Has being a nurse changed your outlook on...

Nurses General Nursing

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...how you would like your end of life care to be handled? After today I know I'd want care to be withdrawn if I ever got to a point that my pts were at today (terminal illness/stroke/vent/unresponsive). It just seems tortuous to put someone through all of that.

I became a nurse when I was 48 and I have been a nurse for a year. I work on an inpatient hospice unit. There are things far worse than death. I am blessed to have the job I have. It really allows me to look at my own life from a perspective of gratitude. I am a better person for it.

Thanks for the topic

Beth

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My biggest fear is to trapped in my own body, with someone else deciding when I get turned, when I get up and what TV show is put on my TV!

I have a young 'locked-in' ALS with vent, g-tube, colostomy, cath, no communication methods, no narcs, no anti-anxiolytics, still on FULL CODE! (left all decisions up to spouse who can't let go)

This is my worst nightmare. All mental faculties intact, sensation of pain intact, and absolutely no voluntary body movement or means to communicate suffering.

NO WAY. I'm checking out in those circumstances. Push the Ativan and Morphine, it's sleepy time.

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Specializes in Med/Surg, Academics.

Yes. So much so that my husband is not my POA. My ex-SIL who is a nurse is my POA.

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Yeah, there's definitely something to be said for having someone be your POA who has the grit to stand up to the fears and emotions of other family members.

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Specializes in med-surg so far.

Yes it has. However there are other nurses that I work with who don't feel the same way. I had a pt several months ago who had copies of his living will & POA on the paper chart but in the computer he was still a full code. I discussed changing his code status in the computer with my manager, my nursing supervisor, and the day shift nurse taking over his care & I left a note on the chart for the MD (since I work nights I often don't get to talk with the MDs). My nursing supervisor basically told me that changing his code status was ridiculous b/c he wasn't actually dying, only there for a surgical procedure, and that if it was me in the hospital & something happened, I surely would want extraordinary measures taken!

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Specializes in Med nurse in med-surg., float, HH, and PDN.
Yes it has. However there are other nurses that I work with who don't feel the same way. I had a pt several months ago who had copies of his living will & POA on the paper chart but in the computer he was still a full code. I discussed changing his code status in the computer with my manager, my nursing supervisor, and the day shift nurse taking over his care & I left a note on the chart for the MD (since I work nights I often don't get to talk with the MDs). My nursing supervisor basically told me that changing his code status was ridiculous b/c he wasn't actually dying, only there for a surgical procedure, and that if it was me in the hospital & something happened, I surely would want extraordinary measures taken!

Talk about over-riding presumption! Oh man, Oh brother, Oh holy ****! If I was the patient and knew the supervisor had said that, I'd have her for my last meal before I went NPO......even if her poisonous ignorance killed me!

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Specializes in Med/Surg, Academics.
Yes it has. However there are other nurses that I work with who don't feel the same way. I had a pt several months ago who had copies of his living will & POA on the paper chart but in the computer he was still a full code. I discussed changing his code status in the computer with my manager, my nursing supervisor, and the day shift nurse taking over his care & I left a note on the chart for the MD (since I work nights I often don't get to talk with the MDs). My nursing supervisor basically told me that changing his code status was ridiculous b/c he wasn't actually dying, only there for a surgical procedure, and that if it was me in the hospital & something happened, I surely would want extraordinary measures taken!

If the patient was young-ish with few co-morbidities, I would have the doc discuss his DNR decision with him. The patient might not understand that he has a very good chance of recovery from cardiac arrest.

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I think the reality of death became more clear to me when I became a nurse. I had never really thought that much about death before. I had attended funerals of my grandparents but never actually saw someone die. My first death was of a child, so it is something that I will always remember. Having the strength to help the pt who is dying and the family members accept imminent death is very difficult. Helping pts to decide on being a DNR with family support has been difficult as well. I found myself being the patient advocate many times explaining to the family that because this patient had 4 co-morbidities and was going into another one was hard. But the nurse in me kept nagging to let the patient and family members know exactly what was going on. I was fortunate in that the medical director I worked with was not one of these glory-type MDs who could not deal with their patient reaching the point of no return and who could present the case medically to the pt and family. For my self, give me Hospice anytime. It bothers me that our country does not endorse MD assisted suicide in chronic illness patients. Sometimes I feel we treat our pets better than we do our human loved ones. At least they can be euthanised without a major legal battle. Yes, nursing has changed my attitude and beliefs on death.

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Specializes in NICU,ICU,ER,MS,CHG.SUP,PSYCH,GERI.

Nursing has totally changed how I view physicians. You can't bill a dead person.I have seen orders "Place feeding tube Monday then discharge to nursing home Tuesday on Hospice." I have seen Stage 4 decubes debrieded. I have seen 1 mg of Dilaudid IV q 4 hours ordered on a 320 lb patient with a dinner plate sized stage 4 decub.This pt hasn't been out of bed for 6 months and cannot be weaned from the vent.She screamas in pain often and her doctors are fully aware of this. They don't want to give her "too much" pain medication. I don't think America has such an obsession with a fear of death as we have gutless greedy physicians who want to bilk Medicare for the very last cent they can get.I had a family member tell me she wanted to make her loved one a DNR and the doc said "shame on you".I had a family member tell me the nephrologist told her he thought beginning dialysis could turn her 94 year old mom "around".I had a doctor throw a royal fit because I didn't draw a pre-abbumin on Wednsday when termination of life support was scheduled for Thursday.I had a doctor chew a nurse out because she didn't call him to try to talk a family member out of a DNR. Now, at the risk of being shot by a sniper all of these "physicians" are foreign. Maybe it's different with a different physician population.I am just not seeing families educated by the physicians about the realities of their loved one's health situation.

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Those doctors just are beyond the pale; forestalling death to get more $$$$.

There are many folks, though, who just can't handle the idea of dying, even Dr.s and nurses. They can't even stand it if an elderly person says, "I've had a good life; I'm ready to go. I pray every night for the Good Lord to just take me." That's not a potential suicide talking; no need to call in the shrinks. Many of my PD patients have talked to me about death and say they are looking forward to it, with a gleam in their eyes. Doesn't mean they're going to actively bring it about, though. Just daydreaming.

I hate it when some patient with multiple co-morbidities (sp?) who is in their upper-ninetys have family members demanding a full-code. You just know their brittle sternums are going to crack within the first few pumps on the chest. And what are they bringing those folks back TO?

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I did actually look into the possibility of having DNR tattoo'd onto my chest! Turns out, it won't fly, not even with a tattoo'd Dr.'s order with tattoo'd signature and date. Pity.

A colleague of mine did have DNR tattooed on his chest. I saw it myself. He must have done it before there were rules against it? Or it may have been done outside of a tattoo shop. It was pretty rudimentary.

He also had a custom plate for his motorcycle that said "NO CPR".

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I am just a CNA but in my last 3 years on our med surg floor i have seen some families put their loved ones through procedures I could never imagine. Like 95 year olds getting hip surgery only to die 2 days post op, terminal pts with ng tubes and eventually feeding tubes. Pts who have stated no vents, but their mpoa puts them on one anyway. Sad. I want DNR across my chest with no entry across my butt, nose, and belly. I cant even being to imagine being trapped in the hospital on a vent with an ng tube, and a rectal tube, not even knowing where im at or what planet im on. No. No. No!

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