Terrible breach of professionalism?

[NurseMarla]

I visited the home of an actively dying patient last night. The extended family was there, and there were a lot of understandably upset people there. The chaplain came, and the elderly husband began weeping (as were others). I was 2 hours in to a 3 hour visit, and I just couldn't hold on anymore. I hurried to another room and cried for about 2 minutes, then went back in and got back to work. I did get caught by 1 family member, but he was very understanding (even when I got mascara on his shirt).

This family really seems to like me. They requested for me to be their case manager, thank me constantly, and even told me today that "hospice is truly your calling."

I've done plenty of crying in my car in the whole 3 months I've been in hospice, and at a wake, but this was the first time I cried in a patient's home. I don't feel overwhelmed or burnt out, it was just a sad moment. So how unprofessional/detrimental is this sort of thing?

[llg, PhD, RN]

I don't think it is unprofessional at all. I have taken care of many patients who have died (in a hospital setting) and cried a few times. It's a "bad thing" if your emotions overwhelm you to the point of not being able to function to help the patient/family. But as long as you are still able to meet their needs, there is nothing wrong with showing that you are sad, too.

[talaxandra]

I once worked with a nurse who became so upset during a code (on an inpatient) that when I left the room she was being comforted by the family. That was inappropriate.

Being upset by the distress of family members, and by the dying or death of a patient you're attached to is fine. Taking yourself a way for a bit to ackolwedge that is fine. Allowing the family to see you share their grief is fine. It clearly didn't interfere with your ability to support the family or care for the patient, and showed that this wasn't just a job for you (((NurseMarla)))

[Spidey's mom, ADN, BSN, RN]

I agree with the other posters. I'm a hospice nurse and sometimes the emotion does get to you and it is ok to cry.

You were not unprofessional.

((((NurseMarla))))

steph

[luckodirish]

I have had the opportunity to share in the most intimate moments in a person's life for over 14 years, it has been a privalege that I am grateful for everyday. You did not breach anything, you showed the family that this meant something to you, this was not a diagnosis, a room number, a patient or anything else, this was someone that many people loved, a person ...and your ability to feel...makes you a great hospice nurse. Time will help you be able to keep your heart in it and find ways to help you cope in a healthy way for you. I have had a couple of those times in my years, and the families realized I was there for them. This is not an easy job, it is not a job at all..it is a calling....it is who we are....we all have had people ask us "how can you do that?"....I always answer "how could I not?".....this is where you belong....keep up the good work and know that you make a difference.......

[leslie :-D]

here we are, hospice nurses, who've been beckoned to care for families at the most vulnerable and daunting time of their lives.

we are recipients of all their anger, frustration, pain, sorrow, fear, and LOVE.

we tend to our dying pts, with medical profiency, infinite patience, experiential discernment, and an all-inclusive commiseration...

always executed with finesse and mastery.

with everything we give of ourselves in this specialty (NOT meant martyrly!), who wouldn't cry?

i'm serious, and am not even alluding to the human component of our work.

i am talking about all that is expected of us - in doing, acting, saying, sensing, negotiating, evaluating...

let's face it - even if we do feel "called" to do what we do, it is no easy feat.

we have to be many things to many people, while remaining focused on who needs us most, our pts.

so while we are seemingly doing our jobs, it just so happens that sometimes, our stressors are such, that we break...

we cry, we grieve, we have mini-tantrums.

then we dry our eyes and continue in upholding some of the most impoverished souls on earth.

if we don't cry r/t the mere requirements of our job description, then we do so r/t the privilege and honor of being involved in the most intimate times of a family's life.

breach of professionalism?

i think not.

rather, consider it a testimonial to who we are, and what we do.

'[real' hospice nurses cry...

even if it's not in our job description.

leslie

[tewdles, RN]

'[real' hospice nurses cry...

even if it's not in our job description

I love that! You were not unprofessional. To echo what others have said, it is only unprofessional if the focus for the family becomes you and not them. We can share in their grief but they should not have to take care of us. You were fine. Sounds like you are well on your way to becoming an exceptional hospice professional, building that relationship with the patient and family is so important in what we do.

[Heogog53]

As an old nurse, I've seen a fair number of people die. For some, I was grateful that they weren't suffering anymore, especially full codes in CCU on older patients whose rib cages I cracked. For others, because we'd grown so close to the patient and the family, most of the staff cried with the family and with each other, too. I've attended a few funerals for my patients, as well.

I'm not a hospice nurse, however, in any nursing area, death is likely to find our patients. It's entirely normal for us to grieve; after all, we've all invested time, emotion, compassion and care in both our patients and our families.

We are all human, and to NOT be affected by some deaths more than others just wouldn't be "normal". We get in there, we teach everyone, we treat our patients, watch the family interactions, etc. I had one wonderful lady who was in her 80's with huge cardiomyopathy and CHF. It was slowly killing her. She and I became close and talked about everything, including how much she wanted to die. She asked God what she had done to deserve this lingering death, and we hugged and cried together. We would die her out, send her back out and then home and within a short period of itme, she'd be back. It got to the point that she simply couldn't stay home for more than a day or two and WHAM....she was back. During her last admission, her family finally made her a no code. Back then, the DNR order's weren't completely figured out, so she was made a no CPR patient, because frankly, they couldn't just turn off the drips and let her drown. Luckily for her, she was ready to go, had made all her plans previously, said goodbyes and then her heart started to slow down, she had trouble breathing, was given morphine to help with that, and she just slowed down all the way. I cried all over the family who cried all over me.

I didn't feel the slightest bit unprofessional. She was a special woman who was loved by her family- and by myself, too.

You were fine, and you probably endeared yourself to the family, by demonstrating how affected you were by your patient's death. Stay that way. The day you stop feeling, the day you can no longer cry, that's the day you change jobs.

[Jarnaes]

Just like everyone else have said, you were not unprofessional, you were human. The day you stop caring, is the day you should look for a new job...

[jerseyRN]

Agree with all previous posters that it's ok to be sad, share a few tears, feel loss and grieve. But in my life I've only gotten mascara on the shirts of guys who were holding me while I was sobbing. If that's the picture.... I think you need to try harder to remember that in the end, it's their loss, not yours, and respond accordingly.

[justiceforjoy]

I would be absolutely touched if my loved one's nurse cried. In fact, it would make me feel more comfortable in my cries.

[jerseyRN]

No problem with a few tears, but if the nurse is so emotional that the family needs to comfort HER, it crosses a line.