This past week was a difficult one for my brother. After caring for a lady with cerebral palsy for 14 years(She lived in), she died. It started on the 21st when he brought her into the ER due to stomach pain. After doing a scan, it was determined that she had terminal cancer and had to have surgery to assess/remove the tumors.
Before the surgery, two surgeons sat down with my brother(who had POA). One doctor was fine, explained the procedure and was very compassionate. The conversation with the other doctor and my brother went like this:
Brother: I want everything to be done for her.
Doctor: You have to think about her quality of life (He was referring to the fact that she had CP and that if she survived the surgery, her life would not be that great anyway)
My brother took offense to this as he felt that her CP should not matter and that the best care should be offered.
The same doctor also raised his voice to my brother when my brother requested that CPR be done if needed, telling my brother that her ribs would most likely be broken and "did he really want that to be done to her?"
Anyway, she made it through the emergency surgery. The doctors and nurses began to pressure my brother, telling him to call hospice as she was terminal. This was on the 22nd, a Sunday, He said that he would call but that he wanted to see an oncologist about her prognosis first. He knew that she was terminal but just wanted these questions answered. He also wanted her to have pain relief but not so much that she could not communicate.
On Monday the 23rd, the breathing tube was removed( her liviing will stated that she did not want life support). By this time, one nurse in particular was acting in a very odd way. Two examples a) A doctor noticed that the lady's oxygen had been removed and the nurse told the doctor that my brother requested that it be removed. He did not. and b) When they transferred the lady to another room, the nurse grabbed the wheelchair away from my brother and said, "I will push the wheelchair and you can be the candleholder". Now, I am not a nurse yet and maybe that is nurse-ese for something, but that comment just sounds off.
By Wednesday the 25th, she was still hanging on. My brother had still not seen the oncologist. Doesn't this seem weird? She has all of these major tumors but an oncologist could not swing by? So my brother stays with her and comforts her. He has still not called hospice. At 4pm, the social worker from the ICU floor rudely hands my brother a piece of paper with the name and number of a local funeral home on it, shakes her head and says in a snotty tone,"I am leaving. Call this number if you have issues. It's too bad you could not have called hospice" . My brother's friend died about four hours later.
I feel that the the first doctor, the nurse and the social worker acted inappropriately. Can I please get some insight from all of you? Were these people acting normal in their world?
Nov 29, '09
by TheCommuter, BSN, RN Senior Moderator
I'm so very sorry that your brother was not treated with the utmost compassion during a very vulnerable time in his life. The healthcare providers with whom he dealt seemed to be brusque and cold, and really should have communicated in a more professional manner. I extend my condolences to your brother for the loss of his friend.
However, I can see the possible points of view of the staff members clearly. Your brother's friend had a terminal prognosis, yet she was subjected to futile treatments, extreme discomfort, and physically brutal rescuscitation efforts during her final days on earth when these measures would not have changed the course of her disease process. I suspect that the healthcare providers were becoming personally frustrated at being directed to do everything possible to save a person who could not realistically be saved due to the diagnosis of terminal CA.
I'm certainly not defending anyone's behavior. I am simply listing some possible reasons that underlie the callous behaviors of members of the healthcare team.
Last edit by TheCommuter on Nov 29, '09
: Reason: added something