Pt cant forgive...

[smalltownLVN, RN]

I have a pt that I have grown close to both he and his wife. Physically, I have gotten most of his symptoms relieved. The main problem is the emotional issues. My pt and spouse are only in their early '50s and are having a very difficult time dealing with his progression although his spouse is a nurse. My question is, has anyone experienced the death of a pt who would forgive his spouse, or whoever, and how did it affect their dying process? I'm trying to figure out the best way to get him to let go of his hurt and forgive not just for her but for him also. Also, he doesn't believe in faith or spirituality. Thanks

[TammyG]

I think that, as an RN, I do not have the training to do that type of work with the patient. Our social workers have this training and are very good at dealing with these issues, as does our chaplain. I'm curious whether your IDT has been involved?

[lhflanurseNP, APRN]

If the patient is at this point, has anyone discussed Hospice? They are trained to help in these matters. We went through this with my father and it helped us all tremendously.

[ktwlpn, LPN]

I think sometimes we have to admit that we can't "fix" everyone. Get the team involved and take a step back.

[MrChicagoRN, RN]

As noted, you can't fix everything.

I know if I was in my 50's facing death, I'd have a lot to be angry about. Ask him if he'd be willing to talk to someone about what's going on.

[areensee]

This sounds like a pretty complex issue and one suited best for a spiritual care coordinator (chaplain) or a social worker. As far as what you can do, let your patient say anything. Trust and rapport is the most important aspect of any nurse-patient relationship, especially in hospice nursing. So if you your patient says something, don't push it back under the rug, invite your patient to explore their feelings further. Remember, it isn't your responsibility to get your patient to forgive anyone, but it is your responsibility to uphold him and let him know that he truly can say anything to you, and it will be heard.

[smalltownLVN, RN]

Thanks for all the advice, guys. He, of course, refuses the chaplain and it's not a topic that he feels comfortable talking about with someone he isn't close to. Luckily, I was able to muddle through and mainly just listened and asked open ended questions. I think just being able to talk to about it, finally, after 15 years helped some. I don't know that he will ever forgive that person but I helped relieve a lot of the poison that he had been hanging on to for so many years.

[smalltownLVN, RN]

Update: somehow we were able to work through all of his issues and he and his wife regained the closeness they had lost years before. They were able to spend his last weeks together in a way they hadn't in years. He passed last week just as he had planned with his wife, son, and I at his side. His wife gave me a letter he had written to me before he passed at the funeral thanking me for not giving up and for keeping the promises I had made to him. It's so hard when you have a special bond with a patient and their family but the reward of knowing the impact you had on their life and death makes my soul happy.