The Patient I Failed - page 13
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... Read More
May 2, '10Not only as a nurse, but also as a person who respects the right to choice, laws need to be passed requiring physicians to follow advance directives, regardless of family objections. Why, as a society, do we care more for the suffering of animals than we do our family and friends? Preserving life, for the mere sake of ...making oneself feel better, without regard for the pain and suffering of the dying, only elevates this injustice to an unforgivable sin. It is time for a call to all nurses and all compassionate people to bring an end to the indignity and suffering of the dying. It is time to cry out and let society know our fellow human beings deserve a minimum of compassion shown to our beloved pet.
May 2, '10I think you are writing about my grandmother. Except for the part about her husband of 52 years. My grandparents made it to 60 and he did not have a full code/ vent death.
My uncle found my grandmother, passed out on the floor. He called 911, and wouldn't you know it, an EMT was on his street with the radio on and responded within 2 minutes. Grandma was on the vent when I got there. It was agonizing to me because I had been her primary caretaker for about 4 months, before she moved into my uncle's home one week before. I knew what she wanted. Now I had to try to convince the family.
Thank God for our nurses. They were great, every single one of them. And death did come, with dignity, more than 36 hours after getting off that d### vent. What a fight. We won.
May 3, '10I'm really bothered by the statement "Not eligible for a DNR". Oncology nurse here. I deal with this subject A LOT. I am eligible for a DNR if i so decide. A patient's health status has nothing to do with their choice to decline CPR or other code measures. Seems like alot of ppl dropped the ball on patient advocacy in this case.
Another thing that bothers me is "The MD refused to terminate feedings but I held them" if this patient had a pre-feeding residual over 200 and the MD wouldn't give me the order to hold the feeding, I would be calling my house supervisor and she could give that feeding if she felt that was prudent. AND If this patient had "no digestion occuring"; a paralytic ileus is a medical emergency and any doctor who valued their license would make that patient NPO rather than drown them in Jevity.
I'm not saying this isn't a sad story...it really really is. Somebody please tell me if I'm wrong, because this is the standard I've been taught to practice at.
Is this story even real? I hope none of my loved ones end up in the care of this hospital.
May 3, '10You did not fail your patient, her family did. This type of thing happens every day, and although sickening, there's little that can be done aside from comfort. That's where we do not fail those who fail their own.
May 3, '10You absolutely have to know that you failed absolutely no one. Those of us fortunate to have had compassionate, caring nurses for our ailing parents would applaud you for doing your best under the worst circumstances.
I lost both of my parents. My mother had no advance directive of any kind and she was young...so we thought we should fight to keep her alive. However, when she had coded twice and was intubated and was clearly crying when I went in to see her, I secretly prayed that if she would not recover, and whispered to her that it was "OK" for her to go if she couldn't fight any more. She passed just minutes later.
My dad signed an advanced directive that my brother and I had no knowledge of until the fateful day. I watched a man who was full of fervor and life at 83, reduced to gurgling noises as his lungs filled with fluid. I held his hand. Then when I realized the hour had come, I summoned a nurse because he looked like he was in distress. The made him comfortable and I held him in my arms as he took his last breaths. Ironic...I took my first in his, and he his last in mine.
I miss him every single minute of every single day. However, I could NEVER have been so selfish to force him to live a life that no longer gave him an ounce of satisfaction. He couldn't do what he had always done. I know we did the right thing letting him go exactly as he wanted to. I felt at peace with his passing moreso than I did with my mother's.
The article was beautifully written. I have so much emotion coursing through me right now over it. Don't stop doing what you do. Compassion is difficult to find these days. You're an amazing woman that gave this poor soul a voice today. Be proud, don't feel you failed anyone. You're a hero. God bless you. And as another post says, may I be so fortunate in my last hours to have someone like you at my side.
May 3, '10This was a very sad story. The main person to fail this dear mother was her daughter. I have been a nurse for almost 27 years and have seen families step in and rescind living will wishes. My Dad was on a vent for about 2 days until everyone could see him, say their good byes, and then the vent was stopped and he died peacefully thirty minutes later while I held his hand and said my good byes and how much I loved him. My Mom had Hospice involved and she was allowed to die peacefully and I spent two days saying my good byes, telling her I loved her, and it was OK for her to quit fighting. As nurses, we see so much and experience every emotion possible taking care of our patients and families. We have to speak up and if needed, get Social Services, Pastoral Care, and Ethics committee involved if we see this type of behavior.
May 4, '10So many times it is the one family member that cannot give in to their family's wish. I've seen it too many times in trauma situations. When this is the case, it is hard to fulfill your advocacy role as you want to. Congratulations for your encouragement. Thank you for the story.
May 6, '10This is such a sad story, but you have written it beautifully. I'm glad your patient found such a compassionate nurse in you.
May 7, '10What a beautifully written article. It is sad, but true. Our effort is not for our loved one, but our selves.
We need to learn to let our loved ones go as hard as it may be.
Put their wishes above our own.
Perhaps if you asked the One Above to help you and guide you you will be able to let go.
It may be the most difficult thing that you will ever have to do.
"Let go and let God".
May 7, '10This article brought tears to my eyes....I can relate to it on a professional and personal level. My grandmother felt the same as this patient and we honored her wishes....it is so important to allow someone to die with dignity/in the manner they request.
May 8, '10My beloved husband was diagnosed with a terminal illness at age 41. As difficult as it was for me as a nurse , he chose Hospice soon after his diagnosis. Hospice allowed him to "live" the remaining year of his life without the stark white walls of hospitals or the constant invasive procedures of attempting to stop the inevitable outcome. He was at home with us and he was as free of pain as was possible. We did not limit his pain medications as would have been done in a hospital. We allowed him to choose what medications he wanted . We had the opportunity to spend the time with him talking about his life and things that he loved. We were able to take a trip together which we called our "second honeymoon". He and I watched the sunrises and sunsets on the Gulf of Mexico. We took strolls on the beach . We enjoyed his favorite meal in a romantic setting that overlooked the Gulf. I treasure the photos I have of that journey and the smiles we shared. He passed away peacefully a few months later. I wanted him to stay. I miss him every day but I am so thankful he did not have to suffer because of my need to hold on to him. My memories are not of him laying in a hospital bed full of IV lines and machines beeping and buzzing. My memories are of his hand holding mine as we strolled with warm sand betwen our toes and watched the sun set.
May 8, '10As an acute dialysis nurse, I have seen this story play out so many times. One family member with some incomprehensible agenda can put another one through hell on earth. That said, I love the writing! I felt like I was right there witnessing this with the nurse who wrote about it.
May 8, '10The patient I almost failed was my very own sister.
I arrived later than her husband and my older sister, also a RN who had allowed the hospital staff to intubate my dying sister. They allowed their own feelings to get past her wishes. Within 24 hours, I pleaded her case, convinced her husband that being on a respirator was not her wishes and she was extubated with me by her side.
That was fifteen years ago and not a day goes by when I don't think about her.