Artificial feeding-Terri Schiavo

Nurses General Nursing

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I posted this here becaue I think this subject is something that we as nurses deal with on a regular basis.....Many many people state that they have a big problem with the feeding being stopped "allowing her to starve to death" The Vatican says " To starve her to death is pitiless" Most everyone agrees that it is one's right to refuse to initiate artificial feeding but somehow this situation "is different" How? The patient "starves to death " in both cases-so why has this one galvanized the WORLD? My husband read me a quote from the Bible -forgive me because I can't remember it in detail-it was something along the lines that a woman marries and leaves her father's house and her husband becomes her family....My husband is my POA I hope no-one in my family questions his motives -He KNOWS exactly what I want....I can't question her husbands motives-I know that some suspect foul play and state the results of a bone scan support this...That bone scan was obtained 53 months after she went into her coma-after her body suffered the effects of her eating disorders for a number of years.... Her present level of responsiveness does not pertain to this matter IMHO-she CAN'T eat naturally--she did not ever want to "be kept alive like that " and she can't state otherwise at this point...So- #1 can someone PLEASE make me see why this case is" DIFFERENT" and #2 How do YOU support your patients and their loved ones when they are agonizing over this decision? ONe thing I always ask is "Did your loved one ever give you any idea of what they would want if something like this happened" and if they did then I advocate that stance for that pt as much possible.......I believe that death is the last great trip we'll go on and we should PLAN it as much as possible.The greatest GIFT we can give to our loved ones is an itinerary...........

I think this Terri Shiavo issue is part of a bigger political plan. There are thousands of Terri's out there, and it is costing the government MILLIONS of dollars a year to care for them. We are in the planning stages of being conditioned to accept "when it is time to pull the plug."

Terri Shiavo didn't surface on the national news for no reason.

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I don't believe that. I don't believe that at all. The whole world from Larry King to Oprah is trying to make this guy like an evil toad. According to Michael Shiavo's lawyer, this guy is going to get nothing from her death, and that I do believe. .

So, let me get this straight. You don't believe a nurse who has nothing to gain from this, and who has provided a notarized affidavit of her observations, but you believe Michael Schiavo's lawyer? On what basis?

No one is trying to make him "an evil toad." What we have are some who think the case sounds suspiciously like wife abuse, complete with a husband unwilling to allow any rehab, which, just incidentally, might allow Ms. Schiavo to testify about her injuries.

As I said earlier, I have no patience with men who abuse their wives. I wish the DA in that area would investigate this further. I suspect Michael Schiavo's intimidation goes further than his wife's nursing staff.

Jim Huffman, RN

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1. I have to question the news sources from which some of you are gathering data regarding this case. Some of you have said that Micheal has denied medical treatment and is using settlement money for selfish means. From where did you get this information? According to last night's (March 21st) broadcast of "ABC News World Report" although Micheal won money from a med. mal. lawsuit; SEVERAL JUDGES HAVE FOUND NO EVIDENCE FOR MICHEAL USING THE MONEY FOR MEANS OTHER THAN TERRI'S MEDICAL CARE. Furthermore, they also stated that Micheal took Terri to specialist after specialist even going to California to have elctrodes placed in her brain to stimulate brain activity (with no success). These do not seem to be the actions of a heartless, selfish individual. Although I have to admit I too did think it was somewhat suspicious that he really started fighting for the removal of the tube after the med. mal. award; however, all allegation of potential wife abuse, etc. have to be substantiated with fact from credible, reliable resources (I personally would love to see those nurse's depositions or the trial court transcripts).

2. What makes this specific case different is that Terri's parents have chosen to take this most private decision into the public, political, and legal forum. We are opening a very dangerous Pandora's Box. If they succeed to override the husband's decision, then they will set a precedent that decisions made by a POA can be challenged. As an trauma ICU nurse I have seen families agonize over these decisions...fighting among themselves as to the actual wishes of their loved one to remain in life support or to undergo further painful surgical treatment...The Schiavo case can make it so POA and family can legally fight and fight each other until the cows come home...meanwhile the patient remains in hospitalized...possibly in great pain...open to infection...suffering...etc. (I'm just thinking of the patients I usually take care of, I recognize this isn't the case with Terri). Can you imgaine the cost of care? The emotional turmoil?

