Pt says "I want to die"

ktwlpn, LPN · Jul 20, 2008

Help--I'm a newbie! What's a nurse supposed to say when a very sick and uncomfortable patient tells you that he just wants to die?

Assess the patient while validating his feelings and re-assuring him that you are going to do your best to help him- then treat the symptoms,both the pain and depression.Anxiety can often exacerbate pain-sometimes relieving that takes the pain away or at least to a manageable level. He may not be in physical pain but psychic pain...

You can take a cool cloth and lay it on the forehead or take the hand of the patient and say " I'm here to help -what is hurting?' Sit down-get to eye level-present a listening posture (even if you have a thousand and one things to do) Or while you are talking with him do what you can to make him comfortable-re-positioning,offer fluids or mouth care,straighten linens etc.

Build a rapport with this patient-you need to learn what his understanding of his present condition really is.No matter what it is you'll let him know you'll support him through.It is really un-comfortable to face this situation when you are a newbie-the right language will come to you faster but it really won't get easier...

Kashia, ASN, LVN · Jul 21, 2008

It really depends on the situation. I may be blasted by replies on this one but I believe each individual has a right to determine when they want to die and I would not say every pt that does is "depressed" or needs counseling or..."the medication."

Our society teaches us to be fearful of death, to avoid it at all costs!

Our nursing homes are full of people that have no quality of life, and are ready to go. But with a for-profit system and with grim determination we keep them alive.

I think it is difficult to hear a patient say this if you have not

considered your own death.

When you learn to "die before you die" you will find inside

yourself what to say to a patient at the moment and this will be quite natural and most helpful.

The "right " response is not a scripted one.

lpnstudentin2010, LPN · Jul 21, 2008

I have thought this after some of my surgeries. Since I already have depression, I did not say it to my nurse, didn't want to have her freaking out. I was in a lot of pain, had woken up with a tube shoved down my throat, and I received 4 units of blood. Basically, I was not in good shape.

If I had said it, I would have just wanted my nurse to show that she was there to listen if I needed it, to make time for me.

PiPhi2004 · Jul 21, 2008

I work in the ICU, we have many demented pts and many chronically ill pts and pts who are constantly in pain. Many times pts will ask me if they can kill themselves or if I will kill them. I usually feel bad for them but I can't say I dont blame them. Some of them come from nursing homes where their care was less than impressive. They have bedsores, teeth rotting or dentures that haven't been cleaned in months, poop crusted to their behinds, etc. It's awful and I cant say I wouldn't want to die. In this situation I usually say "Well I cant kill you or let you kill youself. I am here to help you feel better. Is there anything I can do to make you feel better? I know that being here really isnt too pleasant, and I want to make it as pleasant as possible for you."

Usually this doesnt help, but at least I tried!

mpccrn, BSN, RN · Jul 21, 2008

this is always a tough one. unfortunately, i've dealt with it quite a bit. as an icu nurse, the goal is not always to fix things, but allow a patient to die, after all, it's bound to happen to us all. my response depends on the situation. sometimes i tell a patient that i will do my best to make sure they are comfortable, make sure they are not in pain. the look on their faces is enough to know it was the right thing to say. sometimes i reassure them that the condition is reversable and they might want to give it a few days before deciding. i've asked patients if they have any quality of life, if anything happens to make them smile, if anything brings them pleasure during the day, if they say yes, i tell them they probably aren't really ready yet, if they say no, i support their decision. (this mainly happened when i was a dialysis nurse). i had a relationship with these patients, sometimes they just wanted someone to give them permission to quit. reassuring them that no one would be disappointed in them for quitting, someone that realized how hard it was was all that they were looking for. it's always difficult but you do what you have to ...for your patient. understanding, letting them vent will usually give a clue of how serious the patient really is. listening is most important.