Tough family questions

Ayvah, RN · Nov 7, 2008

You have to be as honest as you can be with family. You can't give false hope, but you also need to be honest when you don't know the answer. For a question such as the one posed above, your response should be tailored on the patient's situation. If the patient is actively dying(i.e. renal failure), then you can say something like "It is hard to say an exact time, as everyone person is different. I can't promise any specific time frame that they will still be with us. They may go soon, or could be around for a week or longer. Is there any way that I can help with this transition? (such as get last rites, get them connected with a chaplain, or work with the social worker to help facilitate death at home, or transfer to a palliative care floor, etc)

If the patient is not actively dying but is in an acute life threatening situation, you can say something like "It is uncertain how long (s)he will still be with us, whether that be tonight or 50 years from now. While there is a possibility of her/him passing tonight, we will do everything we can to keep _____ here with us and as comfortable as possible. Is there anything that I can do to help?"

Its hard to deliver bad news to a patient when all you want to say is "Everything will be OK". But in actuality that's the worst thing that you can say. Family needs to know they can get straight answers from you. It will help their comfort level. If it is very bad news, it will help prepare them for what is coming, instead of them feeling shocked if the death did come that night. Always be truthful even if you don't know.

If a family asks a tough question, you can tell them you'll get back to them, or you can get your charge nurse to come help diffuse the situation too. You can also refer them to a doctor (i.e. questions regarding a surgery)