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by TazziRN

Updated Aug 12, 2008 at 08:47 AM by TazziRN

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[lyceeboo]

Re: When doctors beat a dead horse........

More chemo? How unbelievably frustrating! That poor family.

I worked with a doc like that in LTC. He would rarely discuss or order DNR status. The families often didn't know better and some felt compelled to check off "do everything" for my dear Mom or Pop if she stops breathing/or heart stops.

Sadly, I was involved in 4 full codes of residents that should have been allowed to pass on in peace.

[StNeotser]

Re: When doctors beat a dead horse........

Know precisely where you're coming from. It's awful and I can't tell you the amount of times I've had to button my lip because I know they've been given false hopes from the MD but I can't say anything.

[zimsaint]

Re: When doctors beat a dead horse........

Maybe the Onc has faith in God and doesn't want to say it is over until GOD says it's over.. I am glad my daughter's doctor didn't give up on her in 1987 when all of his colleagues said she was a "hopeless" case. She is now 21 years old a junior in college and I have a beautiful granddaughter.

What you need to do as a nurse is follow the Doctors orders and stop initiating things (hospice conversation) that you have no power to bring forth. Don't your agency have Social Workers for that sort of things. You would do well to stick to nursing and try to bring your patient and her family peace in her illness................not another reason the stress.

[psalm]

Re: When doctors beat a dead horse........

Originally Posted by zimsaint

Maybe the Onc has faith in God and doesn't want to say it is over until GOD says it's over.. I am glad my daughter's doctor didn't give up on her in 1987 when all of his colleagues said she was a "hopeless" case. She is now 21 years old a junior in college and I have a beautiful granddaughter.

What you need to do as a nurse is follow the Doctors orders and stop initiating things (hospice conversation) that you have no power to bring forth. Don't your agency have Social Workers for that sort of things. You would do well to stick to nursing and try to bring your patient and her family peace in her illness................not another reason the stress.

Yes, all things are possible. But a frail, skin & bones, dehydrated, wound-seeping pt. is a poor candidate, you must admit. Not quite the same as a newborn or infant who may have a chance...

AND as a nurse, you ARE an advocate for your patient. You don't blindly follow doctor's orders, think of all the med errors nurses and pharmacists have avoided by NOT following or questioning a doc's orders. Social Workers are very important and they work WITH nurses and nurses work WITH them. After all, who is with the pt. 24/7? The doc? The SW? The family member?

[luvmy3kids]

Re: When doctors beat a dead horse........

Originally Posted by zimsaint

Maybe the Onc has faith in God and doesn't want to say it is over until GOD says it's over.. I am glad my daughter's doctor didn't give up on her in 1987 when all of his colleagues said she was a "hopeless" case. She is now 21 years old a junior in college and I have a beautiful granddaughter.

It sounds to me like "God" is trying to say it's over and the Doc is trying to do something about that. Sometimes you just have to let go...


ETA: sorry about the poor quote job... I don't know how to fix it..

[zimsaint]

Re: When doctors beat a dead horse........

Originally Posted by psalm

Yes, all things are possible. But a frail, skin & bones, dehydrated, wound-seeping pt. is a poor candidate, you must admit. Not quite the same as a newborn or infant who may have a chance...

AND as a nurse, you ARE an advocate for your patient. You don't blindly follow doctor's orders, think of all the med errors nurses and pharmacists have avoided by NOT following or questioning a doc's orders. Social Workers are very important and they work WITH nurses and nurses work WITH them. After all, who is with the pt. 24/7? The doc? The SW? The family member?

I totally agree with everything you have said, but I find sometimes as nurses we are too judgmental. I know there are times when we need to question Dr's orders but if Chemo gives this lady an extra week to live, then that is another week she gets to enjoy her family or make peace with GOD: Who are we to say that her life is not worth living.

[elizabells]

Re: When doctors beat a dead horse........

As I used to say to myself during the 6 months we beat the living tar out of a poor baby on my unit, until all her ribs were broken from CPR because we coded her at least once per shift, she was totally neurologically devastated, and her body weight was more than half third-space edema from ARF, and family wouldn't consider a DNR because "it's up to God".

I think God has made His opinion pretty clear at this point. Just because we CAN doesn't mean we SHOULD.

[zimsaint]

Re: When doctors beat a dead horse........

[quote=luvmy3kids;2821219]

Originally Posted by zimsaint

Maybe the Onc has faith in God and doesn't want to say it is over until GOD says it's over.. I am glad my daughter's doctor didn't give up on her in 1987 when all of his colleagues said she was a "hopeless" case. She is now 21 years old a junior in college and I have a beautiful granddaughter.

It sounds to me like "God" is trying to say it's over and the Doc is trying to do something about that. Sometimes you just have to let go...

God doesn't have to "try" at anything, he is ALMIGHTY and omnipotent. If he wanted it over, he could take the life out of her in an instant. Maybe he is giving her time to make some reconciliations in life before she leaves.

I just think as nurses we should carry out our responsibilities w/o judgments. If the Chemo present a danger to the patient's health and may even hasten death, that is one thing. But because we fill it is useless is another......and not our call as nurses.

[TazziRN]

Re: When doctors beat a dead horse........

Originally Posted by zimsaint

Maybe the Onc has faith in God and doesn't want to say it is over until GOD says it's over.. I am glad my daughter's doctor didn't give up on her in 1987 when all of his colleagues said she was a "hopeless" case. She is now 21 years old a junior in college and I have a beautiful granddaughter.

What you need to do as a nurse is follow the Doctors orders and stop initiating things (hospice conversation) that you have no power to bring forth. Don't your agency have Social Workers for that sort of things. You would do well to stick to nursing and try to bring your patient and her family peace in her illness................not another reason the stress.

1. I am following the doctor's orders. In fact, I hounded the doctor for a hydration order that she didn't want to give, even though the pt was so dry her skin was tenting.

2. I am well within my rights as a home health nurse to initiate a conversation about Hospice. And I may not have the power to order it, but I do have the power to tell the doctor "Hey, she's ready, can I order a Hospice consult?"

3. Yes, we have social workers, but everything that the social worker can initiate, so can I.

4. Did it ever occur to you that it might be the physician who is fighting with God and not me???


I'm very glad your daughter survived, but each case is different. This is not a matter of giving up on this woman, but a matter knowing when God has decided it's time. If He's not ready to take her home, then she ain't goin', but if He is, who am I to fight with Him and play tug of war with a woman who doesn't have the strength to tell me what she wants??