3. The U.S. Supreme Court refused to hear this case TWICE (ABC News and World Report, March 21). What that says to me is that the justices do not want to get involved with what has traditionally been a PRIVATE FAMILY MATTER - they do not, DO NOT, want the highest court of the land to exact a precedent setting decision that would allow government and law to get involve with private, family matters.

4. Due process of law means having one's day in court. This case has had 34 court appearances and been heard in front of 15 judges (ABC News and World Report, March 21). Lastly, judges are hesitant to overturn the decision of another judge because it would undermine one of the most sacred principles of the American legal system - "stare decisis" or "let the decision stand." The actions of courts (trial court, the appellate system, the Florida Supreme Court and U.S. Supreme Court) in this case have overwhelming asserted that medical decision making, without a living will or other such legal document, will follow the current industry practice of spouses over parents.

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I have to take issue with the following remarks quoted here. If this person had so many doubts, why didn't she go to someone higher up and express them?

She did.

Carla Iyer, RN: "I ultimately called the police relative to this situation, and was terminated the next day."

Then she provided an affidavit of what she had seen and heard.

I am proud of Carla Iyer as a nurse. She went to the police. I'm not sure where else we would expect her to go.

Jim Huffman, RN

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She did.

Carla Iyer, RN: "I ultimately called the police relative to this situation, and was terminated the next day."

Then she provided an affidavit of what she had seen and heard.

I am proud of Carla Iyer as a nurse. She went to the police. I'm not sure where else we would expect her to go.

Jim Huffman, RN

How about the BON, the ombudsman, the office of long term care (or whatever it is called in florida), the dept of adult protective services, the states medical board, the labor board (for unjust termination)just to name the first few that pop into my head, if I was THAT concerned abou the care/abuse a res/pt was recieving I would not have stopped c/o until someone investigated.

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She did.

Carla Iyer, RN: "I ultimately called the police relative to this situation, and was terminated the next day."

Then she provided an affidavit of what she had seen and heard.

I am proud of Carla Iyer as a nurse. She went to the police. I'm not sure where else we would expect her to go.

Jim Huffman, RN

What I don't understand about Carla is that why if every day you go to work and your nursing notes are deleted, didn't she report this to some governing board. The nursing home has no business complying with record tampering even if the husband wanted it. The nursing home is at fault for permitting this.

I would not let my notes get deleted time and time again without putting up a stink. Maybe she needed a job real bad who knows.

We need to pray for Michael to have a real change of heart instead of flame him and by flaming him we are sending more negative energy out. Terri's parents need prayers too to stop the animosity. And I pray for Terri that God's will be done for her, not her parents, the courts, the press, husband.......

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The only sick alive people involved in this case are the Shiavo family. They need to grasp reality that Terri has long since past. It's reported that an MRI has shown her cerbral cortex to have been liquified many years back. Instead, the family uses video and anecdotal experiences to manipulate congress and the public. Just yesterday on CNN Terri's father was quoted that he talked to Terri about taking her out for breakfast and she supposedly responded. Right! That family needs counseling.

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I agree the Schiavo family are putting their own selfish reasons in front of their daughters and it is not a place for the courts to be involved. And since her care is being paid by medicaid that means we as tax payers are paying for her care. Its just time to let her go. She is not with us anyway.

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Just a clarification - Schiavo is the name of Terri's husband. Terri's parents are Mary and Bob Schlinder.

I don't think this case will cause there to be more problems with POA's . . .I think this case will highlight the need to get your personal matters settled early and legally.

This case hinges on we do not know what Terri would have wanted. Her family says one thing and her husband says another.

steph

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The only sick alive people involved in this case are the Shiavo family. They need to grasp reality that Terri has long since past. It's reported that an MRI has shown her cerbral cortex to have been liquified many years back. Instead, the family uses video and anecdotal experiences to manipulate congress and the public. Just yesterday on CNN Terri's father was quoted that he talked to Terri about taking her out for breakfast and she supposedly responded. Right! That family needs counseling.

