I'm a new grad LPN working in a LTC facility. I've only been there a couple of months. I had fifteen days of preceptorship and am now on my own. I only work every other weekend for now. I have so many questions constantly d/t the fact that I'm a new grad and also have never worked as an aide. Sometimes when I ask a question I get the 'deer in the headlights' look from the nurse. The nurses have been wonderful but sometimes I think the veteran nurses forget what it's like being fresh out of school. Here's a question I'm so hesitant to ask, I guess b/c I think they'll think I'm a complete idiot... but here goes.
How do you know when your pt. is dying?
I went in last weekend and one of my residents had all her PO meds D/C'd. (a lot can happen in two weeks) I was reading her chart and I guess she had started declining.... all the chart said, so I'm not sure what all was going on. So basically she refused her meds for two days and they D/C'd them and now she stays in bed and is on SL Roxanol q4h. She looked good and vitals were good when I was in last weekend. She did eat some mashed potatoes at lunch and some liquid, but for the most part has stopped eating and drinking. So of course family had been notified prior that she was dying and she's had lots of relatives in visiting. How would I know she was dying?
About a month ago my preceptor was called into the dining room and one of our res. was sitting in her W/C unresponsive (staring straight ahead) with a brown foam coming from the corner of her mouth. We got her to her room got her on O2 and the pulse Ox machine and Dynamap. Got an order for Roxanol. Her pupils were sluggish. Called all the family to say they'd better come in coz she was dying. At least she didn't suffer long, she died later that evening. I feel so stupid, but how did they know she was dying?? People have strokes all the time, even severe ones and they survive. Anyway, thank you all so much in advance for sharing your knowledge with this newbie.
I use this as the only way I truly know someone is on their way to dying without the use of tele etc. Once you start seeing a patient in Cheyne Stokes breathing that was always a clear sign to me that someone was dying.
I have seen many instances of patient's who have had respiratory or cardiac arrest with proper treatment go on to live. Just as you have seen with strokes and such. So that darn breathing is what always sticks in my mind.
I am sure others probably have many more signs they use.
Last edit by lpnflorida on Apr 3, '09