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Who You’ll Hear
Kati Kleber, MSN RN – Nurse educator, former cardiac med-surg/stepdown and neurocritical care nurse, author, and speaker.
Elizabeth Mills, BSN RN CCRN – highly experienced neurocritical care nurse, current Stroke Navigator for a Primary Stroke Center.
What You’ll Learn
- Communication
- Practical Advice
- Palliative Care and Hospice
Communication
- Educate
- It’s really upsetting for loved ones, prepare them for what they’ll see
- Suctioning, snoring, pain meds, gurgling
- It’s really upsetting for loved ones, prepare them for what they’ll see
- Communicate the medications you’re giving, what you’re doing before you do it
- Talk to the patient as if they can hear, even if you don’t think they can
- Be careful about your wording and tone
- Don’t come into the room all peppy and happy
- Words matter
- Do not say, “withdraw of care” – rather, “withdraw of life support”
- People may think that if the focus shifts from survival that they will receive less time and care from the staff
- Don’t tell the family when/time frame, because you honestly don’t know and don’t want to fail to meet expectations
Practical things for you to do and know
- Know your institution’s policies and procedures
- Know when to notify the organ procurement team
- Know the specific needed paperwork (release of body)
- Remove restraints if appropriate
- Know post-mortem care procedures
- Know if the patient will be sent to the medical examiner because that will impact your post mortem care
Practical ways to support the family
- Ask about religious or spiritual preferences, as well as culture to ensure they are prioritized and observed appropriately
- Allow silence
- Don’t rush out of the room
- Make sure there are lots of tissues
- Utilize other support systems – chaplains (who are usually trained to be with people in crisis, whose focus is to provide spiritual support and not convert people to specific religions), child life specialists, family supports
- Transfer to a larger room, if possible
Palliative care and hospice
- “Palliative care is whole-person care that relieves symptoms of a disease or disorder, whether or not it can be cured. Hospice is a specific type of palliative care for people who likely have 6 months or less to live. In other words, hospice care is always palliative, but not all palliative care is hospice care.” (Source)
- Can help put the big picture together
More resources
- When Your Patient Starts Crying – FreshRN Blog
- I Wish I Could Cry With You, But I Can’t – FreshRN Blog