Taking a child off life support - page 5
What do you think? This 14 year old boy accidently shot himself in the neck. The local news is reporting that the hospital is trying to take the patient off life support without parents approval. ... Read More
0May 20, '06 by NotReady4PrimeTime, RN Senior ModeratorQuote from Mermaid4Brain death isn't an event, it's a process. It's possible that in the first hours after his injury that he had enough cognitive or reflex function left to do the things family members said he did. But as the brain swells and displaces itself those functions fail. Once the brain is irreversibly damaged to the point that brain death is being assessed, other functions have failed as well, such as respiratory drive, temperature regulation, fluid and electrolyte regulation, hemodynamic regulation and so on. The heart will beat indefinitely as long as there is ventilation. I've cared for many severely brain injured children; of those who survived some of them have recovered almost completely but most of them are left with a quality of life I would not wish on my worst enemy. It's very hard to care for these kids, knowing what their outcome will be, but it isn't really the caring for the child that's hard, it's the caring for the ones left behind. In these situations I talk myself hoarse explaining everything to families so they understand what has happened to the child and what will happen next. Years ago, I was unfortunately given the task of explaining brain death to my daughter (then 15 years old) and her friends when one of her close buddies wrapped his car around a pole. They had all been in to see Chris in the ICU and couldn't understand how he could be dead when he looked so alive. They needed to be sure that there was no mistake and that Chris's organs weren't being given away prematurely. That experience gave me the opportunity to practice what I say to others now and although I regret every day that Chris died, I admire his parents for their strength and compassion.This is so sad but I am wondering if the child is brain dead, how he can be squeezing moms hand, etc.
As for this case, I feel great sympathy for the mom, but I also feel empathy for the hospital staff who cared for Mike while he was in their unit. It's unlikely that Mike's mom would ever have considered organ donation, and the prolonged period between determination of brain death and the eventual withdrawal of ventilation likely rendered them too damaged to be transplanted. A tragedy on many levels.
1May 20, '06 by LilPeanutWe see futile care frequently in the NICUs, sadly. We have a baby right now whose apgars were 0/0/0. We have another one who is in septic shock and was in status epilepticus for 1-2 hours and is on a 3.5 epi drip. Prolonging their suffering is not helping the patient.
0May 20, '06 by imenid37I hope it is resolved quickly and the child doesn't have to be maintained on life support for months or longer. It makes me ill to think that "pro-lifeers" are protesting thie hospital. The poor child is dead. There is nothing more that can be done for him in this life. It is terrible for mom. I wholeheartedly agree. It is also awful for the staff and awful that resources and staff are being utilized to give futile care and take away from other patients. I think it is unethical to keep a person "alive" on life support like this.
0May 20, '06 by NotReady4PrimeTime, RN Senior ModeratorMike Todd was taken off the ventilator yesterday afternoon (May 19) and would have experienced cardiac arrest within minutes. His body has now joined his soul and the rest of the players are left to pick up the pieces.
0May 25, '06 by MarySunshineQuote from fergus51I get that and agree with your stance on not continuing treatment when it's futile. I just still consider it suffering to treat any person like that whether they are brain dead or not. I've said it before at work and it sounds terrible, but sometimes I feel like I'm being paid to torture and desecrate a corpse in the name of respecting their parents' wishes. And I do it... but knowing they are not alive in any meaningful sense doesn't change the fact that a baby is in front of me and he or she is still a baby. It's hard for me to justify doing unpleasant procedures on them.
I understand EXACTLY what you are saying.
0May 25, '06 by MarySunshineQuote from ForensicRN99Having lived through this, I can honestly say there is nothing harder than a mother saying good bye to a child, and even though we are nurses and sometimes build up a wall in order not to get emotionally involved with our patients we have to validate the mother's feelings and not worry about who will be paying the bill, I think that is the most insensitive remark I have ever read. I had lost a child, and to this day 21 years later, I can still remember the feeling of lost and emptiness I felt, and thank God for the good nurses who had cared for him during the three days of his life, and am glad that the nurses weren't worried about who will be paying for the bill. I am sorry if I am coming off strong, but children hold a special place in my heart:angel2:
Nurses aren't concerned, in a selfish sense, about who would be footing the bill. I cannot image any nurse giving different care to a patient because of the billing arragements. That would NEVER happen! It's exactly what another poster stated -- finite resources. Is it morally acceptable to keep a brain dead person on a vent when a LIVING person is in the ER needing an ICU bed? Probably not.
