The Patient I Failed - page 19
by nerdtonurse? 374,545 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
- 1Nov 11, '10 by MaliffyI read your article aloud at the end of our IDG meeting. You made an entire room full of hospice nurses cry. That's not an easy thing to do. Thank you for a poignant reminder to all of us, to think about how we care for others, and how we would choose to be cared for.
- 0Nov 11, '10 by nurseshellyjwkDear nerdtonurse?
I should have asked your permission first but I copied and pasted your article to my notes on facebook. I also "liked" your article so it came up as a link on my page. In the copied and pasted note your allnurses name is included and the date you wrote the article. I just wanted to share it with my friends because it really, really spoke to me. Honestly I cried like a baby when I read it and I've been a nurse for 11 years. I just wanted to let you know what I did, thank you for writing that and tell you I gave credit where credit is due. Thanks again for being so honest and sharing that with us.
- 0Nov 14, '10 by GeekafiednurseI find this confusing... Anyone can choose DNR/DNI status; it is not reserved for the sickest of the sick or those with terminal conditions. I have experienced incidences where a family member recinded DNR status, because he or she was not able to "let go." Those experiences always seem to cause moral distress, because caregivers feel like he or she is ignoring the patient's wishes.
- 1Nov 14, '10 by nerdtonurse?Geek, in my state, a doctor has to sign off the DNR order, whether in the hospital or for a patient at home. Her PCP wouldn't do it (possibly because of the family dynamics he was so busy trying to stay out of).
I wrote this several years ago, but I will see that sweet little lady's face forever. When my knees and back won't take the ICU anymore, it's my intention to become a home hospice nurse. I couldn't keep my patient from her fate, but maybe I can honor her memory by doing good where I can.
- 0Nov 14, '10 by jv3661Your story is one that is definitely poignant and something we see as nurses often. You wrote a beautiful letter and it was touching. I want to play devil's advocate for a moment. The first thing we are taught in nursing school is not to judge. Funny, I might not remember the Kreb's cycle, but I sure remember being taught that unless you walk a mile in someone's shoes, you do not know what they are going through. I say this as someone who has worked hospice, oncology, psych and case management.......and as someone who lost both her parents. Even as a nurse, when you are in the situation, and don't want to lose a loved one, it is much more difficult to let go. As nurses we see it from one perspective, as children from another. When my mom, who was so vibrant and passionate about life, coded after cardiac surgery, I agreed to the code. Twice. She was a tough lady who made it through multiple cardiac surgeries in spite of having COPD and smoking like a fiend. It took open heart massage for me to realize what I was doing. Do I feel guilty? No. I did what I thought was right as a daughter, who didn't want to lose her precious mother, her best friend, her rock. When my dad was on vent, as a family, we fought about whether or not to extubate him.
We are all entitled to our personal feelings. I have steamed inside on many occasions. But as a caregiver, I try to take care of the whole families needs and can feel the pain of this daughter.Last edit by jv3661 on Nov 14, '10 : Reason: spelling
- 1Nov 14, '10 by nerdtonurse?I just "Googled" the title of my article.
I'm mentioned on hundreds of webpages and there's Twitter and there have been over 74,000 views of my article on this site alone....
I think I'm going to take an Advil and lay down for a bit...
Thanks to everyone who's read my article, and shared it. St. Augustine once said God would never allow an evil so great that good could not be brought from it, and perhaps this sharing, this conversation we're all "virtually" having can make a difference in at least one life. If it does, then there was good to come from this overwhelming sadness...
- 1Nov 17, '10 by jenbpUnfortunately, I see this horror every day. I could tell stories enough to fill a novel regarding patients who have been tortured due to the family's wishes. I have even had a wife tell me that she needed her husband to stay alive for the pension check. I have had patients riddled with cancer who have said they do not want heroic measures, only to be talked out of it by family members. I don't think the families have any idea what horror and pain we cause when we are "doing everything we can!" Resuscitation is painful, torturous and cruel especially to those who do not want it or are so sick that it won't make a difference. Due to the litigious society that we live in, it is impossible for doctors and nurses to work without being worried about repercussions. Everyone is so worried about being sued, that the patient and their comfort comes second! That is just unacceptable! Why fill out a living will if it won't be honored and if a family member can override it? What's the point of even going through the trouble?? It is so frustrating and horrible to think that all I do is torture people for a living.