Libitina 4,366 Views
Joined Dec 21, '07.
Posts: 149 (30% Liked)
Haven't seen snow in 15 years, sucks to live in Hawaii.
Yep, lived in the Chicago area all my life, and this has been pretty much every employer's response to a big snow.
Fortunately, I now live 10 minutes from work, and since all my patients are at one facility, I know they're reasonably safe if for some reason I can't make it in.
All the hospitals I ever worked at always opened some kind of "emergency center" for snow storms and staff that is expected to work in am can come in before and stay overnight or stay after the shift and stay overnight. They usually set up something and all I had to do was call the supervisor or number and make a reservation. Sometimes you share a room and have a patient bed, sometimes it is some kind of pull out thing, one time I slept on a stretcher. I also worked for other employers like acute dialysis and they would just book hotel rooms close to the place of work and pay for it.
Having said that - when my children were little I did not always stay overnight after a shift when I thought it was ok to drive but I am also an experienced winter driver. My advice is to check with your employer in terms of accommodations. In addition it is good to have certain things in your car in case you hit unexpected winter weather, need to pull over in winter or what not. I have a large box with lid for my trunk that contains stuff like emergency food, hat,gloves, extra socks, and so on. I usually toss a sleeping bag in the car because I like that better as opposed to blankets and some water when I go. In addition I make sure I have a full gas tank and, some sand or melt, some mats I can use in case I get stuck with the car, a small shovel and large broom.
I always drive carefully, plan for extra travel time. There were times I had to pull over because there was sudden icing and I had to wait for a sander to drive through. One time I had to wait on the side of the road for something like 3 hours - that is when you are glad you have a sleeping bag ....
I "caught" a nurse in that same lie when my husband's grandfather was dying. My husband, brother- in- law and I were the last to arrive. No resps, monitor in asystole. The nurse had told my father in law that he was " just barely hanging on". She panicked a little when another family member told her I was an ER nurse and my BIL was a paramedic. We kept her secret. To this day my FIL believes that we made it " just in time". I know believing that gives him peace.
such a touching and compassionate story.....you did exactly what the family needed to help them heal!! You are an excellent nurse!!!
Dictionary.com defines a lie as "a false statement with deliberate intent to deceive". You didn't lie my friend, you gave a dying patient's husband and her family a chance to say goodbye. They deserved that and you alone gave them that chance. This speaks volumes to your character and your abilities as a nurse. Even in her last moments, you took care of your patient by taking care of her family.
Having personally worked in an emergency department and in other acute-care settings caring for patients who are actively dying (and their families), I can understand where you are coming from and would have made the same decision, without question. Please don't see this as a burden that you must bare by yourself or a sin for which you must seek absolution. I would be honored to work beside you and sincerely hope that if a member of my family was in the same situation a nurse like you would be caring for them.
You were brave. Don't feel bad for what you did. You gave a family peace.
OP - I understand you. Be gentle to yourself - you deserve it.
Oh my gosh, that brought me to tears. It is a heavy burden we often carry, to keep calm in the face of other's pain, however what you did for that family was something so special. I can only hope to be as strong and brave as you if faced with a similar situation. I know that you brought this family immeasurable comfort, and I hope that you may hold onto that instead of feeling as if you lied. <hugs>
I got the call on the EMS radio around 5 am. This is the usual time we get calls from EMS responding to nursing homes- The nurses are rounding on their patients to give am meds, and they find their residents dead or in distress. An 87 yo female, febrile, and in severe respiratory distress coming in. Pt is a DNR, but family is very involved, is aware, and will meet them in the ER.
I'm alerted that family is in the waiting room before the patient even gets there. I go out and introduce myself, tell them I will be her nurse, and that I will bring them back as soon as I get her settled in the room.
EMS arrives, and carefully transfers their frail burden onto one of my stretchers. You can see the relief on their faces, that they got her here and are able to hand her off before she dies on their watch. I'm now the proud owner of one very ill person. Temp 102+, Respiratory rate 14 and irregular. HR 50's, sat 84% on NRB, I don't need my Littmann to hear the rhonchi- Other hx is advanced dementia, DM, CHF. Has been in the nursing home for about 6 months- her husband had taken care of her at home as long as he could, but it finally got too much for him to manage, as he was also dealing with his own health problems at the age of 92.
I got her settled, and the Doc comes in- I give him the pertinent info- Not a whole lot we can do at this point other than make her comfortable and treat the infection. Chances are poor that she will make it, and we both know it. Doc moves on to deal with people he can help, leaving me in control of this mess.
I bring her visitors in, including her only daughter in her 60's, and several close friends of the family. I get them settled in and TRY explain to them what is going on. They don't get how bad off she is- I try to explain it to them in soft terms- They share with me who she is- a wife, a mother, a friend.I learn her husband is frail and elderly. I strongly suggest that if he is able, that he come. The daughter tells me she is going to leave to go get Dad. I explain that mom could go at any moment, each gasp she takes could be her last. I don't want them to have to deal with the idea that she died without ANY of her family around. But I REALLY wanted her husband there. The daughter calls her husband, who is dispatched to go get him dressed and here.
In this age of technology, we can keep up with a lot of things. I'm updated that son in law is at dad's house, he's getting him dressed, getting him loaded in the car with the wheel chair. I'm watching my patient brady down, 50's, 40's 30's.......The monitor is alarming, and my pt.'s daughter sees it. Husband lands in the parking lot, and the son in law is getting him loaded in his wheelchair.
Then she died, no resps, asystole on the monitor. The daughter asks me- "Is she gone?"
