Medical Futility

Nurses COVID

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When do you accept that it is futile to code or prolong a code? I had a patient maxed on 5 pressors. He was saturating in the 70s on 100% vent settings and gradually dropping lower. He ended up being coded twice. It was a combined time of over an hour of CPR. I felt like the patient was being tortured half way through the first code.  He ended up dying anyway which I felt was the obvious outcome from the onset. Am I wrong to feel this way? No one else seemed bothered by it. 

Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

A litigious society based on the idea that life is always fair and people should always have their dreams come true, augmented by the “miracles happen, science doesn’t know everything” crowd, has a hard time accepting the inevitable. This goes for staff, too. 
 

 

It seemed cruel to me. A compression machine was used. It looked off center. I can only assume most of his ribs were broken by it. 
 

I feel pretty hardened these days, but have not been in a ton of codes. Many of the other nurses were much more experienced than me. Plus, I am a traveler and not familiar with a lot of things on this unit. The MD also seemed determined to keep going which another nurse told me was characteristic of this doctor. No one seemed emotionally involved, but I felt disgusted by the situation. Everyone broke out in laughter a couple of times during the code and seemed to completely lack respect for the dying patient. It just seemed like pointless suffering inflicted on the patient without any consideration of the long term outcome. 

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