sometimes this job breaks my heart.

Medic/Nurse, BSN, RN · Aug 14, 2011

Self care at home "young 80"s" female - buried 2 husbands - tough ole gal. Devoted to her family, all of them and there were lots and lots. Doesn't want to "bother anybody" - has feverish feeling x few days and hesitancy urinating. Family insisted on bring her to the ED to "get looked over".

Pt had WBC count 80K - I have the diff written down. She was septic. Very septic. The ER doc pulled me aside and told me the patient would die and there was nothing that would change that. I told him that he must be mistaken - the patient has asked for a dinner tray and we all had an introduction and I was introduced to her family. She was A & O and wanting a snack.

ED doctor said give her whatever she wants - get a private room, you are NOW 1:1 (THAT NEVER HAPPENS!) and don't forget she does not have long for this world.

I went with MD to patients bedside, explanations were made and 6 hours later I did what I had to to ready and release her to the morgue.. BUT BEFORE IS TH EPART THAT BRINGS ME TO TEARS - It was a joyous 6 hours and would be spent that way - her choice. I fluffed and frou-froued her up - including I washed her hair & dried it, I even trimmed her brows - added a little make-up and her daughter and I painted her fingernails. The was so beautiful and showed such dignity and grace in the face of death. It took my breath away. Many visitors raced to be by her side - children, grandchildren, great-grandchildren, nieces, sisters and many friends. Her church family visited briefly and held prayer (the pastor never left the hospital and a group stayed and prayed - just in case they might find a "miracle.") We made sure her dog was snuck in the ED along with 2 "favorite cats" - pictures were taken.

I felt so very humbled by the entire experience - as much as I train for and can do - that there are times that compassion and kindness are not LIFESAVING - but, LIFE AFFIRMING.

Thant was in 1992 AND I HAVE NOT EVER FORGOTTEN IT.

:angel:

There are others - I'll share more if I can. I guess you never forget your first ones though.

Nurse are AMAZING - be blessed in all that you do!

TDeniseRN · Aug 14, 2011

Thank you for sharing NREM! Your experience brought me to tears. I have a year of school left and it is very inspiring to read about a situation where as a nurse you took time to genuinely support a family. Im sure your heartfelt presence helped the family in their time of need.

NurseLoveJoy88, ASN, RN · Aug 14, 2011

LTC can be a very depressing place to work at times. I have seen the same experience with my previous residents. My only intervention that works is to be my bubbly self while at work. Hold their hand, sing to them, do a silly dance, call a family member for them, and just listen. LTC residents need alot of TLC, its ironic how both accomyns have the same letters but its so true. I miss the residents so much !

grandee3 · Aug 14, 2011

I work at an LTAC and for the last 3 weeks we have a 31y/o female with ALS. She was diagnosed while she was 8 months pregnant with 2nd child. She was recently trached and has a peg. It is so very sad to watch her with the kids and her mom stands at her bedside holding her hand.

When I took her for the first time I thought ok, I know how to handle this. I have a 47y/o nephew (my sister's son), he was diagnosed with ALS at 24y/o, got married after dx and had 2 kids. Before Katrina I lived across the street and very involved in his care.

Every day I watch the life get sucked out of these two young adults. I watch, I pray and sometimes I cry.

xtxrn, ASN, RN · Aug 14, 2011

I'd changed jobs from LTC to a LTAC....one of the nurses said that a guy from my old LTC was coming in- vent dependent. He was a character, disabled by COPD. I went over to see him when he got there, and his eyes registered his recognition of someone familiar. He stayed in the vent ward for a few days, then to a private room(don't remember why now). I had him as a patient for a few evenings. He knew he'd never get off the vent.. his teenage daughter was his POAH (she was 18 or 19). They made the decision to turn off the vent. Before they did that, he had pleaded with me (read his lips) begging me to turn off the vent. He wanted me to do it...I guess just to have someone familiar while dealing with the unknown.

I went back a few days later and he was gone. I asked how he did, and was mortified to find out that the doc didn't order enough Ativan to ease the hypoxic panic. He was restless and didn't go easily. That made my heart hurt. I'd seen this guy (totally with the program, and funny... I have a book he wrote about adventures w/friends in the 60s) up and walking all over at the LTC- still had his car and ran errands with an E-tank (this was before O2 concentrators). Then, he was on the vent. He deserved to go in peace. He had chosen to go off the vent, but didn't have a doc who thought about how he'd be feeling.

xtxrn, ASN, RN · Aug 14, 2011

Another patient was actively dying. She'd had a massive stroke, and there was nothing that cold be done. Her OLD husband was at the bedside, just befuddled at all that was going on- his life partner was leaving. I got him tucked into a recliner for the night (this was back with visiting hours but there was no way I was going to boot him out). Later, I took her addressograph plate to the cafeteria to get him something to eat- he'd been there for hours. I checked on/turned the Mrs often. She had "the smell"....