1. The only "Schiavo family" is that of Michael Schiavo and Terry Schiavo. The family I presume you're referring to is the Schindler family.

2. No, Ms. Schiavo is not "long since past." She is -- at least at 11:56 a.m., EST -- still alive, despite her husband's efforts.

3. Ms. Schiavo has never had an MRI. Michael Schiavo has refused to allow one.

4. The family uses video to inform the public, since Michael Schiavo has consistently portrayed his wife as worse than she is.

5. Since, presumably, you have not had the opportunity to interview or otherwise evaluate any family dynamics or the individual family members, it is probably safe to assume that neither of us knows whether "the family needs counseling."

6. What grounds do you have for doubting that Ms. Schiavo could respond to her father's statement?

Jim Huffman, RN

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My step-dad had a traumatic brain injury back in the late 60's. He was basically an infant in intellectual terms and had to relearn everything. Walking, talking, etc. He was in physical and occupational therapy for years and when he met my mom was a truck driver, 6'7" tall, blonde and good looking. You'd never know he had a brain injury.

I'm not saying this is what the future holds for Terri . . .in fact I'm sure it isn't. But whose to say what would have happened if her husband had allowed more physical therapy? We had a guy in our LTC with contractures from a paralyzing accident who didn't get P.T. initially. Later he did and was finally able to get out of bed and into a chair and engage in life with his family.

My step-dad died of a brain aneurysm in 1971. But he had a few years of life after his injury with my mom and he took an active part in raising her four kids.

Life is complicated. Since Terri is already in this state and we don't know what she would have wanted and her husband doesn't want to care for her anymore and her parents do . . . . why not just let them take care of her? You can't go back in time. The feeding tube is in.

steph

Physical and occupational therapy won't jumpstart a brain that is no longer there. According to what they say the doctor's say, she is in a persistant vegatative state....therapy is not an issue. It is a sad case with the primary facts lost in the parent's selfishness. Yes, they love her, but it is now the focus of their life, and the dramatization is more the obsession than what is best for Terri. Why are we now a nation afraid to let go of life and afraid of death? We prolong a beating heart in hopes we will forgo the pain of loss and the process of moving on with life without the one we have loved. We now clone our pets for the same selfish reasons. Death is a part of life and should be welcomed eventually.

In Terri's case, the couldofs, shouldofs, wouldofs of the past ten years don't matter. She is gone according to physicians. Let her go. While her parents wish for her return or at least, the continuance of a warm body that exhibits uncontrollable movements and noises, who cares for her when they are gone? The American system? Are we setting up for an overload in the healthcare system? Sadly enough, if she were to be aware of her state and not able to vocalize or move or whatever, how maddening to be trapped inside........is there ANYONE who honestly would want to be in that position? I think not.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

thanks pizzigirl for posting the link re schiavo timeline maintained by university of miami.

key events in the case of theresa marie schiavo

http://www.miami.edu/ethics/schiavo/timeline.htm

selected the following excerpts:

february 25, 1990

terri schiavo suffers cardiac arrest, apparently caused by a potassium imbalance and leading to brain damage due to lack of oxygen.

november 1990

michael schiavo takes terri schiavo to california for experimental "brain stimulator" treatment, an experimental "thalamic stimulator implant" in her brain.

january 1991

the schiavos return to florida; terri schiavo is moved to the mediplex rehabilitation center in brandon where she receives 24-hour care.

july 19, 1991

terri schiavo is transferred to sable palms skilled care facility where she receives continuing neurological testing, and regular and aggressive speech/occupational therapy through 1994.

december 1, 2003

jay wolfson, guardian ad litem, concludes in his report that terri schiavo is in a persistent vegetative state with no chance of improvement.

wolfson's report

governor bush's response to wolfson's report

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i was not aware of the length and depth of initial rehabilitative care provided. it isn't until 1998 that michael petitions to have feeding tube removed due to no improvement and persistent vegetative state.

timeline includes court rulings.

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