Hi everyone,

First I'd like to say that this forum has been a blessing all throughout nursing school! Additionally it was my support after I took the NCLEX 2 weeks ago. I passed and have been admiring my license card. This is such a wonderful resource and i'm so thankful to have found such great company (although anonymously) on the www. Thank you :redpinkhe

I'm writing because I could really use some feedback from a nurses point of view. A few days ago, my grandma's friend found her crying for help and she was rushed to the hospital. The Dx was a Type A Aortic Aneurysm (5.5cm). She has been alert and making jokes until yesterday. Today however, she could only nod her head to respond and currently she is in a semi-coma state.

For what it's worth the past few days have been wonderful as her children and grandchildren flew in from out of the country and drove from out of state to see her. We all got to say our last goodbyes.

However, tomorrow is Feb 29 and as you know leap years come every 4 years. My mom was the closest to her and she's having a difficult time accepting that my grandma may pass away on a day that only comes once every few years. She cried as she explained that she knew she was being selfish, but the thought of not having a memorial day for her mom anually pains her.

The doctors have given her the choice to insert an NG tube tomorrow and to do hemodialysis one more time (she has renal failure and had been getting dialysis 3x/week for the past 2 years).

Currently my grandma is:

-85 yo

-on an O2 mask 90-100% sat

-BP 84/50 (norm was around 110/73 so maybe she's hemorrhaging slowly)

-HR 55

-R 25

My family has been looking to me for advice throughout and they know i've been against medical interventions because i'd like my grandma go with as little suffering and pain possible. I'm heading to the hospital soon and my mom wants some input from me but i'm so lost. I would really appreciate any insight. Thank you~

i'm really sorry about your grandma.

it sounds, at this point, she will die gently.

it's unfortunate that process may be interrupted.

your mom could have a memorial in another 365 days, whatever date that falls on.

wishing your grandma, a peaceful transition...

and for you, mom and your family, many loving memories.

leslie

Tell her that the fact that the date comes once every four years makes it a special one, one that not everyone shares. It's the same for people born on the 29th.

I am so sorry about your grandma, but it sounds like she will have a peaceful passing.

I'm very sorry to hear about your grandmother. I like TazziRn's way of explaining it, that it's a special day. Even if she passes tomorrow you can always pick another day to remember her. And do something extra special when the 29th comes around again. You and your family will be in my thoughts! I think it is wonderful that everyone in the family has been coming in to show your grandmother how much they care.

I really appreciate your replies. I think it's extra special too and what is the concept of time & date really? it's only for the living! But the relationship we each had with her is precious and transcends everything. We should consider us blessed that she can have a peaceful passing. Thank you guys i'm gonna go talk to my mom now!

I really appreciate your replies. I think it's extra special too and what is the concept of time & date really? it's only for the living! But the relationship we each had with her is precious and transcends everything. We should consider us blessed that she can have a peaceful passing. Thank you guys i'm gonna go talk to my mom now!

You can't choose the day anyone dies - some people may surprise you and go fast or take longer than than the MDs/RNs/family expected.

Try to explain to your mom that the 'date' is a detail you can't control - and to be with her till the end. If your mom is so stressed then one more day of treatment (if it buys her another day) would be ok - as long as she's comfortable .....

good luck:nurse:

Unfortunately, you can't control the date that it occurs... if we could, I surely wouldn't have chosen my niece's birthday for my dad to die.

It sounds like you are going through a very rough time. I am glad your family is able to support each other and be there.

I deal with end of life more than my fair share, all I can recommend is think of your grandmother's wishes first. There is nothing worse than watching someone suffer because family place their needs and fear of letting go above that of the patient. If she made specific wishes respect that.

End of life care usually will make sure that your grandmother is comfortable (we place patients of PCAs that deliver a certain amount of pain medication every hour this helps to ensure the patient is not suffering). Most hospitals usually have grief counselors or social workers who will speak with your family and give that additional support that you and/or your family might need.

As for the dialysis, speak with the physician (a lot like to sugar coat these sort of situations because they are tough) how successful he thinks dialysis would be and what state she would be in (vegetative, dependent upon others to complete ADLs, etc). It might be uncomfortable to speak in front of the whole family for you, you can always ask to speak with him to the side.

Good luck and my hopes are with you. Also, good luck in nursing. May your nursing experience be a great one.