stepping over the line?

Nurses General Nursing

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Specializes in all fields at least once.

this problem has weighed on my mind for what feels like forever. i have been assigned to a terminal cancer patient (adenocarcinoma) originally given 6 mos to live upon her arrival here, fast fwd 2 yrs later. this incredibly strong, vibrant young woman, 4'10" maybe 90 lbs soaking wet has been completely on her own here. throughout heart wrenching chemo, surgeries and procedures she has been alone. she has family, mother, brothers, children and a husband yet i can count on my hand how many times all or any of them have come to visit her. she is constantly in pain and cries quietly to herself. i have asked her why her family isn't here with her, as i know she needs them. she defends them, saying they are "busy" with work, school etc. her husband is in the navy stationed out of ga, he lives there. her mother, siblings and children live in mi. i feel i cannot keep my mouth shut any longer. i have been thinking about calling her husband and telling him how his lack of support and not being here is affecting her. i know this would be out of line but she could pass any day and i don't know if it's a combination of for years following through with orders, trying not to get too personal, moving on to the next patient or what. but this has been tearing me apart. i cry for this lady everyday as i leave work. help!

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

For the most part you should respect the patient's wishes if she is competent. You can continue to ask her if you want you to call her husband and get him hear. The Red Cross can always get persons stationed away home for family emergencies. Have the docs with realistic with her about her condition. Perhaps she's in denial herself. Is she receiving agressive treatment or palliative/hospice care?

Good luck.

(I'm moving this discussion to the general nursing forum where you might get more input.)

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Specializes in ICU/ER.

I would not call unless she asks you to, also I would stop asking her about her family---I say this because I too have no family in town. When baby #4 came if one more nurse asked where my "family" was I was going to scream....I already felt alone enough with out being reminded and having to explain they all live out of town.

Does/Did this patient have any friends? Or was she a member of a church? Maybe you could contact some local churches and have her placed on a prayer list(yes it is hippa so get her permission)--I know my church as the Sunday school class each week make cards/care packages for those on the prayer list.

Family comes in all colors, shapes and sizes--family does not have to be genetically linked. Maybe you and your family and the other staff and their families can adopt this fighter as one of your own.

I commend you for wanting to call, but I wouldnt. I would though spoil this lady with love. Sounds like that is already happening!!

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Specializes in just about everything.

racing-mom4, very well said. I commend you for your compassion, and love for others.

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Specializes in Med Surg, ICU, Tele.

the patient could have pushed her family away-defense mechanism style- because in her mind she was supposed to die already and is trying to protect her family from the situation. People deal with things in different ways. It is not our place as nurses to call families and tell them to visit their dying/suffering family member. All we can do is give them love, support, and make them as comfortable as possible, and let her know that you are always their to talk to her. I also agree asking about her family is not a good idea. .

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Specializes in RN, BSN, CHDN.

OMG what an awful situation and I completly understand your dilemma.

I really dont think you can go against her wishes you could get into serious trouble and then you wouldnt be able to care for others as you would like to.

May I sugest you have conversations with her encouraging her to talk about her feelings, hopefully she will touch on missing her husband etc and then you may be able to broach the subject of her contacting her husband making sure he understands the gravity of her condition. Then you could offer to phone him for her, maybe she feels it is not fair to bring him home-military wives are very used to coping with absent husbands and will compensate.

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Specializes in all fields at least once.

thank you all for your input. she is a special lady who has won us all over. i asked her last night if she would like me to call her husband and inform him (medically) how she is doing, she said yes. so i called only to find that he has been sent to d.c. for some reason or another. she wasn't aware he would not be there and i didn't tell her otherwise. i left a message for him to call. thanks again!

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Specializes in all fields at least once.
For the most part you should respect the patient's wishes if she is competent. You can continue to ask her if you want you to call her husband and get him hear. The Red Cross can always get persons stationed away home for family emergencies. Have the docs with realistic with her about her condition. Perhaps she's in denial herself. Is she receiving agressive treatment or palliative/hospice care?

Good luck.

Sorry Tweety I didn't see your ? Yes she is receiving aggressive treatments, she knows and has accepted all possibilities. She speaks about it often and is happy as she says "to see the sun rise on another day".

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i love the answers here esp racing mom

don't ask her about her family, their rejection hurts bad enough w/o being reminded of it

they are probably trying not to deal with this situation with denial..give her as much support as you can..she really needs you

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i love the answers here esp racing mom

don't ask her about her family, their rejection hurts bad enough w/o being reminded of it

:yeahthat:

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Specializes in ED, Flight.

You all are her family, now.

When I was in peds for a short time I had a little boy who had short gut and contact precautions. Was in the hospital for months. His social development was noticeably affected, but it didn't take long at all for ALL the staff to get it together and 'adopt' this kid. Everyone (cleaning staff, social work, nurses, techs, docs, everyone!) made time to give this kid some of the attention he didn't have from family who were right in town. They sat with him, read to him, played with him, etc.

I assume your staff have all conferenced on this woman at least once. Maybe it is time to do so with the sole agenda of apportioning roles and figuring out how to fill in some of the gaps for her. Your caring is wonderful. Since some courses of action may not be open to you (dragging the family members in by the hair), and since the family may really have hardships or issues that we don't know about, it is time to take one of the detours available and travel the best way left.

Good luck! You have a good heart, and that can do a lot for your patient.

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I am glad that lady has a compassionate nurse looking out for her.

There is a chance that the family is not a supportive family. They are absent for a reason(uninformed of the seriousness of her condition, family rifts, lack of closeness, poverty making travel difficult).

There might be issues with this family you are not aware of. Could this couple be separated or estranged?

If you have been a nurse a while, you will have met family members who not only do not deal well with stress, they cause it in others.

Be compassionate with your patient, and follow her lead.

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