Ethical Death or Not?

[dinkysam]

Hi,

I need to get an opinion. My fiance' and I are having a "difference of opinion" as you could say. Today, for the first time, I had a patient pass away. She had ESRD, COPD, the whole nine. Her family was still trying to make her better. She had this test, that test, Vanco here, Morphine there. I was, to be honest, scared to go in her room at first. I had a coworker come with me while I changed her position Q4 hrs. She had a stage 4 decubeon her coccyx. Face it folks, this woman was suffering. I was curious as to the signs of impending demise so I went online and looked it up. She had every one of these signs starting with the confusion, loss of speech, loss of ambulation, eventually becoming non-responsive. I also had read that some people just keep "hanging in there" so to speak. The day before yesterday she had her "miraculous recovery type" good day and then went backwards. I had her on 5L o2 with a rebreather mask. She was o2 sat 94%. Everytime I changed her position her sat would drop down to the 80's. The CNA had taken vitals and forgot to tell me that she had a temp of 101.3. I put icebags under her arms and gave her a Tylenol suppository and that's when she crashed. But, before this all happened I had sat with her a few times and rubbed her arm and told her that she didn't have to hang on anymore, that it was alright and she could go. My fiance' thinks that this is unethical or possibly illegal. Please help me with your opinion. I have more to tell but I'm running out of room.

[TazziRN, RN]

First of all, you can make your post as long as you want! The screen will scroll down as you type.

Second, why was that unethical? You did nothing to hasten her demise, you just told her it was okay to go if she was ready. That's the sign of a good nurse! You did great, sweetie.

[RNin'08]

You did what you could for this patient and offered reassurance and compassion. Nothing wrong with that.

RNin'08

~my reality check bounced~

[DusktilDawn]

I had sat with her a few times and rubbed her arm and told her that she didn't have to hang on anymore, that it was alright and she could go.

I personally don't consider this unethical and certainly not illegal. What you did was comfort this woman IMO, and really comfort measures was the only thing anyone could do for this poor soul that would be of any value. I believe that sometimes during the dying process, some people need to be reassured that it is all right to move on.

I'm not sure why your fiance feels the way he does about this.

[nuangel1, BSN, RN]

you did nothing wrong.you weren't doing anything to hasten her death just being caring and compassionate.

[dinkysam]

Thank you to all who replied. I am not sure as to why he feels the way he does either. From a christian viewpoint I know that there wasn't anything I could have or should have done different. But, I can't help wondering if that suppository ( isn't the orifice connected to the vagus nerve, possibly her heart?) might have exacerbated things.

[TazziRN, RN]

He may see it as unethical because in his mind the medical profession is supposed to fight tooth and nail to prevent deaths, yet you did nothing. In that frame of mind, to those who have no true understanding of how awful a slow death can be, he may see it as unethical but there was nothing illegal about it.

[dinkysam]

Thank you Tazzi, I do feel better. I know I shouldn't be beating myself up about it. I am struggling because I don't know how to feel. I feel saddened, happy that her suffering is over, and tearful because someone has lost a loved one. When I found out, I felt my heart jump out of my chest. Do you think she really " heard" me? I have read that hearing and touch are the last 2 senses to go.

[gwenith, BSN, RN]

Some of this is a byproduct of a society where death is reasonably rare. In those countries where death comes in many many forms you just do not meet this mindset of "death MUST be avoided at all costs.".

Some of it is also because the person who is pushing for life at any cost has not come to terms with mortality - thiers or anyone else's. In working as a nurse you will come to terms with mortality and learn to accept it with greater equamity than those not in our field. We know that when God is calling, there often is not much we can or should do to delay the call but there is a lot we can do to make it more comfortable.

[karenG]

I'm sorry your fiance feels this way.

the hardest thing to accept as a nurse is that sometimes you cant save a life and the person should be allowed to pass on. I remember my first death clearly and the man died almost 30yrs ago now! It stays with you.

you will find that sometimes a person waits for permission to die.. they stay for various reasons, and someone needs to say.. its ok.. you can go.

you did a brave thing, and deserve a hug. Death never gets any easier and you will find yourself asking why, and crying at the unfairness of it all. I think its about accepting that its not up to you when someone dies, its up to God and his word is final.

take care

karen

[nursejohio, ASN, RN]

I had sat with her a few times and rubbed her arm and told her that she didn't have to hang on anymore, that it was alright and she could go. My fiance' thinks that this is unethical or possibly illegal. Please help me with your opinion. I have more to tell but I'm running out of room.

So because you comforted an *actively* dying woman, you're unethical? I should be strapped down for my lethal injection if telling someone it's ok to let go is illegal. I can't tell you how many hands I held, how many "you don't have to hang on anymore" talks I had while I was in LTC. What you did was provide the very last positive thing this woman had while she was alive. Being present for the passing of a soul was your honor and priviledge, be proud of that.

[Multicollinearity, BSN, RN]

Bless your heart. You did the right and proper thing. Your fiance doesn't understand.

This modern attitude of fighting for life at any cost boggles my mind. I guess it's about ignorance and fear.