"I don't want to die"

LPN27713 · May 8, 2015

id just keep saying "stay with me" they are almost here...

scaredsilly, BSN, RN · May 9, 2015

How about "I don't want you to die either--see all these people trying to help you? Everyone here is doing all that they can to prevent that from happening"

KelRN215, BSN, RN · May 9, 2015

Seizures are usually not fatal, especially not with prompt medical attention. I wouldn't have a problem telling someone that he isn't going to die in the middle of a seizure. I worked neurology/neurosurgery at the beginning of my career. I recall one time a child went into status epilepticus and stopped breathing, a code was called. The child's mother hysterically asked "is she dying?" and our director flat out said "no."

anh06005, MSN, APRN, NP · May 9, 2015

I don't think it was truly a seizure but more "seizure like activity" and I guess the ER agreed as she went home that night. Either way she needed some stuff checked I couldn't check in the little ole clinic of mine.

She will be back Monday to see the other provider as we are there on different days.

Given that I'm now in the clinic setting, though, this may not be the last time someone is petrified and asks me that so I'm still enjoying the feedback.

Tenebrae, BSN, RN · May 9, 2015

.....snip....
Working hospice, I get questions sometimes like, "Am I going to die tonight?" I almost always answer, "Not tonight!" Because seriously, if you're alert enough to ask me, you ain't dying yet, unless you throw a clot or have a massive MI on me, and I can't predict that. (If risk for that is high based on diagnosis, I'll change my usual answer to more like, "I don't think so." )

Mind you there are always exceptions to the rule. I had a palliative patient ask me once "am I dying?"

They died about 4 hours later

Sadly, one of the questions I hear more often is, "Why is it taking me so long to die?" That one makes me so sad, because they're tired and done and just want peace, but their body isn't cooperating.

I hear that alot as well.

brownbook · May 9, 2015

Honestly I might roll my eyes if a patient is breathing well enough, conscious enough, alert enough to say, "I don't want to die." The odds of them dying are very slim. (Unless they are stuck under a fallen tree in a flood and the river is rising, I love to watch disaster movies!). But under normal patient care circumstances I might say..."I know you feel like you're going to die but you are breathing okay, your pulse is strong, etc., you going to be okay".

Entirely different from a patient who says, "I feel like I'm going to die!" That is scary! Very subtle but significant difference between those two phrases.

anh06005, MSN, APRN, NP · May 10, 2015

Honestly I might roll my eyes if a patient is breathing well enough, conscious enough, alert enough to say, "I don't want to die." The odds of them dying are very slim. (Unless they are stuck under a fallen tree in a flood and the river is rising, I love to watch disaster movies!). But under normal patient care circumstances I might say..."I know you feel like you're going to die but you are breathing okay, your pulse is strong, etc., you going to be okay".
Entirely different from a patient who says, "I feel like I'm going to die!" That is scary! Very subtle but significant difference between those two phrases.

Oh movies. The reason I don't like my shower curtain being closed when I'm up in the night to pee....

Chi chi chi chi ah ah ah ah

brownbook · May 10, 2015

Wait a minute here.....disaster movies are entirely different from slasher movies......slasher movies rely too heavily on young dumb buxom females getting themselves into perilous situations.

Disaster movies are young not so dumb buxom females suddenly, through no fault of their own, faced with an upside down ship or earthquake or rampaging dinosaurs or rising flood waters. That is high brow entertainment! :laugh:

calivianya, BSN, RN · May 11, 2015

Somewhat unrelated, but what do you say when your patient IS going to die and they say, "I don't want to die!"

I hate that. I never know what to say to them. Had one recently on the BiPAP, end-stage COPD, if she took the BiPAP off for even five seconds to take a sip of water, she immediately desatted into the 70s and it took her a good few minutes to get her sats back up once the mask was back on. It was pretty obvious to everyone, even her, that she wasn't going to recover. She had bounced in and out of the hospital almost 20 times in the past year because she just couldn't maintain her breathing on her own, not with home nebs, not with home health nurses... she pretty much couldn't survive outside of the hospital. She's sitting there gripping my hands with a death grip, telling me she didn't want to die.

