Hello all. I'm a relatively new RN and currently work in the NICU, so I don't know that much about end of life care. 3 weeks ago my very active, cognitively intact grandmother had a stroke. When I say active, I mean paddling a paddle boat daily, taking long walks with her dog every day, so this was very unexpected.
To make a long story short: She actually was in the hospital for some dehydration issues and the doctor said they were going to rehydrate and probably send her home. The next morning however, as the doctor was about to discharge her, my aunt came to visit her and she was having obvious stroke symptoms (left side face droop, speech garbled, and couldn't raise left arm). Each day for 4 days it progressively got worse, failed the swallow study and the family had to decide to do a gtube or not. She was having a lot of pain all of the sudden and the doctor put her on a morphine and ativan gtt, she never woke back up after that. She was made hospice, for as the doctor said she would not come back from this and my family knew she wouldn't have wanted to live like this with a feeding tube and whatnot.
My question is about hospice care. When my grandma was made hospice, she was in an ICU. We wanted home hospice the nurses said that she would require a procedure to put a PICC line in and they didn't think she was stable enough survive the procedure, so we were unable to take her home since she only had peripheral access. We asked to be moved to a hospice/oncology floor, but no beds were available. So we stayed on the ICU floor for the next 2 days. On the ICU floor, my grandmother wasn't turned for 2 days, no vitals taken, no assessments, didn't even scan her bladder (she did not have a foley in---why????)
Almost two hours before my grandmother passed away, I asked if the nurse would take her vitals and scan her bladder just to have an idea of where she was. She had 820 mls!!!!
The nurse couldn't believe it, i couldn't believe it and i was so upset. I had to travel far in order to get home, and I only got to spend the last 8 hrs or so with her and i couldn't believe she wasn't being made as comfortable as possible. The only time we saw the nurse was when she would pop her head in and say "does anyone need anything?" Is this the normal practice for hospice care in the ICU, does all patient care stop? Are you kept on 4.5L of oxygen, because that is what she was kept on, i thought anything about 2L was therapeutic. I honestly don't have much experience with this but am just looking for some other perspective. I wasn't aware that when you go hospice in the hospital (ICU especially) that even your basic nursing care ended. The whole experience was emotionally draining and horrible enough, but it left such a bad taste in mouth for "hospice" care. This was not the wonderful experience I had always heard about hospice, maybe the problem was we didn't have a hospice nurse taking care of her. Everytime my family would ask something about the dying process, we would get the response "well i'm not sure, we aren't hospice nurses".
Sorry so long, just venting and looking for some insight and understanding. Thank you to all you hospice nurses that are wonderful and truly are angels to your patients and their families.
Your job is so important to the family and I wish my grandmother could have recieved great hospice care like she deserved. Thanks.