Leaking AAA

I worked my first night and had an elderly woman die of a leaking AAA. She chose not to go to surgery and just get comfort care with her family around her. Very sad, but understandable. I had not encountered this diagnosis before so it was interesting to see. She was presenting very much like a kidney stone but the pain was in her abdomen. Lots and lots of drugs before she felt comfortable.

The next night I got two more leaking AAA's (having never seen them before that week). One was ruled out, and the other transferred out to a larger facility. Funny how they come in spurts. The gentleman that was transferred out was restless and ornery, didn't want to hang around for all our foolish testing. I told him "I had someone die of this last night, so you're going to have to put up with me being a little fussy and cautious about how you're taken care of tonight." Got a big "you tell him!" from his son.

The first patient was cold and clammy, but I didn't want to clean her until her pain was under control. Then I was wary about turning her and having her die when the family was out of the room. After a few hours I couldn't stand it any more, and got someone to help me change her and fluff pillows. Family was as good and loving as they could be, but after she was changed one of them took one look and burst into tears. She looked too "hospital," and not like herself. So they asked for an extra blanket, scrunched it up and put it on the patient to make things messier and more comfy. It's so hard to decide what the right thing is- I didn't want them to think we left her in wet sheets and neglected her. So now this hardened cranky ER nurse got another look at how every patient belongs to someone's family.