Was so impressed with my patient yesterday and not so impressed with the family

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Ok so my little background.....I was taking of a very nice 98 year lady yesterday,had a congestive heart failure and was desaturating to 80s due to the respiratory failure,doc prescribed lasix,other meds and put her on 5 liter oxygen,lady oriented as a almost 100 years old person could be..had an awsome labs for being that age,her own child is pushed for hospice to make her comfortable but she refused,she wanted to be taken to a hospital and be treated,lady was very nice for the whole time I was being there,cracked me up from time to time especially when she requested to sit in the chair for a long time and asked if we have anything to read,I told her that there are some "entertainment" magazines,but she said 'bring it on" Her child though made me so upset for pushing the hospice,just let her be ya know.

Specializes in Corrections, Cardiac, Hospice.

Well, since I just got home from one of those hospice places, I have to say I am a bit surprised that people are still so ill informed as to what we do. I do not, repeat DO NOT kill people. I keep them comfortable while they die from their DISEASE. I give exceptional care to my patients and get hugs from them and their families every single night I work. So many times patients (and their families) say, "if only we knew it was going to be like this we would have come a week ago!" I am proud of the work I do and the care I give. By the way, did I mention, I DO NOT KILL PEOPLE????

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Shay. I'm sorry if that is the impression these posts gave you. I certainly do not, and never would say that hospice nurses KILL PEOPLE!! If I ever leave my job now, hospice would be the place for me. I think I have the skills and personality for it.

Our job as nurses is to educate the patient and their families as to what hospice really does. I mentioned that even nurses don't realize that, for example if you get pneumonia on top of your lung cancer the pneumonia is treated. I really think we are on your side!! Take care. :)

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This doesn't have anything to do with this thread, but I didn't know how else to figure this out....I am a new member and I cannot for the life of me figure out how to start a NEW thread. I obviously know how to reply to one. Can anyone help me out? Thanks so much!

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Originally posted by ShayRN

"Well, since I just got home from one of those hospice places, I have to say I am a bit surprised that people are still so ill informed as to what we do. I do not, repeat DO NOT kill people. I keep them comfortable while they die from their DISEASE. I give exceptional care to my patients and get hugs from them and their families every single night I work. So many times patients (and their families) say, "if only we knew it was going to be like this we would have come a week ago!" I am proud of the work I do and the care I give. By the way, did I mention, I DO NOT KILL PEOPLE????"

I like nurse56 hope that my post did not convey hospice as the reason people "die" with hospice nurses being those that "kill people." On the contrary, I think all nurses should learn more about the beautiful things that hospice nurses do. Hospice nurses provide excellent MEDICAL care in addition to the emotional and psychological care they are specially able to provide. I believe there is widespread misunderstanding about this. Which is why a hospice consult is needed in this situation, in my humble opinion.

My posts were an attempt to address some of the barriers I have seen to patients accepting hospice care. One of those barriers is a patient being profoundly afraid or unwilling to leave their home. This is not because I believe if they go to a hospice center they will receive anything but the highest quality of care (or that home hospice or hospital hospice is superior). It's just, if the only thing keeping this patient from receiving everything hospice can provide, then the option of remaining at home should be addressed.

In my first post, I mentioned palliative care, which in the clinical presentation presented is probably not the best option. Why did I mention it? Not because hospice is going to let this woman die (clearly - the disease process will be responsible for that), while palliative care is going to jump start a failing heart ... but because a patient should have dignity at the end of their life. If sheer fear and denial cloud her acceptance of her prognosis, if no amount of education and honest discussion will help, then palliative care may be an option she is willing to accept. This is sad for another set of reasons, but at least she could have educated health professionals helping her preserve her dignity and quality of life upon discharge.

My "care versus cure" comment was not meant to infer anything but the fact that treatments designed to cure the underlying disease process are no longer employed once a patient is under hospice service. For example, cancer patients must be willing to stop chemotherapy and radiation to accept hospice services, unless approved for a specific palliative purpose such as debulking. That does not mean an infection won't be treated with antibiotics or that blood transfusions for severe anemia will be withheld. My apologies if this was too liberal or vague a statement.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
This doesn't have anything to do with this thread, but I didn't know how else to figure this out....I am a new member and I cannot for the life of me figure out how to start a NEW thread. I obviously know how to reply to one. Can anyone help me out? Thanks so much!

Here is a video that might help--

.https://allnurses.com/howto-video-tutorials/getting-started-allnurses-149297.html

Getting Started on Allnurses. I've never started my own thread either, but this probably tells you how. Hope this helps!

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Well, since I just got home from one of those hospice places, I have to say I am a bit surprised that people are still so ill informed as to what we do. I do not, repeat DO NOT kill people. I keep them comfortable while they die from their DISEASE. I give exceptional care to my patients and get hugs from them and their families every single night I work. So many times patients (and their families) say, "if only we knew it was going to be like this we would have come a week ago!" I am proud of the work I do and the care I give. By the way, did I mention, I DO NOT KILL PEOPLE????

Sheesh! I hear that a lot from other health professionals.....very sad. Even docs and nurses haven't got a clue sometimes.

The lady shouldn't be forced into it, but she needs some education to make an informed choice. Her reaction sounds like a 'knee-jerk' reaction to me.

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Specializes in pulm/cardiology pcu, surgical onc.

I took care of a pt in her final days of CHF on hospice. It was one of my most memorable experiences working with a pt and family who were okay at letting go. This pt was 80, alert, oriented, and just plain tired of fighting her disease. Education re hospice as above posters mentioned would be extremely helpful in giving the OP a better quality of life IMHO.

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"Hospice" does not mean "Home to Die" any more than "DNR" means "do not treat", and I think that's a huge part of the problem. People don't realize that. As an oncology RN I go through this explanation at least twice a week and sometimes once a day. Maybe this lady doesn't realize that.

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This doesn't have anything to do with this thread, but I didn't know how else to figure this out....I am a new member and I cannot for the life of me figure out how to start a NEW thread. I obviously know how to reply to one. Can anyone help me out? Thanks so much!

on the top or bottom of each forum, there is a blue box that says "new thread"...

just click that button and go for it.

Sheesh! I hear that a lot from other health professionals.....very sad. Even docs and nurses haven't got a clue sometimes.

The lady shouldn't be forced into it, but she needs some education to make an informed choice. Her reaction sounds like a 'knee-jerk' reaction to me.

i agree there is a HUGE knowledge deficit re hospice.

with this pt, i DO agree with palliative care vs hospice, because for whatever reason, it 'sounds' like this pt is not ready to die.

and it should be her choice (after appropriate education, of course).

but palliative care will allow her to seek the tx SHE wishes while subtly preparing her for her inevitable death.

even hospice pts (who sev'l, remain full codes) often kick and fight til the very last minute.

it should always be the pt's choice, bottom line.

leslie

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