The Patient I Failed - page 13
by nerdtonurse? 374,188 Views | 321 Comments
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... Read More
- 1Oct 2, '08 by interleukinIt may vary from state to state, but in our state, you have to have a "terminal within 6 months" diagnosis (just like hospice) before the doc will write a standing DNR.
Wow, is that true? In which State do you live?
But in this case, the patient was clearly "terminal" and yet the DNR was, essentially, worthless. The term "terminal" can be defined and perverted in a thousand ways.
- 1Oct 2, '08 by CandiceA:heartbeat Thanks for sharing your heart with us. I was also moved to tears...
I wonder if the daughter was really being selfish or was she holding out for a miracle that she thought could come. Please don't get me wrong, this was tragic and the patient's living will should have been honored. It's just that sometimes we forget that folks outside of nursing/medicine don't understand the progression of events that lead to end of life. We've seen it so many times that we can almost predict it. But they can't because they don't have that experience. And, truthfully, IMHO medical advancement has contributed to blurring the lines. A trach/vent sometimes works and sometimes it's the top of a long, horrible slippery slope. Many times patients are thought to be beyond hope and they somehow defy the odds. So is it selfishness or is it hope, however unrealistic, that is fueled by faith, media, and even doctors who won't admit to families they can't save everyone?
I have no answers...only questions. I do know this, you should have no guilt and I hope that your spirit is lifted by all of the supportive posts and hugs you have received. All the best to you. - Candice
- 1Oct 2, '08 by rustyshacklefordwell done on writing a very eloquent and poetic piece of your nursing career. wishes of patients often seem to be ignored, forgotten or just lost along the way, eh? i dont know if it could be seen as a good or bad thing, but over here, neither patient nor family need be consulted as to a DNAR decision.
as for failure, i dont think so. as long as you put your heart in to caring for someone, irrelevant of any circumstamces, i would agree with everyone else that you've succeeded in your role as a nurse...
- 4Oct 4, '08 by landesmummyThank you so much for this story. I am half way through my rn degree programme and I recently had a stage 4 breast cancer patient--who wanted to go to hospice but the medical team, not the oncology team, wanted to debride the 'monster alien' growing out of her chest. She cried so much and said it was time for her to go--her mother agreed yet her brother said that she could not leave the hospital for hospice until this was done. Thank god she finally signed a DNR because if she codes, her chest will collapse, she will explode and we will kill her. Thank you so much for your beautiful words. I have just finished writing my own will, using these words as a template. Thank you for caring. You have touched alot of people with this post.
- 4Oct 5, '08 by PeriThank you for writing about your patient, it was so moving.
I especially liked the way her wishes had been inserted to add poignancy.
I understand that the daughter didn't want to face the pain that her mothers death was going to bring, but I don't know how she can live with the brutality that was inflicted through her desperation.
My own mum died peacefully after suffering with Dementia.
It was her decision many years ago that we abided by.
I miss her
- 2Oct 6, '08 by amdaleWow, I'm not even sure what to say. I think you are impressive I don't think you failed her. Thank you for your story.
That daughter was only thinking of herself. I'm sure shell never comprehend what a horrible way her mother passed.
Thank you again.