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- Mar 20, '12 by beckster_01i have thought about this (op) sometimes while at work and see a real sad case. what trips me out sometimes is how old some of the open heart\cabg patients are. they seem to doing these surgeries on patients in their 80s now.
our surgeons do some amazing things, i just wish they weren't so over-zealous. how about we clearly explain to our patient what the recovery process for this surgery is, and let him make a well informed decision before we break his sternum?
- Mar 20, '12 by VespertinasQuote from GiGi223Okay okay, I became "that person" for a moment over a personal issue. Both my great-grandmother and grandmother died while on PEG feeding and my grandmother had died literally the same week I wrote my post. I got really annoyed with hearing how many people said TO ME at the funeral how a PEG feeding was tortuous and they would never want it done to themselves. Meanwhile they hadn't been in my family's shoes and were basically criticizing our treatment options for OUR loved one as nearly inhumane.LOL! I was thinking the same thing when I read it.
That Guy's quotes around "loved one" sounds biting/sarcastic/judgmental. Of course the people making decisions for the patient love the person they're caring for, that shouldn't be what's questioned here. The question is whether those people are informed about the appropriate indications for certain interventions and the likelihood of a good outcome after implementing it. Someone who is failure to thrive... evidence says not helpful. Someone who is advanced dementia... evidence advises against. Someone with a neurological deficit who is undergoing rehab... sure! It's even okay in ICU because hey... we are are working toward an end-goal of getting this pt out of the ICU, right? It maybe LOOKS bad if they're on all kinds of equipment and what-not but if you don't believe that many of those patients will make a recovery then what are you doing in ICU in the first place?
- Mar 20, '12 by VespertinasQuote from beckster_01Oh no! They have CoreValve option now for patients like him! It's still investigational but basically instead of open-heart surgery, it's a percutaneous transcatheter femoral artery approach where an expandable bioprosthetic valve implants itself in place of the old AV.I was actually going to post about the 92 year old I am caring for that had an AVR. There is nothing more heart breaking than a fully A&O little old man who looks at you in the eye and says "this isn't worth it, I shouldn't have had this surgery."
Our surgeons do some amazing things, I just wish they weren't so over-zealous. How about we clearly explain to our patient what the recovery process for this surgery is, and let him make a well informed decision before we break his sternum?
- Mar 20, '12 by redhead_NURSE98!Quote from Esme12All of that should be up to you though, and people should be expressing these feelings via advanced directives. The problem lies in the fact that not enough people have these things spelled out for them until it's too late! And it leaves people's children to make these decisions for them and usually make poor decisions due to guilt, selfishness, or erring on the side of caution ("what if mom would have wanted to live at all costs, and I choose wrong?")I deserve to be treated fairly. I desreve to be around for my family. I deserve to contribute to life anyway I can.
- Mar 21, '12 by beckster_01Quote from VespertinasThey are just starting that procedure this June in my area. From what I understand it is still in trial, and will only be done on those that are still ineligible for a normal valve replacement. I know we sent a placement to Cleveland clinic for it last year, but this man is quite healthy fir his age, and I don't think he would me all the criteria despite being 92.Oh no! They have CoreValve option now for patients like him! It's still investigational but basically instead of open-heart surgery, it's a percutaneous transcatheter femoral artery approach where an expandable bioprosthetic valve implants itself in place of the old AV.
- Mar 21, '12 by BostonTerrierLoverRNI have the worst fear of being in the Nursing Home with a dirty, sticky, and itchy butt, . . .in a catatonic state.
- Mar 22, '12 by twinkletoes53My aunt is 84 years old, and scheduled for an AVR in a month. Up until about 3 months ago, she still worked 4 hours a day twice a week at the office she'd been with for 34 years.
I am very ambivalent about this surgery. I do not want her short of breath, like she is now. I also don't want her to be in the pain that I know she will have after this surgery. She is so frightened. I love her with all my heart. She raised my brother and I for 6 years after our mother died suddenly @ the age of 28. So she is the only mother I have known.
Are there nurses who have cared for a patient in her 80s who survived this surgery with a good outcome? I am too close to her to be objective about this.
- Mar 23, '12 by beckster_01^ Absolutely. We have plenty of people in their 80's who have valve replacements. They won't bounce back like someone in their 60's, but they can still do well, especially if they are active at baseline (a stubborn personality and supportive family always helps). However, when someone hits 92 you wonder how many years that valve will really give them, and if it is worth the risks of open heart surgery.
- Mar 24, '12 by R!XTERQuote from DookieMeisterRNI think you misunderstood my views and choices for what I would want for myself as being projected onto others. This is not the case at ALL! I fully respect other people's decisions and I care for all of my patients equally, regarless of their personal choices, with care and compassion. I was merely commenting on my feelings for myself, if g-d forbid I were ever in a situation such as the ones I mentioned. When I care for people like that, I cannot imagine every living that way. I have endless respect for people who have illnesses such as MS, cancer, etc and fight with every fiber of their being, however I don't think I could be that strong, and I hope to never be put in the situation where I have to find out...In response to the OP,
I understand you are venting, I really do but I find this really disturbing for some reason I can't exactly put my finger on.
AHA, I got it!
I am going to get a lot of flack for this but you know what? I DON'T CARE because it's MY opinion. This post reeks of judgement, a gross lack of compassion/respect for other human beings.
I'm so sick of people judging others and their decisions without ever walking a mile in their shoes.
I apologize if you took my personal opinions for judgement... (I actually find your statement "This post reeks of judgement, a gross lack of compassion/respect for other human beings" to be extremely judgemental, and hurtful, while accusing me of being the same way....ironic.)
- Mar 24, '12 by Ruby VeeQuote from r!xterimho, no one here "hates" on fat people, (and this is totally off topic of the op), however, regarding bariatric patients, i find them particularly difficult to deal with because very often the majority of their comorbidities come from being overweight, i.e. diabetes, chf, hypertension, etc, and they come to us needing total care as they are largely helpless (can't walk, can't wipe their own behinds). i can't help feeling that if a lot of these people had not let themselves get to the point of morbid obesity, they would not have the majority of the issues they are facing, and i would not be injuring my back trying to care for them.i'd like to see an go 30 days without a post/thread hating on fat people/fat nurses.
2 weeks ago i had a ~400lb patient come in for *shocker* shortness of breath/chf exacerbation. when the dr. said she would need a dose of nitro the patient said "oh i don't want that! that's the s*** that gives me a headache." to which i responded "well, that's the s*** that's gonna make you breathe." now, understand that i am always very kind to my patients, and i never curse, but i had had it. she had given herself every health problem in the book by being obese, and then comes to us expecting us to fix her, and has the nerve to make that comment. additionally, there is no way she can hold down a job in her condition, as she can barely even talk, never mind breathe, so it is also us who are *paying* for the honor of treating her highness. this bugs me to no end.
yes, i know that often obesity comes from other things, psych issues, etc. and i am fully expecting the onslaught of comments telling me i'm a horrible person for thinking this way.[/quote]
for someone who claims that no one here "hates" on fat people, this post sure hates on fat people.