I took over care of a "comfort-measures only" 37 yo woman who was comatose and dying -- I was the night shift nurse. Her vital signs were being monitored via telemetry but were not being displayed in her room. Her vital signs were normal when I assumed care except for an 02 sat in the 80's. I was told that her family was all exhausted beyond belief but wanted to be called if she had any changes.
So, about an hour into my shift she is satting in the 60-70s and throwing lots of PVC's for over half an hour. So, I thought "This is it." I called her family and let them know. The entire night she lived, satting in the 60's and throwing occasional to frequent PVCs.
She was on 16mg morphine/hr, btw.
Her family all came in after I called. But after I realized that her status had really reached a plateau I was honest with them. I said that she had not gotten worse over the last few hours and I didn't know whether she had a few hour left in her or a couple days. I said that I would try to keep them updated via phone if they decided to go home and catch up on their rest. I said that whether they decided to go or stay -- neither decision was wrong -- just to say their goodbyes if they decided to take a break and that would be very understandable.
But no one wanted to miss her death, of course! So, then I left my shift feeling like she was probably going to die any moment after the family had an unneccessarily sleepless night. Probably, thanks to me, they'd miss her death AND be sleep deprived wrecks.
