The Patient I Failed - page 14
by nerdtonurse? 374,881 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
- 5Jan 12, '09 by Dragonnurse1I have experienced the same thing with many patients in the ER. There are many times that a living will never makes it to the ER and so many times family threw fits because their loved one did not have any dignity when dying. I can not count the number of times I had to "code" a patient that was on autopilot. Rubs I broke, medication I gave because the patient did not have a DNR. Then the family and the private physician would get there and finally the DNR was given. One time I had a nurse that refused to turn off the vent and was enraged when I did. He did not care what her family wanted or what her physician wrote. I could not get him to see that the heartbeat was mechanical (paced) and after all she was still breathing - she was on the vent. I told him he needed to get out of the ER until he could show compassion.
From Jan 2007 to Aug 2007 my mother was bed-ridden and slowly dying at home. I had been called on many times by Mother's friends when their family's had to consider how to proceed. I live 19 miles from my parents home and one early morning the phone rang. It was my father, I knew what had happened. I called my eldest son - he lived within 1 mile of Dads house - and got him over there before the medics arrived. I had taught him what to do. He was able to run interference wth the medics and she was pronounced.
You did not fail her. Her "family" did, her doctor did, yours was the only voice she noticed in those last moments and she knew you had tried and she loved you for it.
Thank you for trying when others would not.
Thank you for the caring you gave and
Thank you for being a good nurse.
- 3Jan 12, '09 by Mommy_of_3_in_AL..RNWould there be something wrong with the physicians and nurses clarifying with a patient or family, upon the decision to make life saving choices, what a "full code" actually entails? I dont have a lot of experience yet, but end of life measures are very dear to me. In the few situations i have been in, the family was informed of what to expect in a code..fractured ribs, loss of function, tubes, wires, everything. In most of those cases, the family saw what could happen with coding a "brain dead" patient, and often times shown the CT scans and EEG report in order to see it for themselves, and chose to allow their loved ones to pas away peacefully. I think that being up front and providing no false hope could be an eye opener. Please note, that this applies to terminal patients or those determined as brain dead, not just anyone who randomly codes.
My best example is a 28 year old patient with a ruptured AVM. The family was adamant that after "three days" she would miraculously wake up and walk out..this would NOT happen due to the immediate brain death caused. However, they kept her on life support for the three days, and the physician and nurses tried their best to show them the actuality of the situation. The patient passed away (after receiving fourth code) while the family was in yet another conference.
- 2Jan 17, '09 by memlz233that is a beautiful story. very sad - there area tears running down my face at work! You will be blessed. You were just doing your job and i'm sure she knew that. At least she isn't suffering anymore. thank you for sharing that story with us.
- 1Jul 24, '09 by morteit came to mind as i was rereading this.....perhaps we need to add to living wills/advance directives/POAs....persons whose wishes are to be ignored, ie this crazy daughter.....this would have allowed the docs to ignore her and allow the woman to pass in peace....without fear of repercussions (for the most part)
- 2Jul 24, '09 by Chapisomg, as i type this tears are making the computer screen blurry, my heart aches for this woman. how in the world can her orders for her last days just be thrown away? i hope to never be selfish with my parents, husband, or kid. i love them to death, but god please give me the strength to love them more to help them in your hands instaed of keeping them alive for me, may she rest in peace now.