Am I going to die?

I am a first year nursing student and had my patient at clinical today ask me if they were going to die? Being totally caught off guard I turned it back to the patient and replied "what are your concerns about dying?" In post-conference I told the group and felt that my response was not what I would have liked to have said to this patient. Our instructor said that we should think about what we would tell any patient that asked that because as nurses you WILL have patients ask you and you should be prepared. Just curious as to what others do in this situation.
Just find out what makes them think they are going to die. My reaction would to patient's words would depend on the diagnosis, prognosis and etc. I mean I would have a different reaction if the person after appendectomy asked me that question vs a person with terminal illness.

My answer is usually: "Everybody's going to die eventually, but today's not your day."Unless, you know, I actually think they might die. Then it's usually something along the lines of, "We're going to do everything we can to keep that from happening."I like your idea of exploring their feelings and assumptions about the issue. Something I should do more, but usually avoid.

We were taught to ask them to share their thoughts and concerns... this actually happened to me.. I told the patient we were doing all we could to make sure that didn't happen... she died a week later.. back at her nursing home. She was a sweet lady and I just loved her...

I'm not sure what the correct reply is, but personally I always ask them in return "Do you feel like you're dying?" This allows for further assessment, because, nurselovescoffee, when they say that to you, get ready!!! I have said "not if I can help it" when I have been asked that, because I feel confirming their fear leads to an increase in anxiety :uhoh21:, thus creating tachycardia, hypertension, hyperventilation .

Quote from TiredMDMy answer is usually: "Everybody's going to die eventually, but today's not your day."Unless, you know, I actually think they might die. Then it's usually something along the lines of, "We're going to do everything we can to keep that from happening."

I think your reply was quite acceptable. Your question allowed the patient a moment to reflect and also demonstrated to the patient that you were listening and willing to explore. There are many right answers or should I say questions that you could have asked. Therapuetic communication takes time to learn. The one thing you do not want to do as a nurse is to ignore or avoid the question that is being asked. You also do not want to use cliche type answers. Just be in the moment and be open and honest. Obviously this patient was scared enough to ask the question...patronizing or placating has no place in this. Therapuetic communication is for the patient, and is different from social communication. You did a fine job!

Quote from registerdin2006I'm not sure what the correct reply is, but personally I always ask them in return "Do you feel like you're dying?" This allows for further assessment, because, nurselovescoffee, when they say that to you, get ready!!!

Thanks for all the great replies! We have not addressed this issue in class so I was very unprepared. I appreciate all of you sharing what you have experienced with your patients and how you respond. Thank you.

I was looking after a lady who was to have a permanent pacemaker insertion (think it was the defibrillator type). She was terrified she was going to die. I guess there are various reasons for the fear. In her case I called the anaesthetist, who ordered temazepam as a premedication. When I went to give it to her, she was much more relaxed. Obviously the discussion with the anaesthetist must have helped. And maybe my quick response to have someone see her showed her and her daughter that we took her concerns seriously.My point here is that there is no right answer. It depends on the situation. I really can't see anything wrong with your question; you showed you were prepared to listen...

Quote from nurselovescoffeeI turned it back to the patient and replied "what are your concerns about dying?"

That is what we were taught to do in class. Ask the question and allow them to tell you what is on their mind. I am worried I won't be ready for what they say or how to handle that. How did she respond to you?

sometimes they need to be reassured sometimes you need to address the situation head onask if they would like to speak to a chaplain, ask them what they doctor has told them don't poopah over their question so that you can get out of the room i have had many who when they had a sense of impending death they did indeed have only days left if that longhowever i had a sweet old guy who was scheduled for an ab aortic aur repair he would sit in the bed and say 'poor old henry, this is the end for poor old henry, he came through the surgery with flying colors, i think it kinda surprised him when he woke up