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Caregiving: Hospital vs Home


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Is there a difference to working in a hospital and caring for a loved one? How different are they?

I have two years hospital experience as a Licensed  Respiratory Therapist. Many wouldn't know what an RT's job is. While we have a lot of responsibilities one of the most noted is that we work with the sickest, the dying alongside nurses and doctors. You'll usually see us running to a code pushing a breathing machine, giving CPR, drawing a blood sample from the artery. Most of the time we get shunned but we are there, working relentlessly.

Sometimes people say that hospital staff in general grow numb in a matter of time. That we don't care, a patient dies in front of us "oh well, it happens". We don't grow numb but our job requires us to separate our feelings. We cannot make sound medical judgements when we are clouded by emotion. But no matter how hard we try, we do feel connection, concern and love towards our patients, we are only humans after all. Our job needs us to move on from one death to treating the next patient. But when all the hubbub subside that is when let the walls crash. There are times, though, when the loss of a dear patient is too much and we breakdown on the spot. When it all gets too much we ask for a break and we welcome it. Mostly it is physically exhausting and emotionally and mentally tiring. We feel for the patient's pain and fear. We feel for the families' anxiety and loss. But at the end of the day, those people come to our lives by chance, we didn't know them till their charts landed on our hands. At the end of the day our sadness must be locked up and proceed to next shift, anew. 

But what happens when a loved falls  gravelly ill, dying? 

This is exactly what I went through. I had to leave my job in one of the most prestigious hospitals in my country. Although my original plan was to study medicine but I dropped that too. I wanted to care for my grandma. 

People say that it's harder to care for a family member or a friend. I used to just ditch the idea. I mean, how different could they be? I was wrong! 24/7 you're anxious, you're awake day and night and on that rare occasion you do sleep your mind doesn't let you rest, one nightmare after the other that leaves you confused whether dream is better than reality. Both wakefulness and sleep are frightening. Being close with the patient makes you decide errantly. You think you're doing it for the patient but behind it you're doing it out of fear. That is why it's important to listen to what the patient wants. A lot of times we long for a 'me' a time, for a reprieve but when we do get it we long to be back beside our family. And when the inevitable happens you feel guilt, how could I be so selfish to want a break? But to want rest is again only human and normal, nothing to feel guilty about. But most of all the greatest difference is not seen or felt. Sure it is exhausting to care for the sick but the emotional and mental toll is beyond draining, to witness a loved one in pain and suffering, no escape from it, no sleep, no R&R to take it away. It haunts you long after the death. It is traumatizing at the least. But most,  including myself, will do it again in a heartbeat. 

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  • 9 months later...
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DennisBrown

I agree with the fact that caring for the loved ones on your own becomes a bit difficult because of fear as you are emotionally and mentally attached to the person. In my opinion, if a person chooses to go forward with the experienced person in skilled nursing in order to take care of the loved ones, instead of taking care on your own, can be beneficial as another person can properly take care of the patient by not being emotional. This was the case with one of my close relatives, for whom skilled nursing facility was taken into consideration under original Medicare insurance plan from The Health Exchange Agency. This turned out to be very helpful for us as she has been taken care appropriately by the accomplished medical caretaker.

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Nicole-my grief journey

I’ve done both and I’m grateful for the nurses and staff that helped me in the LTAC with my mother. I know they were so heartbroken when she passed. They grew attached to her and we shared a life changing experince together. I actually had to enter the facility again for ankther elative the other day and I ran into the food servjce gentlemen that tried to help my mom everyday for a month. We shared some tears and I thanked him for being so kind and gentle with her. I didn’t have the emotional strength to fully go down the ward that day and thank the wound care ladies and charge nurse, but I plan on doing so. Having my mom in the LTAC kept her alive longer I think. They said she could have gone home, but she needed everyday wound care and so I fought to keep her in their by appealing with insurance denials. It’s different for everyone with choices and I feel like I’ll always replay choices we made and questions things...but I think tou’re so right about feelings, anxiety and sleepless nights and how families take for granted staff at facilities and all that they do. Not everyone was great at the facilities, but I found that more than not, they really cared and did their best in an impossible situation and I did too. I woukdn’t have been able to do everything myself with her at home. Sending you wishes for oeace i your heart and strength. Thank you for sharing.

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RenegadeRN

the RTRP...as a retired RN, who retired the week after my wife of 43 years passed from Stg 4 Gallbladder cancer 90 days ago....you are right in what you write and feel. Background: I spent 13 years on a step down unit in a hospital. ACLS, PALS, and of course CPR. And other Certs. I feel for each caretaker and patient it maybe easier or better for the patient and caretaker to have the patient InPt at another facility. It’s their choice based upon their circumstances.
However my wife chose to be at home after 3 separate surgeries, chemo and ultimately hospice. I learned more than you know. She chose me to be her sole care provider at home. In a hospital it can be frightening or at least some concern for patients.....providers come and go, they spend a few minutes and move on....lab, radiology, PT/OT, Social worker and all the people are new to the patient. Add in the fact the reason they are their adds stress. As an RN having 4-6 patients it can be difficult to provide the care your loved one might need , people come and go and while a few providers get attached, not all do. My wife chose to have care at home. And in many ways it is harder at home. I was with her 24/7 for 17 months. And here is what I will say for ME and is only my opinion: it dawned on me one morning getting ready to go with her to chemo. I had been given the privilege of going into
Nursing, went to years of school, attended classes, took countless CME courses and conventions over the years and spent 13 years of caring for untold number of patients for one reason: I was going to be my wife’s sole caretaker for 17 months! Yes we had Home Health and Hospice with their entourage...but only a short period. I learned all that education and training was to be the nurse for my wife! And I sit her and say this with truth....it was the hardest thing I ever had to do and wouldn’t trade it for anything.


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The RTRP I agree, nothing is the same as the feelings that come from caring for a dieing family member. My brother and I cared for my father full time, his final 7 weeks. We also had my uncle, his youngest brother, an RN there to help the last week.  So thankful and endlessly grateful he was there, so many things he knew that helped keep my daddy comfortable.  There is nothing I have ever done that was more difficult.  I will never forget those last few week, the struggle, the hurt, that final breath. I took nights so they could sleep, I ....I can't even talk about it. It was so hard, so painful, I am so glad that I could be there to make my father more comfortable, but it was so hard.  So hard, and I run through it over and over in my head still, 7 months later. 

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