The good, the bad, and the ugly - page 3
by R!XTER 6,735 Views | 37 Comments
So much has been going on at work lately, I just wanted to start this thread for us to share one or two lines on each to reflect recent events at work. I'll start: The good: the last two shifts I worked have been so much... Read More
- 0Jan 22, '13 by leslie :-DQuote from TakeTwoAspirinI'm sorry, but there comes a time when the doctor needs to step up, grow a pair, and spell it out to the families real nice and simple! The families need someone to tell them "no" so that they can feel less guilt about not trying everything possible I know, but there really comes a time when we are just torturing these folks.Quote from HouTxwhat a timely thread.Sorry - don't mean to threadjack BUT
PLEASE don't hesitate to involve your ethics committee in cases of 'futile care'. Granted, I work for a faith-based organization and our facility-based committees may be stronger than most, but they never hesitate to get involved when a clinician asks them for help. Group membership includes physicians, so they don't have any qualms about having 'critical conversations' with other docs. Just because a (misguided, deluded, inappropriately motivated, etc.) family wants a treatment/intervention does not mean that the doc has to do it.
As a bedside (ICU) nurse, I have actually refused to participate in an futile resuscitation - thought I was gonna get fired because of my conscientious objection, but didn't. Wasn't my assigned patient, but I knew enough about the situation to make an informed choice. Afterward, the doc (ED, code leader) & dept. manager said they respected my choice - but wished I had told them in advance of my feelings. Note: my refusal did not stop the code because there were plenty of others available to work it.
although this is a personal situation for me, it still pertains to nursing and its ethical standards...or its lack.
the good: my father is officially a dnr.
the bad: he does not know, as his wife is the mpoa and she has not told him.
the ugly: dad wants to fight it all - he is PETRIFIED to die.
he has 1 kidney with approx 10% function, and cannot be consistently dialysized (sp) because his bp plummets.
in the icu, he has had 3 cardiac arrests in 2 wks - rescusitated ea time.
on a vent with a new trach (can't wean him off); new fdg tube; and a zillion lines.
also newly dx'd with liver ca with mets to spine.
just turned 82.
i agree with the dnr.
still, and as a nurse, how can his wishes be dishonored when he remains completely alert and oriented?
his wife agreed to dnr after much pressure from pulmonologist and oncologist.
they both maintain he must not be processing all this info (about his health).
is that their way of suggesting he's incompetent?
thanks for letting me share the g, b, and u.
- 3Jan 22, '13 by CheesePotatoOh my heart. Leslie, I am so sorry to hear of what you, your dad and your family are going through. As one who is in the midst of the ICU/intubation battle with my own dad, I understand the turmoil. It's not much, merely the words of a stranger on the internet, but you have my sympathies and my support. I'm always here to lend an ear and a virtual hug PRN.Kindest regards,~~CP~~
- 0Jan 22, '13 by leslie :-DQuote from CheesePotatoas i am here for you as well, cp.Oh my heart. Leslie, I am so sorry to hear of what you, your dad and your family are going through. As one who is in the midst of the ICU/intubation battle with my own dad, I understand the turmoil. It's not much, merely the words of a stranger on the internet, but you have my sympathies and my support. I'm always here to lend an ear and a virtual hug PRN.Kindest regards,~~CP~~
and thank you, most sincerely. <3
- 0Jan 22, '13 by 1hotnurse08I know I'm a little off topic but here it goes:
The good: I'm getting married next month!
The bad: I failed nursing school this past semester!
The ugly: I'm unemployed at the present, but I'm job hunting!! No luck yet!! When I get hired again, I'll be back with an update!!!
- 0Jan 22, '13 by itsmejuli GuideThe Good: I have a job interview for a newly created position that has never been held by an LPN, its only ever been done by RNs.
The Bad: My current employer doesn't know I'm looking for another job. My employer cannot match the benefits of the prospective employer.
The Ugly: I got assigned 2 more buildings to supervise care in. That means another 90 clients and 20 more aids on top of the load I already have.
- 3Jan 22, '13 by LobotRNThe sooper dooper good: Able to go part time, and now I AM part time
The bad: I'm now legit cheap enough that I cant/won't hire a cleaning service.
The ugly: Now that I'm home a lot more with the family, I can really see how disgusting we can be. Ewwww.
- 2Jan 22, '13 by onyx33usQuote from TakeTwoAspirinI truly agree with you. But there are some families that have issues (hateful, taking sides or just don't agree) among themselves and that affects their decision making on their sick one. there are also some POA that feels they know better than doctors. Also some are scared to let-go. so there are many issues facing healthcare team..... nice point.I'm sorry, but there comes a time when the doctor needs to step up, grow a pair, and spell it out to the families real nice and simple! The families need someone to tell them "no" so that they can feel less guilt about not trying everything possible I know, but there really comes a time when we are just torturing these folks.