Doctors that think they are god...

[DebRN06]

I am increasingly becoming sickened by a group of docs where I work. They seem to keep their pts alive at ALL costs. I have heard one of them tell the daughter of my pt that the pt didn't have anything he couldn't "cure" and that she was "not terminal." This about an 85 y/o woman with sepsis, COPD, etc, etc, etc....stating she wanted to go home with her daughter to die. Doc makes daughter (POA) feel like she is killing her mom if she brings her home...All Holy Doc can CURE her!!

This is only one little story (there are more)...I am just curious, since I am newer to nursing, where is the line drawn? What can I do for my pt that is honestly being tortured, by a group of docs that think they are god, before the inevitable?? I am newer to this hospital, but this group has a horrible reputation for keeping people alive at all costs. ALL the RNs talk about it & can't stand them. I have seen it numerous times in my own short period there. Why is nothing done...or, what can be done??

Also...would you agree that it is more the docs are $$greedy$$ and need to keep their bankroll alive to get the medicare payments than that they are "trained to save lives" and can't give up??????

Thanks for any input...very tired hope this made sense!

[gonzo1, ASN, RN]

Uninsured patients get treated very well in our ER. My family knows very well what I want, and how I feel about treatment under certain conditions. This is a persons best protection. Only God can decide when enough is enough for those who haven't been able to discuss this with their families and make their wishes known. I work with the assumption that the patient may recover, and leave the rest to God. There is no right or wrong answer to this debate and it is great to have a chance to explore how others feel and what can be done to make nearing the end of life a better experience for the one leaving and the ones left behind.

[lauralassie]

Seems once angin people have gotten off topic. I know what you mean about Dr's acting like God. I've also seen nurses (including myself at times)act like God , using statement such as, "They are just seeking", just as an example. To add a little humor to this . There are a couple of docs that have God attitudes. One is a resident. He wrote an order on the ER chart to repeat vital signs. Almost every pt is on the monitor or at least o2 sat and BP, if they''r getting narcs Q 15 min. I wrote in the nursing notes " pt on Q 15 min. vitals prior to order. Resident instructed on how to read the monitor." Probalbly shouldn't have but, it felt good at the time. One Dr. wrote, suture set up to BS, open package. I of course put the suture kit on the stand, un opened. He asked an EMT to open it, I inturruped in front of the pt. and said " see as the directions say..snap smartley at the top and pull. Thought they would have taught that in med school" and turned around and left.

[withasmilelpn]

I think that life is precious and the most valuable thing a person has. If death were to come calling right now I would Fight with everything I had to stay alive, I would want everything done to keep me alive. I can't imagine how years can possible change that. I think anyone given the option at the final moment if given a chance would choose to fight to live. I have seen the reverse of what you accuse me of. I have seen life saving treatment held because nurse have imposed their thinkings upon the family and painted a no hope picture for them. I think many nurse shove their "peacefull death" too far..after all it does soothe the conscience and eliminates alot of work and does cut costs. Let's make a deal, I'll not put you on a vent or code you if that is what you really don't want but please do it for me and let's not impose either of our wishes on others.

You ask if I would like a compassionate nurse or doctor. Yes I would not one that because I am old with multiple aliments doesn't want to treat me...at all costs. Are these nurses really keeping an eye on the tab of these patients becasue the original op states in her first complaint she didn't like the doctors keeping the patients alive "at all costs". Do they think they are going to see a pay raise if they help cut the cost of these inevitable deaths. I thought the doctor said the patient was not terminal , do we just stop treating them? The patient may want to go home to die but if the doctor said she is not terminally ill what is she dying from?

If she is septic do we stop antibiotics because she wants to go home to die? I can see withholding life support if the patient wishes but I can't see withholding medical care so the patient can die,

Life is precious, but how do you define life? For me, if I can't ever hug my kids again, and take care of them the way I need to, LET ME GO! For me life is about much more than a heart beating, but that's just my opinion. We really need to respect people's wishes. I've seen patients living wills ignored because of family's wishes and that upsets me as well. However, I try not to judge, because it is such a hard decision. Patients really can suffer terribly because of some of the decisions made. It is not a black and white issue. All we can do is try and advocate for our patient and present a picture of what the future might hold in store for them, given the different choices(such as hospice or aggressive medical care.)

[burn out]

Yes..if it were to come RIGHT NOW. I would assume you are healthy, so you have not truly had to (as of yet) contemplate your own mortality. I will also guess that you have yet to lose both your parents, your siblings, your spouse, most (if not all) of your friends, cousins, aunts/uncles. I will also throw caution to the wind and take a gamble that you do not have a chronic, debilitating illness, are not constantly in pain, have not lost all independence, and most basic functions.

Some people lose their desire to live. THERE IS NOTHING WRONG WITH THIS!! THIS DOES NOT MEAN THEY DON'T LOVE LIFE!! This simply means that they have come to terms with their own mortality and that they have come a point in their life where they are, in fact, AT PEACE with the fact that they are, as we all are, going to die.

Have you not had the honor to witness this?? I hope you do because it is a beautiful thing to hear a person (and I only have experienced this with elderly friends) say that, “Yes, life was hard. It had its up and downs, but more ups… I have had a good life…a good family, husband…I wouldn’t change a thing...I'm ready to go.” To hear someone say these things is breathtaking...I can’t even begin to express the admiration I have for these people and I feel extremely privileged to have heard their thoughts/feelings/insight.

Yes I too have heard these very moving words. I have witnessed beautiful deaths as well as agonizing ones. I have witnessed death of strangers as well as death of loved ones. I have witnessed so much death that I am sick of it. Your patient originally mentioned was not at deaths door-the doctor said she was not terminal. We are not talking about with holding life support we are talking about withholding medical care...are we allowed to withold care that will cause death to occur..such as stop giving blood pressure meds or heart medications just becasue someone doesn't want to live anymore? Isn't this like Kvorkian (sp?)? Last I heard he was in jail.

[withasmilelpn]

Kevorkian (sp?) actually administered medications to cause death. Choosing not to have treatment is totally different. I have a patient who decided not to undergo surgery for osteomyelitis. (She had a stroke following hip replacement, pretty debilitated physically, but not mentally.) She refused IV meds or surgery and went on hospice on po antibiotics, even though the surgeons opinion was that it would kill her. That was 2 years ago! You just never know, do you? I think the most important thing is her wishes were honored. I was always taught that the patient has the right to refuse. Blood pressure pills, etc. Hard to accept, true, but nothing about nursing is easy!