I've lost children, too. I'm so sorry for your loss. Mine was 5 years ago, and I have no doubt that I will always feel the same as you do about the feeling of the loss.
0May 25, '06 by buddiageGood posts.
The real question, is it ethical and moral to provide futile care regardless of the amount of resources a hospital has?
In other words, if every bed was empty, would it then be okay somehow to keep the body of a dead child (or adult for that matter) alive? No.
Yes, you could bring up resources, paying the bill, amount of staff, etc... But that ultimately doesn't have anything to do with the first question.
NO, it is not okay to prolong a complete death, period. I look at that as when "one door closes and another opens" kind of thing.
0Jun 1, '06 by carolinapoohQuote from Nurse 1979God help me - I mean you no harm, and I feel privileged that you shared your horrible experience with us. But if someone is brain dead, I think God already has him or her. The person - even if someone has no religious background at all and doesn't believe in a soul - the person and the personality are gone forever. The person isn't coming back; they're already gone, medically and I'd dare say spiritually as well. I think when we removed life support from my dad and let him go peacefully, we truly allowed God to take him. But if he had been brain dead, then God would have already intervened, no matter how badly we might have wanted to believe otherwise.Let me talk to you viewing this issue through the eyes of a mom who has been there. I lost my oldest son following a ATV accident not quite three years ago. He died in my arms on a country road not far from our home. I realized that nothing could be done for him, spoke to him and comforted him as he passed on. I am sure he was nearly gone by the time I got there, but...... My point is this-- it is so easy to say that we should not "waste" resources or that it is foolish to try to keep the child alive just because the parents want us to. Yet, please put yourself into their place. I know of no parent who would want to change places with them. I personally could not have imagined the pain that a parent goes through. In time, most folks would be able to assimilate the trauma of the situation and would come to the appropriate decision-- to let God have their child. But, you must let them get through the process. It is the most difficult thing you would ever have to endure. We waste many resources in healthcare -- take a look around you. Let's not forget the humanity of our profession.
I grieve for this woman and CANNOT imagine how she must feel. I also know how easy it is to be sideline coaches and quarterbacks...
I think God took your son while you were there. I'm so glad you were there for that; I have no doubt how hard it was but I'm glad you were there. God bless you and your family, and above all your son.
0Jun 1, '06 by carolinapoohQuote from imenid37Disgusting. The "pro-lifers", I mean. Completely disgusting.I hope it is resolved quickly and the child doesn't have to be maintained on life support for months or longer. It makes me ill to think that "pro-lifeers" are protesting thie hospital. The poor child is dead. There is nothing more that can be done for him in this life. It is terrible for mom. I wholeheartedly agree. It is also awful for the staff and awful that resources and staff are being utilized to give futile care and take away from other patients. I think it is unethical to keep a person "alive" on life support like this.
I take it from another post that he was taken off support. I know he's in Heaven and I hope his mom can find some comfort in that. :redpinkhe :angel2:
0Jun 1, '06 by sjt9721
0Jun 1, '06 by supermoQuote from sjt9721People like her make me want forced sterilization...
okay, not really, but geez. You should have to have a license or something before they let you have babies......
0Jun 1, '06 by NotReady4PrimeTime, RN Senior ModeratorThe link worked. Yet another sad story with a child at the centre. Has there been any further developments in this case?
0Jun 1, '06 by ZASHAGALKA"I have concerns that Dixie may not be able to care for Daniel to maintain his multiple medical needs," wrote Sally Adams, a pediatric nurse practitioner at the hospital's low birth weight clinic. "I consider Daniel to [be] high risk for his multiple medical problems regardless of his home and social situation or his mother's problems."
Wow, excellent charting, there.