Dnr In Icu - page 2
Hi. I just had another one of those knock down drag out fights with the manager. Our unit has its issues. (see my other post) We have just lost 12 nurses with a total of over 200 hundred years of... Read More
Jun 18, '04Occupation: SICU/MICU RN Joined: Jun '04; Posts: 235; Likes: 8If nurses aren't considerate and compassionate to families at such a terrible time, then who will be? You showed yourself to be an excellent nurse gizela, because you put your pts needs above all else. I know in my hospital we have set visiting hours, but extending those hours is always at the discretion of the nurse. A nurse with a good heart empathizes with families and you did exactly that. Your manager should be ashamed. If that were her father/mother/close family member how would the situation have been different? It would bother me also about the change in attitude whenever the mgr finds out the niece works in administration. We should treat all patients and families with proper respect no matter who they are or who they know.
Side note- in our facility is always stressed to families dnr does not equal do not treat. I know in this case the pt had no chance of recovery, but if we have a dnr we do all we can to support the pt through the acute process. There is just no invasive attempts if a code does happen to pull the pt through.
Jun 18, '04Occupation: RN Specialty: 15 year(s) of experience ; Joined: Oct '02; Posts: 4,763; Likes: 843I was a hospice nurse in an INPATIENT ACUTE hospice facility. Sounds like this would have been a great option for the pt and family.
Unfortunately, most hospices provide only homecare, and care in others' facilities. They do not provide 24 hrs a day RN care, and do not have inpt facilities.
I think that many more hospices should have inpt facilites.
I had a hospice pt very similar to the pt described by the OP:
Pt in his 40s, malignant melanoma w/ mets. Very large, wonderful family.
His entire family was with him, when he died a gentle, peaceful death.
His death was just about as "good" a death as I have seen.
I have often thought that it would be a great idea for ICUs to have an ajoining hospice unit.
ICU staff and hospice staff could have transitional pt focus meetings to facilitate the transfer of pt and family from ICU to hospice.
The pt's bed could simply be rolled through a set of double doors to the hospice unit, where the focus would be completely different. Docs could be educated in hospice and palliative care, so that the pt could retai9n their same doc when they transfered to hospice.
I've fantasized about the possibility of ICUs w/ ajoining hospice units for a long time.Last edit by Hellllllo Nurse on Jun 18, '04