We Truly Care

Many of us, as nurses or case managers, have had the experience of speaking to an “enflamed” family member, and practiced all our communication skills to bring calm and rational judgment into play? Recently, amid my patient’s terminal agitation and inevitable rapid decline and a families’ sense of being overwhelmed and powerless in these situations, yet not accepting that patient was dying, I had the opportunity to use some of these skills recently, as I use them on as needed and often basis in a Hospice setting.

My patient was 80 years female with a rare terminal disease where your brain shrinks, and your nerve cells degenerate and die over time. She was married to the love of her life (her husband) for more than 50 years. He has been making decisions for her since she started being incapacitated. She remained full code throughout our care, despite me talking to him on a weekly basis on the importance of him allowing her to pass in the comfort of their home when the time comes. He was not ready to change her status code. Weeks and weeks had passed, and she was declining furthermore. Medical Director as a crucial role in this setting was able to step in and make an in-person visit for the patient and meet with the family to explain what may happen if 911 were to be called and her to be taken to the Hospital. Soon after, the family changed her code to DNR. The patient was able to have a dignified end-of-life experience with continuous care nurses and family at her bedside in the comfort of her home. I know that her husband will have a hard time continuing life without her, but he knows that she was comfortable and surrounded by her loved ones and that is exactly what she wanted to be. As an RN and case manager for a long time now, even though I was unable to get through the family, the doctor did. Or was it that they needed to hear that from both of us as the main guidance on this ship called Hospice Care? Regardless of what may be the true story, Case managers and Skilled nurses are not alone in this overwhelming field. Doctors that are 24/7 at our back and call are there for us with constant support.

In the business of the day, in the overworked staff’s experience, and in the power that rests in the hands of the decision-makers, we must primarily advocate for the patient and family and truly demonstrate what most medical establishments mission statements claim: The patient/family unit is at the CENTER of all the care received from the entire medical team.