The Balancing Act: A Dying Patient and a Spouse Who Can’t Let Go

Illustration by McClain Moore

Illustration by McClain Moore

The Reflections essay in the March issue of AJN is called “The Balancing Act.” The author describes a situation she faced as an ICU nurse in which her efforts to keep a dying patient comfortable were complicated by a spouse’s reluctance to accept the inevitable. It’s often hard to advocate for a patient while honoring the emotional struggle of a close family member. Here’s the start of the essay.

I have just arrived to work in the ICU and am assigned a patient in respiratory distress. Her name is Darlene and her husband Tom is pacing the room. Within 10 minutes, he drinks three cups of coffee, ignoring the cot provided by the previous nurse so he could sleep next to Darlene. His wife has more than one cancer and both are growing. She left the hospital a week ago for hospice care, but has been readmitted after a decision by her husband to reattempt curative treatment.

Many ICU nurses will be familiar with some variant of the situation as it develops, in which a nurse must tread carefully in her efforts to fulfill her ethical responsibility to alleviate suffering despite the constraints imposed by family members. Sometimes, with patience, a way forward can emerge. You can read the entire essay, which is free access, by clicking here.—Jacob Molyneux, senior editor

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Susan K Hiatt March 10, 2016 at 2:25 am

    I’m an RN MSN ed. And my husband died in June of 2015 after being in a hospital of poor care. Also a oncologist who could not give me the truth, so as usual I fought for good care, because he wasn’t getting it. No turning, no resp tx, and when alarms went off no one came until he desated. Sometimes in the 60’s before help. If I tried to care for him they told me I could do that. Finally a oncologist who cared told me theye was no hope. I took my husband home to save him from dying a horrible death in the hospital. Hospice I should say saved his life so he could have a pleasant death.

  2. Sara March 9, 2016 at 10:41 am

    You verbalized everything I’ve been feeling lately! How do you fulfill the wishes of the patient, while supporting the family dynamic?

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