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Department: EDITORIAL

When you are the nurse in the family...

Laskowski-Jones, Linda MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAAN

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doi: 10.1097/01.NURSE.0000733988.48272.f0
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When I first sat down to write this month's editorial, I was reeling from the weight of being both a nurse and a family member. Someone dear to me was close to death from COVID-19 at that point. It was an emotional roller coaster. A surprise improvement gave us new hope just when the end appeared near. The dark side loomed in the shadows, however, and manifested as the steady decline that followed the rally. The day arrived when it was clear that we were out of miracles, but we still prayed for one nonetheless. COVID-19 was the final arbiter.

It is a tough position, being the nurse in the family, especially with the wisdom and experience that comes from many years in clinical practice. Objectivity is difficult to maintain when it is hard to hear your own words. Family members reached out for answers, for advice, because of that experience and the trust I have earned with them. They said, “Tell it to us straight,” and knew that I would. I owe it to them to help sort through the medical complexities and communicate information in a way that they can grasp that is firmly grounded in integrity.

The heartrending decisions were not ones that I needed to make, but other family members did. The most I could do was to sensitively and objectively offer clarity around the directives the healthcare team urgently requested ... as well as the likely outcomes, even the ones that tore me apart inside to discuss. All I could provide was interpretation and potential perspectives for them to consider. Whatever the direction they ultimately chose, they needed to feel at peace with their choices.

It is very likely that most nurses have or will find themselves in similar positions as trusted advisors, perhaps many times over. When they are asked by loved ones, “What should I do?” there is rarely a straightforward answer. Emotions run high. These are not directives nurses as family members can or should render, unless they are the legal decision-makers, no matter how tempting it may be to make decisions for the family. Instead, when asked, nurses can offer clarity, insights, and support. Two questions are central, in my opinion: “Do you have a sense of what (name) would want?” and, short of clear advance directives, “What choices can you live with in peace?”

On the subject of peace, be sure to seek your own.

Be safe and well,


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