I was at another patient room (had charting 'boxes' and med drawers/linen/trash at the door), and he came out of her room, and said he thought she was gone. I went and checked, and she had died.

I asked him if I could call family for him, and ....he said that his kids wouldn't come :eek: I asked if I could call the chaplain, and he said no- he just needed to go home. I'll never forget him walking down the hall alone, with his cane, to take himself home and have nobody to share his pain. I'll never forget seeing the back of him getting more distant in the hallway.

RN58186 · Aug 14, 2011

Another patient was actively dying. She'd had a massive stroke, and there was nothing that cold be done. Her OLD husband was at the bedside, just befuddled at all that was going on- his life partner was leaving. I got him tucked into a recliner for the night (this was back with visiting hours but there was no way I was going to boot him out). Later, I took her addressograph plate to the cafeteria to get him something to eat- he'd been there for hours. I checked on/turned the Mrs often. She had "the smell"....
I was at another patient room (had charting 'boxes' and med drawers/linen/trash at the door), and he came out of her room, and said he thought she was gone. I went and checked, and she had died.
I asked him if I could call family for him, and ....he said that his kids wouldn't come I asked if I could call the chaplain, and he said no- he just needed to go home. I'll never forget him walking down the hall alone, with his cane, to take himself home and have nobody to share his pain. I'll never forget seeing the back of him getting more distant in the hallway.

Okay, that made me cry. My Mom is in LTC, and my sister visists every day, I'm there 2 or 3 times a week. There are residents there who have never had a visitor in the 5 years my Mom has been there, it breaks my heart.

Many, many years ago, long before I was a nurse, I did some volunteer work. As a Girl Guide I volunteered to push wheelchairs around for an evening at Christmastime. This particular mall would close early, open up just for the hendicapped and elderly in wheelchairs or with walking aids, and recruit volunteers to push the chairs or walk alongside, so that these people could do Christmas shopping without the chaos of the regular shoppers. I was assigned a little lady about 90 years old in a wheelchair. I asked her what kinds of gifts she was looking for and she told me that she had come basically to get an evening out, but that she would like to find herself a blouse wiht "pretty sleeves" just because. Turns out her children didn't talk to her, they had moved away with their jobs, and eventually the mail came back unopened marked "addressee moved, address unknown". She said she had tried to call them and to find them but never did. She didn't know if they were alove or dead, if she had any grandchildren or anything. She hadn't heard from them for about 15 years, and she told me she didn't expect to be alive the next Christmas. I went home and cried to my Mom about this lady who was all alone. Granted, I don't know if something had happened that they didn't want to contact their Mom, but I couldn't wrap my head around this lady being so alone, and no one to visit her or be there when she died. It was sad.

I have worked renal for my entire carreer. We really got to know our pts, and it often broke our hearts to lose them. We cried alongside many families on that unit. At one point we had a chaplain who would come to the unit 3 or 4 times a year for the staff, to help us decompress after losing a number of pts. This chaplain recognized that we had a different relationship with our pts than the nurses on many other units did, and he felt like someone needed to be there for us. I now work in the outpatient transplant clinic, we still cry for a number of our pts, the families just don't get to see us do it.

If I ever leave the clinic I would go to palliative care. (When I graduated from Nsg School, i had not lost a pt, and I was very afraid of dealing with dying pts. However, as time went on I found that I like the palliative care side of things, and was told by a number of managers and colleagues that palliative care was really where I stood out. I was so surprised.....) I love helping families and pts through that transition. We will all get there eventually, and I would hope there will be someone who really cares there for me and my family.

But I couldn't do peds - that really breaks my heart.

NaKcl, BSN, RN · Aug 14, 2011

Thank you all for sharing your experiences. your stories made me cry, yet they were beautiful.

Nursing truly is a beautiful profession. I am proud to be a nurse.

1968cowgirl · Aug 14, 2011

I work in LTC and love it. I know it's heart breaking when you see people are not visited. However, remember not to judge the family as you do not know what the resident may have done to them earlier in life. Yes, this may seem to be the sweetest person in the world but could have been quite abusive to the ones closest to them. This might not be the case for all but for many it is. Just my two cents. Please don't flame me.

StrwbryblndRN · Aug 14, 2011

I agree with you Cowgirl. I try not to pass judgement on families. Everyone deals in their own way based upon their relationship with the resident/pt, and their personal coping skills. I like to think the nurses are there to cover for families who are incapable of doing so. Extended family.

evabloomy · Aug 15, 2011

Yes i totally agree especially with d visiting issue. Some of them always in constant pain dat no form of painkiller could take care of as in the case of a particular resident of mine who has a severe case of arthritis....she is always crying / screaming in pain but we r helpless cos she cant have painkiller every min...and when she is asked if her legs are hurting again she will tell u dat she doesn,t have legs anymore cos d "blood-suckers" have eaten 'em up.... i tear up whenever she says dat......i cant imagine wat kind of pain she,s in!!! and so many more.