I think I just squeezed her hand, tried to give her the most sympathetic look I could muster, and said, "I know." What else can I say? Maybe if you didn't smoke three packs a day even after you were diagnosed you'd still have a few years left? I'm really sorry your decisions killed you and you regret it now that you're dying? It's frustrating. I feel for her, but we can't fix all of the bad decisions she made over the past few years with some sort of miracle treatment or pill, so her asking us to save her... well, it's not going to happen. Obviously, I don't want to hurt her feelings or upset her, so I just say nothing. Is there a better option for things to say?

RNerica12 · May 11, 2015

I really liked reading how honest your post was calivianya.I also feel it is very important for us to keep our personal views and opinions aside. We are not there to judge, (no matter how easy people make it for us sometimes to) we are there to treat, comfort, care for. So I really liked how you described your interaction with her even though those thoughts were running through your mind. I think I may say something like "I'm here with you.you are not alone" but really that doesn't even help. Nothing can. I have not been in that situation, but if I am ever in such a scenario. I will remember your comforting approach.:)

Libby1987 · May 12, 2015

Somewhat unrelated, but what do you say when your patient IS going to die and they say, "I don't want to die!"
I hate that. I never know what to say to them. Had one recently on the BiPAP, end-stage COPD, if she took the BiPAP off for even five seconds to take a sip of water, she immediately desatted into the 70s and it took her a good few minutes to get her sats back up once the mask was back on. It was pretty obvious to everyone, even her, that she wasn't going to recover. She had bounced in and out of the hospital almost 20 times in the past year because she just couldn't maintain her breathing on her own, not with home nebs, not with home health nurses... she pretty much couldn't survive outside of the hospital. She's sitting there gripping my hands with a death grip, telling me she didn't want to die.
I think I just squeezed her hand, tried to give her the most sympathetic look I could muster, and said, "I know." What else can I say? Maybe if you didn't smoke three packs a day even after you were diagnosed you'd still have a few years left? I'm really sorry your decisions killed you and you regret it now that you're dying? It's frustrating. I feel for her, but we can't fix all of the bad decisions she made over the past few years with some sort of miracle treatment or pill, so her asking us to save her... well, it's not going to happen. Obviously, I don't want to hurt her feelings or upset her, so I just say nothing. Is there a better option for things to say?

I used to have these thoughts but somewhere along the line they've turned to some form of less frustrated compassion. I'm glad too because I hated feeling that way towards someone who obviously paid the consequences.

I don't know that you can say anything different but the change in perspective made it feel less contrived.

Red Kryptonite · May 12, 2015

Just the other night, I cared for a woman whose COPD exacerbation was so bad that if she took off her nonrebreather, running at 12L, for even a minute her sat went down to 50. She was crazy restless all over the place, panicked, clawing at everything.

I told the nurse that I wished I could bring smokers to see that and ask if they really thought it was worth it. I'd like to prevent that for other people. I do have thoughts at times that they brought it on themselves. The dangers of smoking have been well publicized for over 30 years, so no one can claim they didn't know. But, bottom line, that doesn't matter when caring for this person in front of us right now.

This patient had been told by her doctor that she needed to go on hospice and she fought that decision. After ending up at the doctor again only a couple days later, she begrudgingly signed the DNR and hospice paperwork, then came to us. The only compassionate thing to do was to sedate her, because her air hunger was intense and constant, putting her in an endless panic state. Once the nurse got a few doses of morphine and lorazepam on board, her breathing evened out and she was able to relax. She still looked blue, though, and to be honest I think some terminal restlessness was in that mix as well. Hopefully she's moved on to a more peaceful place. She didn't seem to me like she could last long.

Two ways I absolutely don't want to die: COPD or diabetes. I don't want any disease, but those two seem particularly horrible.