Kettek53

That is what is so hard for me to wrap my head around: it's not always ethical. I understand there are always going to be those families out there that are going to demand everything be done, no matter what the circumstance I have also seen families that are ready to let go of their 40-something family member, but then convinced to continue treatment because the doc is painting a picture of roses and butterflies if they just give the patient a couple more days. This is what keeps me up at night, and I really wish I could let it go. Is there anyone that we can't "save" anymore?

I'm really struggling lately at work. I have now been in the CVICU for 1.5 years after working in the MICU for 1.5 years, and initially I loved it. I loved recovery hearts straight from surgery, and managing severe heart failure patients. It offered me a new set of challenges that my previous jobs hadn't. I really enjoy the quick progression that is associated with heart surgery (most of the time). Now that I have gained more experience on the unit, and am beginning to feel more comfortable in my role, I have began caring for ECMO patients it is since taking on this new patient population that I have really been finding myself struggling morally, and I don't know what my best personal course of action should be. We mostly do VA ECMO, and these patient arrive to us essentially dead. They are resuscitated for as long as 1.5 hours with a Lucas device, and then placed on ECMO once ROSC is achieved. Sometimes the patients need to be on ECMO for as long as 2-3 weeks, at which point, regardless of level of stability (sometimes the patients are on CRRT for this whole time as well), they are transition to an LVAD. The patient is usually trached and peg tube is placed after the VAD, and they wake up. I fear for the patients overall quality of life once they leave our unit. It is not uncommon for this patient population to lose a limb, or suffer trauma to there femoral arteries from the ECMO placement. I find it to be increasingly difficult for me to care for these patients. I feel cynical over the situation, and that family doesn't really understand what all of this new equipment entails. My hands are tied as a bedside RN, because I am limited in what I can share with family. I am am wondering, all you ECMO nurses out there, do you involve ethics committee in all of your cases? Or just certain ones? I find our ECMO docs to be dreamers, and statistic driven in their treatment options, that they don't take a step back and think about the fact that this is a human life we are dealing with, not just another percentage point. Maybe be I am too driven by fate and chance to be an effective bedside RN for ECMO patients. I really love the complexity of the medical aspect of the patient, but it am having to force myself to not think of them as people in order to not feel heartbroken over the numerous lifelong ailments we are potentially causing them. I am ready to quit. I need feedback people.