The pt who is going to die no matter what you do

[RNAnna]

So, I've just gotten off of work. What a difficult shift. It's not that there were that many pts. It's the one that you know that no matter what you do for them, they are going to die. Some times I just wish they would go. It really would be a blessing.

This woman has a peg tube and an ileostomy. She's been on tube feedings for the past two years and she doesn't get around or communicate well. She has MERSA. So add the issolation to all of it. Today she has audible rhonci and there is nothing coming out of the ileostomy. there is a lot of residual from the peg tube, so you know that nothing is being absorbed. Just open up the peg, get a graduated container, and it just runs right out. at first it was just this yellow green. 200 ccs. then 140. Then at the end of the shift it was 200ccs of brownish red liquid with frank blood. The feedings have been held because her abdomen is distended and rigid and nothing is going in. So what can you do when you notify the Dr. and they say that there is really nothing more to do for her?

With all the suctioning, the Roxinol, the VS, the checking residual, the gowning up for issolation, and everything else, I feel like I should be able to do something for her to at least make her feel better. It really is very stressfull and distressful. I've only been at this for 4 months now and I've seen a few that haven't made it, but there are the ones that hang on and hang on. In the report room they call it "circleing the drain". Then we come home and there is no one that we can talk to about it (especially in a small rural town where everyone knows everyone else).

How do all of you maintain your sanity in the face of the "waiting game". How do you cope in the face of the one pt you know is going to die. I always feel like it's wrong to say that I hope that she has died before my next shift, but is it?

Anna

[barefootlady, ADN, RN]

Good morning Anna,

I read your post and I know you are feeling stressed by this situation. I hope you take a few minutes to deep breathe and allow the weight of this situation to melt away as much as possible before attempting to drive home or going into your home and interacting with your family. You are being very astute in not talking about this patient to anyone, expecially if you are from a small town. Please do speak with the facility chaplain, your own minister, or another trained professional to get assistance with this stress.

You will find out the longer you are in nursing we don't know why some suffer so and others go quickly. I do know God has a plan in all that happens. I will pray for you and I hope your next shift is not so stressful. Do not feel guilty because you feel this patients death would be a release from pain and suffering. All of us have feelings like this when we are taking care of a patient like the one you described.

[stidget99]

"""How do all of you maintain your sanity in the face of the "waiting game". How do you cope in the face of the one pt you know is going to die. I always feel like it's wrong to say that I hope that she has died before my next shift, but is it?"""

First of all, it is my opinion that it is not wrong to wish death upon someone, to wish them out of their misery, to let their family out of their misery.

And what I do when I have a rough shift? I do what you just did. Post on here. Vent openly. You are venting to thousands who totally understand where you are coming from because we've all been there.

[Chad_KY_SRNA]

Some patients are just there to die and there is not much we can do for them. Make them comfortable and wait. It makes me feel so useless, I would almost rather have a sudden full code than have someone slowly passing away because I feel that I have been able to do something to help them. If we held all of our feelings in we would have a breakdown in a few days. I like to take a long walk, go shopping, or have lunch with a good friend or a loving relative after a sucky shift.

[RNAnna]

Thanks all that responded. Ironically when I came online to allnurses, there was an ad up in the right hand corner than said "Will Today Be the Day?". I had to go in for a mandatory shift meeting today and she's still hanging in there.

Anna