midazoalm1953
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Ahhh. When I was an ICU nurse up until 18 months ago I never had a problem with "i'm sorry (mom, dad, grandma, your brother, wife, etc) has died. It became sort of "routine. But what was not routine was I was developing a dread, close to definitetly not liking taking care of pt's that really should be on palliative care vs " do everything" for a person long beyond help. So I left ICU and have now become a Hospice nurse. Best decision I have made as a nurse. Reality is common place and helping a patient die at home with the family doing the primary care is as rewarding as my first code resucitaion way back when..... Not everyone can deal with death but comfort care and compassion far supercede intubating everyone and starting pressors and dialysis, etc ....just bad medicine I could no longer be a part of.
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as a former ICU nurse I understand the need to do a head to toe assessment. I am now working for hospice and still do a head to toe assessment. Where my job now requires mostly documentation vs actually taking care of a pt I will never stop head to toe. You will adjust in the ER as it becomes more comfortable for you. Good luck.
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above was placed in you comment, sorry..those last opinions are mine.
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In our ICU pretty much the same protocol. After 10-12 days with multiple failed weaning the Trach is approached as wekk as the PEG. We used to do both at once, but now wait a few days as some people do well affter the trach with just the need for overnite vent support. Unfortunately many are done as family pressure to do everything and the patient dies anyway as they are to often stage 4 of some disease with multiple comorbidities and almost all are obese.Planetree in it's conception might be grand but in reality is a bunch of crap. We have "visitors" at all times in the ICU and the families are obnoxious. They follow you into the med room and scream at you because their 85yr grany with the massive frontal lobe bleed is not responding to them! I am responsible for all their dysfunction and administration actually sends gift baskets to the ahole families that complain abount us not smiling enough, or not up dating all 25 familiy members that call to us instead of the family.Also the illegals just run through the hospital to bring in more ETOH to their family loved ones...freaking nightmare...Nurseo s need to be in control or we lose as well as the other patient's who don't have obnoxious family. Twhhere need to be LIMITS in an ICU as well as protection. I am not responsible for your obese, non compliant full of cancer family member...who is also demented and addicted to opiates. No elective surgery for these people!again...will they honor your wishes??? TOO often seen person's wishes completely ignored...assault if you ask me.....just be sure your HCP has the balls to standup against family that are out of control.It's just that I have too often seen pt's wishes not carried out, and extreme measures instituted against pt wishes...disgusting...and the flip side; a pt clearly circling the drain and he/she "wants everything done" when the best thing to do is hang a MSO4 gtt! an exercise in futility, painful, degrading and unecessary.I think you are wrong. Very wrong......there is a need for "limits" on invasive care with re: end of stage diseases...and for persons in their 90's with multiple comorbidities....selfcare deficit, mult cva's, MI, non compliant IDDM, obesity, cancer with mets, COPD, dementia, parkinsons, chronic falls, chronic aspiration...the list goes on, and believe you me I have had a single pt with all the aformentioned process's at the same time, at many times. There needs to be a limit.Thank you for such an elegant way of expressing how I feel, but could not quite express it as well as you. I would like to print your reply and post at work if you'll grant me permission. Thanks again:smokin:aso where I work, in a "Planetree" hospital, obnoxious visitors actually receive a "gift basket" from senior administration...talk about BS. I watched a family member jack a nurse up against the wall. I intervened, was disciplined while the family got a basket of goodies. Wanted to puke!oh boy.....where to start???hmmm. first I am not waitress so making a pot of coffee for your whole family is out. Go down to the cafeteria. To the pt whose finger is glued to the call bell...if you ring that bell one more time I'm going to break your fingers! To all obnoxious visitors....I am doing CPR right now, your cup of ice can wait. I secretly would love to rewire the call bell with a "limit" of use. If you exceed your limit you get an electric shock.