In 30 something years of doing this deal, I have seen countless people leave this world... but then, I've also seen some enter it. Our life process is just that, a journey we all will take. Today, sent an 84 y/o gentleman to IP Hospice, Had been on 3/week dialysis for ESRD, came in with multiple pressure areas, and gram positive cocci in his blood. Sick guy. His little wife was trying her best to take care of him at home, but just couldn't do it any longer. This doc with real integrity and compassion tells the wife and sons, that it is unethical to continue treating, that their family member is dying. After about 30min family meeting with myself, SW, family, and the docs, the agreed to meet with hospice, and we moved the patient there this afternoon. This is MHO, American medical culture is not comfortable, as a rule, with facing death in their patients. How in the world, can families get there, if the clinician who knows the patient best, keeps forging on with futile care. Oh well, didn't mean to get on soapbox and turn this into a rant, just focus on how we can be open with families about their options, be someone who can tell the truth, if the questions are asked.
Morghan, ARNP Case Manager