A patient sick for more than a week with pneumonia, took a terrible turn for the worst. We called in hospice and all. The last few days she was drowning in white thick mucus. Terrible thing to watch and to listen to. She really looked so uncomfortable struggling to breath due to the secretions were so thick and copious. We got an order to suction PRN (already had atropine, Roxanol, and Ativan Intensol as well)from hospice. She appeared much more comfortable after suctioned. Anyhow, the night supervisor came in and really got upset...stating suctioning her was cruel. The family might I add wanted us to suction and I guess the supervisor was told this, the supervisor told the nurse on duty, "then the family needs education". I guess she directed the nurse to remove the suction machine from the room but the nurse would not do it ( she told her twice to remove it). Later the supervisor called another supervisor telling her all about it. I took report and was told about the supervisor comments. I suctioned the little lady x1 prior to her dying several hours into my shift. Ya know I worked with this little lady for months and would of done nothing CRUEL to her. And if the supervisor really thought this was such a big issue, why didn't she call hospice and get the order DC'd and go "educate" this family herself. This really burns my behind. I think this is her OPINION, and her opinion/how she feels about it should of taken a side seat. I guess she never even went in an assessed the patient, nor had any communication with the family. If the family wanted this done, and it made the patient more comfortable then what was her deal. I really hope she does not speak to me on this matter.:angryfire I had an order, the family wanted it and the patient appeared comfortable....get over it.
I'm with you. We treat it with meds. We avoid anything invasive. It's cruel and ineffective. Also, when someone has suctioned a patient, the tissues wind up excreting more fluid because they become irrated. A cascade effect winds up being created. Definitely not good for the patient.
yes...that certainly takes care of the dyspnea, and even the pt's perception of struggle.
but unfortunately, it doesn't do anything for secretions....something that drives family's nuts.
Some of my families mistake the "death rattle" for excessive secretions. Unfortunately, as the body fails, the airways collapse and snap open, you can't clear even minimal secretions, and there is going to be sound. It can't be stopped. Even when you educate families in advance, sometimes they still think the patient is drowning.
I just give more morphine. Makes them feel like we're doing something.
NurseyBaby'05, BSN, RN
1,110 Posts
Leslie-
I'm with you. We treat it with meds. We avoid anything invasive. It's cruel and ineffective. Also, when someone has suctioned a patient, the tissues wind up excreting more fluid because they become irrated. A cascade effect winds up being created. Definitely not good for the patient.