My grandfather, who, I have to mention, raised my sister and me along with the help of my grandmother, was involved in an accident on April 13 '04. He received multiple injuries on the left side broken clavicle, scapula, shoulder, all but 2-3 ribs (both sides), shattered hip, broken pelvis, femur, ankle, wrist, neck, and a tear to the aorta.
He was sent to the Elvis Presley trauma unit in Memphis, TN. while he was there, he received amazing care from some very qualified nurses. Thank god there are those that can do it. By the way, I am not a nurse yet and will begin my nursing classes soon, so I have a few questions. On may 22 we arrived at the unit and stayed most of the day (we were given unlimited access to him, and I knew enough then to know that they weren't very hopeful). Anyway, during the afternoon we had asked if the vent was the only thing holding him and they said no that his heart was still holding up and that his blood pressure was stable. Knowing that we went to eat and when we returned his pressure had dropped, and we were told that he could live a couple of days more b/c of the vent or we could disconnect and it would only be a few minutes. After a family meeting and a meeting with a Chaplin, we decided to disconnect and let him go. the staff was fine with that and agreed that it was the best step
I was waiting to be prepared for what to expect, and no one said a word, they just began disconnecting everything to make it as quiet as possible so that it would be peaceful as possible. Well, what happened after that was something I don't believe I will ever get over. He had been on morphine for a while and was nonresponsive before they started the disconnect, and then immediately when they disconnected the vent his eyes flew open and he looked at me with a horrible look on his face as if screaming from his mind that he couldn't breathe and what is going on.....he then began really struggling and turning purple and his tongue hit the roof of his mouth and he was making horrible noises and tears started pouring out of his eyes. So, my question is, is this the norm, are family members usually not prepared for this, and how am I supposed to help patients when I become a nurse (which I am seriously beginning to doubt that I can now)? I feel like I will just be reliving this over and over. He was like my dad ... sorry for the long entry, but this is bothering me, shouldn't they have prepared us even a little? And just for the record, I could not have left the room regardless; I could not let him pass alone. Thank you for your time, and let me at least get this off my chest for the moment.
i wasn't quite sure where to place this question. my grandfather, who, i have to mention, raised me and my sister along with the help of my grandmother, was involved in an accident on april 13 '04. he received multiple injuries on the left side broken clavicle, scapula, shoulder, all but 2-3 ribs (both sides), shattered hip, broken pelvis, femur, ankle, wrist, neck, and a tear to the aorta. he was sent to the elvis presley trauma unit in memphis, tn. while he was there he recieved amazing care from some very qualified nurses. thank god there are those that can do it. by the way, i am not a nurse yet and will begin my nursing classes soon, so i have a few questions. on may 22 we arrived at the unit and stayed most of the day (we were given unlimited access to him, and i knew enough then to know that they weren't very hopeful). anyway, during the afternoon we had asked if the vent was the only thing holding him and they said no that his heart was still holding up and that his blood pressure was stable. knowing that we went to eat and when we returned his pressure had dropped, and we were told that he could live a couple of days more b/c of the vent or we could disconnect and it would only be a few minutes. after a family meeting and a meeting with a chaplin we decided to disconnect and let him go. the staff was fine with that and agreed that it was the best step.......i was waiting to be prepared for what to expect and no one said a word, they just began disconnecting everything to make it as quiet as possible so that it would be a peaceful as possible. well, what happend after that was something i don't believe i will ever get over. he had been on morphine for a while and was nonresponsive before they started the disconnect, and then immediately when they disconnected the vent his eyes flew open and he looked at me with a horrible look on his face as if screaming from his mind that he couldn't breathe and what is going on.....he then began really struggling and turning purple and his tongue hit the roof of his mouth and he was making horrible noises and tears started pouring out of his eyes. so, my question is is this the norm, are family members usually not prepared for this, and how am i supposed to help patients when i become a nurse (which i am seriously beginning to doubt that i can now)? i feel like i will just be reliving this over and over. he was like my dad........ sorry for the long entry, but this is really bothering me, shouldn't they have prepared us even a little? and just for the record i could not have left the room regardless, i could not let him pass alone. thank you for your time, and letting me at least get this off my chest for the moment.
