Could I have done more

My dad died 3 weeks ago from his metastatic prostate cancer. He had spinal mets and his mobility was decreasing towards the end. I managed to take him away for a week to Scarborough but he sadly died the end of the following week. On Thursday night his legs gave way and because he couldn’t get-up and my mum couldn’t move him the paramedics came, but it was 4 hours wait. Then because his BP was low they wanted to take him into hospital. He hadn’t fully completed preferred place of care. He went into hospital late Thursday night. We heard nothing from the hospital. I rang his palliative cns.amd asked if they could contact their inpatient colleagues to try and found out what was happening as unable to get hold of anyone. He was in a and e until 8pm on the Friday night we were not allowed to visit. I told the nurse on ward I was concerned he was in last days of life. But noone could visit until he had been reviewed he the doctors. 9am Saturday morning the doctor called to say dad was very poorly and drowsy. He said we could now come and visit, but before we even had time to leave the house they rang back and said he had died. I am struggling to come to terms with the fact that none of us had been able to see him in his last 24bours of life. I have visions of him alone in a and 3 and no-one caring or even thinking does this man have any family. It is not how I wanted things to be at the end and I cant get this.out of my head.

I think if I had spoken to the paramedics and asked them was there any benefit in taking him to hospital. They could have just got him into bed and then we could have got the hospice team out next day and either got more care at home for the last few hours or got him into the hospice.

I am a cancer nurse specialist myself and feel so guilty that I failed my dad at the last hurdle.

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Hello Mandymoo, yours is a very sad story because you know about all the restrictions which have and are horrible when your loved one is very poorly. Please don’t think you didn’t do everything you could, you know in your heart of hearts that there is so very little we can do when people are at the stage you dad was. You did really well taking him to Scarborough and he must have enjoyed every minute. Please reach out to your working team mate for reassurance because as I write this I am at a hospice and I know everyone here would help you with your grief because that is what makes us doubt whether we did do everything for our special person.
Please take extra care because at present you are very vulnerable both physically and mentally but I am sure you don’t need me to tell you. Sending big hugs and blessings. S xxx

Hi susie.

I know you are right and I have fantastic work colleagues who will help me work through this. All the way through his treatment and when it stopped I supported both my mum and dad. I tried to prepare my mum and then it all went so wrong at the end. Yes covid has stripped so many families of the opportunity to say goodbye and never thought it would happen to me. I am always trying to advise my own patients to complete advance care plans but my dad had not done that final page and the paramedics probably thought they were taking him to hospital for a reversible issue, but sadly was not the case. I think also I wasn’t prepared myself that the end would come so soon. I have spent the last couple of weeks executing his will and supporting my mum and last night I sobbed and sobbed. I feel grief has finally caught up with me now I have taken my professional hat off

Hi, I understand totally how you feel and there is no way you can prepare for the what you know will happen. When ever, it still comes as a shock but you are right about having a lasting power of attorney, it just makes things easier.
We keep going for so long then it hits us full on and crying is you just realise all that pent up emotions. Please be careful about returning to work, for some it’s better getting back but for others they do it too early. Don’t put on that brave face, it doesn’t help. Grief keeps hiding then it hits again just when you don’t think it should.
I keep thinking about Scarborough and that saying ‘wish I was there’’. I shall have to have a day trip, covid or no covid. S xxx

I used to be a nurse and also research cancer, my Dad died of cancer nearly 5 years ago, and my Mum died in January also from cancer. My Dad had a horrible cancer journey over many months, it was so bad we officially complained to the hospital about numerous things that went wrong, after he died i felt so guilty that i couldn’t have done more given my knowledge and experience and this lasted a very long time, I used to dream about what I could have done every night for the first year, it was torture, My Mum died suddenly from an undiagnosed cancer, the guilt there is I didn’t spot it. I have to remind myself I wasnt my parents nurse, I was a relative, their daughter, with all the emotional stress that that brings, I didnt work in the hospitals my parents died in therefore was not responsible for their medical care, my role was to be their daughter and do the best I could to support them in that capacity. You couldn’t predict your Dad would pass away so suddenly, you tried your best in the circumstances, you and your family made the best decisions you could within that capacity, you weren’t your Dads doctor or nurse, the paramedics made the decision to take him to hospital, because at the time that was the best desicion, you didnt have that role, patients relatives can only do so much, they are suffering as well, we look to health professionals to help us. Also remember hindsight is a great thing, but you made the decision for your Dad to go to hospital without knowing he would pass away so suddenly. Dont let the things you could have done given hindsight make you feel guilty, grief is bad enough without this, be kind to yourself, you did your best.

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Thank you so much. You are so right. I always had my nurses hat on. Checking on his pain control amd explaining to my mum how the mst and oromorph worked and getting it increased. I am worried about going back to work next week. I maybe fine. I have a great team of friends and work colleagues who I know will support me. I remember when my dad was first diagnosed with his prostate cancer I was so upset and he said why was I so upset when it was my job. I said but you are my dad

Just take it one day at a time, I have good and bad days, I have had to really make myself do things, work was hard to start with, but it does get easier, my best advice, be kind to yourself, and to others, nothing in this is easy xx

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PS, you sound like you did an amazing job, your Dad must have been very proud of you xx

Thank you. I think he was as he always told the nurses.on the cancer ward he was on that I was a cancer nurse

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