Several of my family members have died of painful illnesses. Unfortunately, they didn't receive much education about what to expect or how to manage their symptoms. That's a big reason why I became a nurse, so I could help other families avoid the frustration my family experienced.

But sometimes I don't feel like I'm making a difference. When I tried to talk to one family about the stages of grief, they just looked at me, then continued bickering over trivial things. In another case, I tried to help a wife get much-needed private time with her dying husband. The whole family got angry with me, even though the wife had said she wanted to be alone with her husband.

I just want to make things easier for these families. What am I doing wrong?-J.E., ONTARIO

You sound like a caring nurse. But let me suggest a couple areas of caution. First, keep in mind the boundaries you must honor in nursing. For example, nurses shouldn't try to care for their own families as health care professionals. In such a situation, you're a family member only. Give yourself a break-don't try to be all things to your own family!!

Also, don't try to superimpose issues that you encountered with your own family onto your nursing care. Each family has different needs and coping abilities. The art of nursing involves seeing and listening to each patient and family, so you can discover and respond to their unique history and needs.

Finally, avoid self-doubt when patients and family members don't listen to you, don't seem to benefit from what you offer, or even blame you for trying. Chances are that you've made a much greater impact than you know. Remember: You're seeing families in crisis, and they may not realize the value of what you're doing for them at the time. As you grow more comfortable in your role as a nurse, you'll learn not to take their anger and distress personally.

So hang in there and hone your people skills and listening ability. Try to set aside your memories of difficult situations with your own family and respond to patients and their loved ones without any assumptions. Let go of unmet needs from your past and focus on meeting your patients' particular needs today.