscitation. I checked her vital signs after I received her from handover. I noticed her temp was >39 degrees C (or >102.2 F). So I gave her cooling cares - gave her sponge bath, opened windows, gave her an electric fan and minimized her linens for cover. Her temp hasn't settled after all those interventions, It was still >39 degrees C. So I decided to give her 500mg paracetamol supps. However, one of my colleagues said that giving her paracetamol (antipyretics) can accelerate the patient's death because I'm trying to lower her body temp she said. I've never heard such statement before. I gave the supps anyway because >39 degrees sounds uncomfortable for a person. The patients temp lowered to >38 degrees C (>100.4 F) afterwards. I've researched journals about antipyretics and dying people, but I couldn't find any topics about it. Fever is a homeostasis imbalance and may cause discomfort on people, but does treating fever actually accelerate the death of a dying patient?

Thank you for the responses. I guess the daughter was kinda guilty that she have to leave her mum dying. There was no way of telling when a person's going to pass away indeed. Thinking back, I wish I could have said something better. Nevertheless, the answers provided me insights on what to do/say next time when such event happens again. Cheers again everyone!

Hi, I'm a new RN. Today, I had a dying elderly patient to look after and the family was in the room. As I passed in the hallway, the daughter of the resident called me and asked if her mother (the patient) will make it through the night (I was doing nocte shift). She asked if the patient is going to die soon as she plans to go home to look after her young son. But she also wants to stay with the patient's side so she can be with her mother while she dies. The thing is, I remember in my BN course study that one should not to make such opinions, especially about whether a patient is going to die or not, to families. I only told her "I'm sorry, I'm not sure. I wish I knew. I can't really tell. It can be unexpected." To make the story short, the daughter decided to go home eventually, but I can tell her face that she's really worried. I wasn't really sure what I was answering. I felt 'blank' at that moment. The daughter kept asking the same question, but the only thing I can think of is "I don't know" - eventhough I feel that the resident can die any time in my shift. How do you answer if a family asks such question?

Hi, I've recently graduated nursing. I love this profession. I just got a job from a dementia-hospital resthome. Everything's okay. Work is stressful sometimes. It's even more stressful when I'm introduced with new stuff, but I got little problem with that. The team/staff are just awesome. They're supportive and just seeing them smile or laugh makes my day. Residents are lovely as well. However, some staff are not easy to go with. Everytime I greet them, they just shove them and snub as if they want me to leave. Some just don't communicate well. Some are lazy. I even get blamed because some stuff weren't done properly, even though they're the one's most involved with, because "I'm the nurse" they said - as if I wasn't working my sweat off. Despite these, I always smile at them back. I know they have a reputation like this (the whole facility knows), but I don't like to make prejudice, whether they're patients or staff. I always aim to have a harmonious team. But sometimes I get to the limit, and I just can't stop thinking about those people, especially when I'm driving to home. How do you fellow nurses handle this kind of situation?