Tonight I had a patient who I admitted last week for change in mental status. Unfortunately, this patient had been declining steadily since admitted. The family was unsure of what to do, so Full code remained. Today I have this patient again (4th time I have personally cared for this woman). The woman is making the horrible gurgling sound (everyone knows what I mean). I call respiratory therapy and we implement the order for deep suction. I call the doctor on call to "please just take a look it would make me feel better". The pt vital signs were stable, slight fever corrected with tylenol, and bp was normal in range. 02 is within normal limits but I just didn't like how she looked and sounded. The poor daughter has been at her mother's bedside for this whole week, watching her mother decline. She didn't want to make the wrong decision by placing the pt on a DNR. So tonight I get the doctor on call involved we continue the original plan (suction, HOB up, Lasix which she received 160 of and not putting out nearly enough fluid). I give the pm medications. The daughter (thankfully) was in the room came out and said "I think she's gone".
Enter in flustered and frantic here. While initiating the code blue, the daughter decides to make this pt a DNR. Some parts of me feel responsible for this woman. I know I called the doctor, respiratory, and did my best to not let her drown in her own secretions. I know she was elderly with multiple organ failure. I know she wasn't going to get any better. Everyday I would think how this poor woman should just be left alone. It's easy to judge the family and their decisions, but I am not the one who will have to live with that decision the rest of my life. The daughter had very little support from other family members. She was receiving conflicting information from different doctors. She was lost, and for that I feel sad for her that we as her mother's caregivers couldn't help her make the decision.
This was my first patient who died. I am relieved the woman was able to pass on peacefully, and that her daughter was with her, and saw that she was at peace. I am thankful the daughter told us to stop before starting the compressions and making this poor little frail lady suffer further. I am thankful she passed with dignity. I have been a nurse for over a year and just experienced my first ever patient death, and it really sucks
Thanks for listening!