i am very sorry for your loss. i too, have struggled with the decision to disconnect life support on a loved one. my father after 7 months of getting better while still on the vent, dropped his b/p, developed brain death due to low b/p, and even though i am a lpn and i have seen death, i still didn't know what to expect. it took my father about 15 min for his heart to stop, even though he stopped breathing the instant they disconnected the vent. when you do become a nurse, just remember the families and remember to fully explain what will happen if you can. sometimes you don't know how a person is going to react during the process of dying. good luck
As a trauma nurse at a trauma 1 hospital, I have been faced with similar situations. I have only been doing trauma nursing for one year, but I don't think I have come across a case where we have removed pts from the vent because their bp was dropping, b/c there are meds you can give for that. The cases I have seen have been in people who had head injuries that left them brain dead which in turn would have made them vent dependent and they would have had no chance at a normal life. The doctor's and nurses at the hospital you spoke of must have believed that the medications to help your grandfather support his bp would have only prolonged death for him, in this case pts and family should be aware of the respiratory distress and changes that pts exp. when they are nearing death of a non-resp or chronic resp. nature. Of course the doctors and nurses had more insight into your grandfathers med. hx. I am very sorry to hear about your loss, thank you for helping me to become a better trauma nurse in the event that I am faced with a situation like this one.
Specializes in Case Mgmt; Mat/Child, Critical Care.
I have no words of wisdom for you, just want to say how sorry I am to hear of your grandfather's passing. It is indeed a difficult time for all. My prayers are with you and your family.
Thank you for writing your letter. My mother has been on life support for a little over a month. Your letter helped me in my resolve not to take her off of life support, in spite of the pressure to do so.
What a lot of people don't understand is, I am more concerned with how my mother dies than when, and I don't believe that being taking off the ventilator is a pleasant way to die, either for the person who is dying, or the people watching.
Thankfully, her primary doctor agrees. He said that there was no use rushing things as long as she doesn't seem to be in any distress. He said that either she would get well, or she would go into complete system shut down. If that happens, she will go into a deep sleep and her heart will stop.
I did sign a code 2 order, so that if her heart stops they don't have to try and start it again, but they are continuing the care she was already receiving, including the ventilator, peg tube feedings, and dialysis when she needs it.
Thank you for writing your letter. My mother has been on life support for a little over a month. Your letter helped me in my resolve not to take her off of life support, in spite of the pressure to do so.
What a lot of people don't understand is, I am more concerned with how my mother dies than when, and I don't believe that being taking off the ventilator is a pleasant way to die, either for the person who is dying, or the people watching.
Thankfully, her primary doctor agrees. He said that there was no use rushing things as long as she doesn't seem to be in any distress. He said that either she would get well, or she would go into complete system shut down. If that happens, she will go into a deep sleep and her heart will stop.
I did sign a code 2 order, so that if her heart stops they don't have to try and start it again, but they are continuing the care she was already receiving, including the ventilator, peg tube feedings, and dialysis when she needs it.
Someone should have prepared you on how it might go, or perhaps the Chaplain should have or the doctor. Maybe the nurses thought the doctor had. But it's never the same, so all the prep in the world couldn't necessarily prepare you. Death sometimes isn't a pretty experience, even with people who aren't being extubated, many struggle for that last bit of air as they pass, some are extubated expected to live minutes and live for days, regardless of the amount of medication they receive.
Still, it was the right thing to do.
Perhaps this experience will help you better emphasize with others undergoing this experience.
That's terrible.. I'm sooooo sorry you went through this. I've been a critical care, trauma, er nurse for many years. I must say, I don't know the family dinamics, I wasn't there so I am careful not to judge the events of that day. There are many emotional and tech events in such a procedure. The top and formost one above all no matter what, is the comfort of the pt. The way we usually do it is make sure the pt is sedated with morphine, dipravan , ativan etc....what ever is needed to maitain comfort prior to extubation. Usually there are very high dose limits are ordered to ensure the comfort. If the pt is extubated and awake and are doing fine (not struggeling), then that's ok. If they're awake and struggeling then we do what is called symptom control to ease the pt . The goal is a peacful death. As , unfortunatley , you've discovered, a death that is difficult leaves so many feelings that are difficult to deal with. I'm not saying the staff did anything wrong, because I wasn't there, don't know the exact details. But, none the less, you know that your grandfather is OK now. Now it is time to deal with your feelings. Be sure to care for yourself , It sounds like your grandfather was the type of person that would want you to come to terms with his death and move on your way to a happy life for yourself. Please talk to someone about this, counselor, clergey etc. It would be such a shame to loose someone like you to nursing that obviously cares about people. Think of it this way, you may be able to help another family that is going through the same issues. Remember, take good care of yourself. My thoughts are with you.
Its nice to know that this isn't the norm for everyone, although it will never remove this experience from my memory........Thank you for your thoughts and any others that may have some other thoughts to offer also.
I am so sorry that you had to go through this.
While what you went through is traumatic and horrible, it did not happen in vain. When you become a nurse, you will never let your patients or families go through the same experience.
nckdl
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