Giving bad news to someone in intensive care

FishyBiscuits · Apr 23, 2020

Hi all,

One of my characters is in intensive care following near-fatal blood loss after a fight. They need to be told that 5 of their close friends (everyone else in the team they were with) were killed/murdered in the same fight.

If they were told the news pretty much as soon as they wake up (it's the first thing they ask about), could the shock/grief cause their already fragile condition to get worse? If so, what's likely to happen (eg. might it be something as dramatic/serious as a heart attack, or would it be more like a delay in their recovery)?

I don't want my character to die, but their condition following the blood loss is critical (they've had emergency surgery and transfusions so far) so I'm wanting to know if my other characters can break the news as soon as they come round or if there would be too much risk so they have to delay telling them.

Edit: in case it helps, the blood loss was from internal bleeding in the abdomen (I'm thinking something like a ruptured spleen) and the character has a clotting disorder caused by a toxin they were infected with during the fight (this is being treated with vitamin k). They most likely had 1 or even 2 cardiac arrests during surgery, though I can take that out if it's unlikely they'd survive it.

Let me know if more info would help.

Thanks guys!

frimble3 · Apr 23, 2020

I don't know what actual medical people would say, but if your character is in that rough condition, would the medical staff let 'friends' near them? Maybe immediate family, but not just 'friends'?
Surely the first people they would see, on regaining conciousness, would be medical personnel, assessing whether or not they can have visitors.

FishyBiscuits · Apr 23, 2020

Their only family member (their mother) won't be able to get to the hospital for at least a day or two, so it's only their friends around. Some of the friends are the equivalent of government officials if that makes a difference.

If they still wouldn't be able to see them, I can work that in, but I'd have thought at least someone would be allowed in with them so they don't wake up alone?

MaeZe · Apr 24, 2020

That's a completely individual and circumstantial thing. There is no one size fits all. As an ICU nurse (used to be in the past) we would rely on the family and loved ones to provide information on what they think the ill person could handle.

Generally people who are very ill are not very talkative. So if the person didn't ask, you wouldn't offer the information.

Why do they need to know at that point in time?

It's not likely to give the person a heart attack or anything like that. Grief and depression tend to cause health problems over a longer period of time.

FishyBiscuits · Apr 24, 2020

It's the first thing the character asks about after they've come round and are able to talk. They knew their teammates were badly hurt before they went into surgery, but they're in denial about the possibility of them being dead, so the news is going to hit hard no matter when they're told.

I'm mainly wanting to know if there could be any physical repercussions from the character getting such a heavy emotional blow while they're still in a serious condition. That will help me decide when the other characters are going to actually break the news.

ironmikezero · Apr 24, 2020

Most (govt.) agencies have protocols in place for such notifications. The info is often compartmentalized, kept on a need-to-know basis as warranted. In this case, after consulting with the appropriate medical authority, the patient would likely be told upon asking, and subsequently be questioned to garner first-hand details known only to those who were there (considered a formal interview and suitably documented).

RBEmerson · Apr 24, 2020

Star Trek said it best: "He's dead, Jim." Might as well cut to the chase.

(Sorry, the devil made write that)

Roxxsmom · Apr 24, 2020

On medical shows, this kind of conversation ensues:

"My friends? How are they? Where-"

Clinician adopts woeful expression. "I'm sorry. We did all we could, but their injuries were too severe. They have all passed away."

No idea if this is exactly how it plays out in real life, but there's really no good way to tell someone devastating news. I think the general consensus is you need to get it out quickly, gently, and unambiguously as possible, then provide emotional and medical support for the shock that follows, and answer any questions the bereaved person may have.

RBEmerson · Apr 24, 2020

When my mother died ("threw a clot"), the doctor that met us was nice enough but basically delivered the news with "I'm sorry" and sympathetic whatever, but we were pretty much left on our own until a nurse asked if we wanted to see her. Full marks to nurse for as much staging as possible in a hospital room.

OTOH, present when my father died (natural causes, just ran out of steam), doctor spent time explaining what was happening (i. e., what was going on to get close to dying). Sympathy all around staff afterwards.

Or... it varies. One staff or lead doc. may be "correct" to the point of "I wish he/she would just go away", another might try to be as caring as possible. Pick what fits the situation.

IMNSHO TV dialogue is probably one of the least reliable sources for "what do they say/do".

ADDED: Keep in mind that med. staff tries very hard to keep one step of remove. Bad news, bad outcome happens frequently. Investing personally in each one isn't a good way to cope.

WeaselFire · Apr 26, 2020

When I was in the ICU after surgery, I was intubated and sedated and nobody would be telling me anything. Only two immediate family members were allowed in and for only short periods. After extubation and off the sedatives, I was there for two more days and still restricted visitors. I basically got no real information until I was in a regular room.

Had anyone I was allowed to have visit told me about others, they would have been relatively blunt:

"How's John? And Amy and the others?"

"They didn't male it. It was lucky you even made it."

In other words, tell it according to your character's nature.

Jeff

RBEmerson · Apr 26, 2020

I can relate to that. I've been in ICU or recovery three times. The PT specialist who was supposed to be showing me how crutches work (not quite as easy, at first, as it might seem) was something of a dud but the nurses in Rutland General, or whatever the current name is, looked after me, and more importantly my scared stiff wife. No candy coating, either, but not left out to dry.

The nurse in recovery, on a simple single day procedure, wanted me out of her ward. I nicely didn't barf on her, but the people that counted were supportive, without stretching a story.

The last go-'round was no joke. The neurosurgeon is on my list of "you could fall backwards blind, and know he'll catch you long before you hit the floor" people. Did then, still do today. He won't tell tales, he answers every question with care, and has some darn funny stories otherwise. The entire crew who had me in the ICU or on their floor cared.

But... nobody ever, ever spoke without the caution to not say what was inappropriate. Not once has my BS detector gone off. Which isn't to say it doesn't, and won't happen. But not if they're pros and not just have a lab coat from Wardrobe.
HTH

Giving bad news to someone in intensive care

FishyBiscuits

frimble3

Heckuva good sport

FishyBiscuits

MaeZe

FishyBiscuits

ironmikezero

practical experience, FTW

RBEmerson

Believes own press releases

Roxxsmom

Beastly Fido

RBEmerson

Believes own press releases

WeaselFire

Benefactor Member

RBEmerson

Believes own press releases