"Not yet" I told her her- I gave her some silly answer- the monitor isn't picking up anything because she is so sick. I mute the alarms, turning the monitor away so she can't see the flat line.. I send 2 of my male coworkers to go out and GRAB the husband, RUN him in.
He arrives, looking a bit baffled at the whirlwind of men running out to snatch him out of his van and deliver him to trauma room 3.
I kneel down and introduce myself. I told him. "I'm sorry, but your girl is dying." He looks at me without comprehension. I took his hand, and joined it with his dead wife's. I told him "Your wife is dying right now- tell her you are here, tell her you love her- these are the last things you will be able to tell her...........Tell her it's OK to go-"
He grasped her hand and brought it to his temple. "I love you baby....it's OK to go, I'm here."
I waited a minute and placed my stethoscope to her chest, made a big deal pronouncing her time of death as just then.
I lied- she died without her husband.......... but that is something they will never know, but I will live with forever. I know I helped the living, but damn, holding this stuff inside hurts. I tried to explain it to my husband when I got home. He didn't get it. This is something I carry inside.
I know my fellow nurses will understand. Thanks for letting me vent and get this out.
A transfer from a psych unit arrived in the ICU after she fell, broke her arm, and was unarousable after orthopaedic surgery. This elderly woman eventually came around, but she had mania-induced psychosis. A cardiologist who was consulted visited her while I was in the room, & she asked the cardiologist if he could see the black cat spying on her in the vent above her. He said, "No ma'am, I don't see a cat anywhere." She said to the cardiologist, "Well, you're obviously stupid."
I could somewhat understand why the daughter did what she did, most of the time it is hard to let go, BUT the saddest part is not respecting your parents wishes.
She knew what she wanted.
She'd watched her husband of 52 years die on a vent, and followed his wishes to remain a full code. But she knew that was not what she wanted for herself.
So, she wrote a Living Will, had it notarized, gave it to her personal physician, told all her friends and family what she did not want. She wasn't eligible for a DNR, as she was a healthy 89-year-old, but she knew what she wanted.
"I do not wish my heart to be restarted through usage of any chemical, mechanical or physical intervention..."
Of her 6 children, one fought against her mother's decision, and it was this child, this one desenting voice, who found her mother collapsed on the kitchen floor.
"I do not want any external device to be used to maintain my respiration if my body is incapable of sustaining it on its own."
The daughter told EMS her mother was a full code, and they intubated her on the floor of her kitchen. Once at the ER, her heart stopped, CPR was performed, and her heart was shocked back into a beat. Under the hands of those trying to follow the daughter's wishes, the woman's ribs cracked and broke.
"I wish to die a peaceful, natural death."
She was then sent to ICU, where her heart tried to stop 3 more times. Each time, the broken ribs jabbed and ripped into the fragile muscle and skin as CPR was performed. Electricity coursed across her body and her frail heart was restarted a 4th time. By this time, the other children were there, but the act had been done, over and over. No DNR was written, and the Living Will fluttered impotently at the front of the chart.
"I do not wish artificial means of nutrition to be used, such as nasogastric tubes or a PEG tube."
Her swallowing ability was lost in the storm in her brain that had left her with no voice, no sight, no movement. A scan showed she still had brain activity; she was aware of what was being done to her. Including the PEG tube sank down into her stomach, and the trach in her throat.
"I wish nature to take its course, with only medication to prevent pain and suffering."
The daughter who wanted the mother to remain a full code also refused to allow narcotics to be given, stating she did not want her mother sedated, since she would "wake up" when the correct medical procedures were performed. Her nurses begged the doctor to write a DNR, and he said, "the family can't get it together, and I'm not getting into the middle of it."
"Allow me the dignity we give to beloved pets. Let me die in peace."
I met her one Tuesday night, and spent that night pouring Jevity into her tube, only to suction it back out. Her legs were cool and mottled, her bowel sounds were non-existant, and her blue eyes stared blindly at a ceiling she could no longer see. The MD refused to terminate feedings, but I held them since there was no digestion taking place. The woman was turned and repositioned every 2 hours, and each time, she moaned and gurgled as her lungs slowly filled with fluid. I whispered my apologies as I did the very things to her she tried so hard to prevent.
Suctioning improved her lung function, but would make her body tremble. Over the next 2 nights, she slowly died, all while the daughter demanded more interventions, and maintained that her mother wanted to be a full code. We had read the Living Will. We knew better.
"Thank you in advance for helping me in the last moments of my life to have a gentle, peaceful passing."
She had another stroke, and went back to the ICU, where she was coded until there was not enough surviving heart tissue to maintain a beat. Finally her heart was broken.
And so was mine.
A couple of orthopedic surgical registrars were smoking out front of the hospital, in clear violation of the no smoking rule. The CEO (who happens to be a small diminuitive femaile) walked past and pointed out that they shouldnt be smoking there.
One of the registrars drew himself up and said "who the hell do you think you are, I'm a surgeon"
The CEO handed him her business card. I wasnt there but I'm told the doctor went a very nasty shade of green...
We had a surgeon who often loudly berated nursing staff.
We started calling a "Code Purple' when that happened. (There was no actual code purple at our facility)
The unit secretary and other available staff would respond with clipboards documenting in real time what was said and done.
Copies were provided to our nurse manager, medical director, and risk management.
Twice it happened in front of a patient. One patient told me the following night that someone from "Customer relations" came to his room and asked about it and apologized for the doctor's behavior.
The yelling, name calling, and insults stopped.
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