What do we talk about when we talk about dying?

[VTRN774]

]I work on a med-surg floor in a small community hospital. I have observed that when doctors (sometimes nurses too) talk to the family of a patient who is not going to get better, they often retreat into clinical language that the family doesn't understand. I've seen some families convinced their loved one would recover when the doc was certain he'd explained she wouldn't, and other families that were left uncertain and confused. I'm curious about what other nurses have observed. What do doctors and nurses say when we talk to families about dying? What don't we talk about? What do you think we should be doing for our patients that we're not?

[tewdles, RN]

Possibly part of the problem is that people are hearing these things when in the hospital...but not from their primary care team during routine visits?

[lpnflorida]

Last week I admitted a patient with a recent crani due to a glioblastoma, pardon if I spelt it wrong.

I asked the patient what was his understanding of what was wrong with him. From there I was then able to clarify any questions he had and hold his hand as he told me what his future plans were.

His goal in his words" I just want to be able to go fishing one more time. I am not afraid to die. The only regret I have is. What will happen to that grey haired lady who has been with me for 53 years. ( said with such love) I am afraid for her." Let me tell you at that moment we both had tears in our eyes.

I allow him the time each day to talk about anything he wants to whether it be death, or hopes for those around him.

[FlyingScot, RN]

you bring up a good point.

the type of deaths you speak of, are those that would happen with trauma and the death is unexpected.

thankfully however, many folks die with all of the above, well-managed.

a family member wouldn't witness any gasping, moaning, foaming, sucking, rattling.:)

if handled well, dying really can be the type of loving, peaceful scene you spoke of.

truly.

leslie

My experience has been opposite. The traumas are usually intubated and such. The ones, I've seen, who seem to have the least peace are often from nursing homes. These are folks who were DNR but when the family arrives at the ECF they see their loved one "struggling", freak out and change their minds. 911 is called and so no comfort care is able to be given because the patient is now a full code. The patient is transported in a most hideous state, we in the ER have a go at resuscitation knowing full well that it is fruitless and finally reality sets in for the family and only then can we attempt to make the process peaceful for both the patient and the family. But by then the damage is done. It's very frustrating when you know it could have and should have gone much differently.

[leslie :-D]

My experience has been opposite. The traumas are usually intubated and such. The ones, I've seen, who seem to have the least peace are often from nursing homes. These are folks who were DNR but when the family arrives at the ECF they see their loved one "struggling", freak out and change their minds. 911 is called and so no comfort care is able to be given because the patient is now a full code. The patient is transported in a most hideous state, we in the ER have a go at resuscitation knowing full well that it is fruitless and finally reality sets in for the family and only then can we attempt to make the process peaceful for both the patient and the family. But by then the damage is done. It's very frustrating when you know it could have and should have gone much differently.

wow....

that makes me sick.

thanks for another perspective. :-(

leslie

[FlyingScot, RN]

wow....

that makes me sick.

leslie

Me too. It breaks my heart.