You are doing gods work... semi rant, wondering what its like for the rest of you - page 2

So I was out the other night with my girlfreind who is charge nurse at boston medical center on a surgical floor. I work in an icu, I have been here for almost 2 years. Discussion comes up about work and someone listens in on... Read More

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    If you and your family want everything done for yourself, and you've got the insurance to pay for it, then why shouldn't you? There are so many things going on in the ICU that you could argue whether they are being done for the right reasons or not, but that's not what you're getting paid for. When the time comes for you or someone in your family to be put in that position, then you'll have you chance to 'do things right' in your view.

    Oh! The stories I could tell!

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    Quote from Biffbradford
    If you and your family want everything done for yourself,
    *** That situation never causes me a moral or ethical delimma, it is also rare in my experience. If my patient wants everything done I am happy to do it and will advocate for their wishes. The situation that really bothers me, and is far more common in my experience is when assumtions are made about the care of a person who can not make their wishes known, or even worse when the patient's wishes are known but their family overides the patient's wishes as soon as the patient can no longer communicate their wishes (like when intubated).
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    Quote from montinurse
    I remember one shift I prayed the entire time that my frail, 80lb alert oriented lady would not code so I didn't have to break her ribs. Chronic COPD, failure to thrive, chronic issues, etc and only 60-70 years old... I could see every single bone and tendon in her body. I double checked with her that day that she wanted FULL CODE-YUP, that's what she wanted!

    Oh gosh, this is me! This happens all the time, most commonly when patient's family's can't let go --- I pray my whole shift that my frail, 80 or 90 year old won't code so I don't have to break her ribs!
    DeLanaHarvickWannabe likes this.
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    I appreciate this thread. I've been bothered by all of this in my short career so far. A lot of the things y'all are discussing has effected me very deeply. I guess it's cathartic to read everyone's thoughts.
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    This is a good conversation to have. As it rolls along, might need to be a "sticky" Miranda.

    I finished a great book recently called "No Good Deed" by Lewis M. Cohen, M.D.

    It is about two nurses who are accused of murdering a patient because of withholding life supporting measures that were in accordance with the patient's wishes.

    The author looks at the entire debate in America about end-of-life issues. He does it in a fair way, telling all sides of the story including the CNA who accuses the nurses of murder.

    One of my favorite doctors, Ira Byock, states in the Forward "No Good Deed" shines a much-needed light on the cultural chasm that divides Americans on subjects of ethics, dying, and intensive care. Lewis Cohen has issued a wake-up call to society to openly discuss how we care for people at the end of life. We avoid this call at our peril."

    The only issue I would quibble with him about is he links the people who don't believe in removing feeding tubes from disabled people who are not terminally ill with those who think we should code that frail 80 pound woman mentioned in this thread.

    But the book is overall very fair and well researched and a "page turner".
    rn/writer likes this.

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