I'm not actually a nurse (yet) and this is really from a relatives point of view, but I wanted to share it here. Patient is an 87-year-old female with COPD/Type II Respiratory Failure, end stage. She was discharged from the respiratory ward three days ago into the care of her family with the parting words, "she's dying, we don't know whether it will be days or weeks" and no offer of support, sympathy or palliative care services from the medical staff. Three days later patient is found, at home, with a GCS of 6, laboured breathing (more so than typical) and a raspy, wet gurgle. Community nurse arrives in the home and assess the patient - who is very obviously in severe CO2 overload and, bluntly, dying. Not dying as in the broad sense of the word, a process - but dying now, today, soon. Nurse assesses the patient and then sits down with the family and recommends.... get this: finding a GP who will do home visits. Does anyone else see something wrong with this situation? The patient is actually my grandma. When the nurse left without doing anything other than assessing that signs of life were draining, and draining quickly, it was suggested (by someone else) we phone an ambulance. The paramedics couldn't have come sooner.