I work in an impatient palliative care/hospice unit. I take care of patients who are dying, and who are not in their right minds a lot of the time. This was yesterday.
Patient 1- There on respite. Said "Get the F out of my room!" several times. Had family drama about which sibling would be the lucky one to take care of her once she was discharged from the unit. One of them brought their kids and left them to race up and down the halls screaming. I asked them to take the kids to the lounge. God bless whichever sibling agreed to take her home for her last weeks.
Patient 2- On the call light literally every 2-5 minutes. She was confused and anxious. Kept asking me to adjust her pillow, etc. As soon as I would leave the room and before I had a chance to put my butt down in the chair to chart, she pushed the light again. Xanax helped her for an hour. God bless her. I would not want be taking the journey she had to take, the way she had to take it.
Patient 3- Actively dying, comatose. No family. Just needed meds sometimes. Just there, peacefully holding his rosary. God bless him.
Patient 4- Brought in from hospital in respiratory failure, to be taken off respiratory support upon arrival. Was told in report she was "semi-responsive, very close to dying." Patient arrived not adequately medicated "so she would not die in transport." Arrived kicking and screaming and tearing off her mask and trying to launch off the gurney, needing to be held down by four people to keep her safe. MD only gave me PO med orders which I questioned at the time, before the patient came in, and was told to try that first. Had to call MD and get IV orders. As I was approaching patient with syringe, she found the breath to yell, "I will punch your face if you get near me!" Husband said go ahead and give it. Patient became more peaceful, held husband's hand. God bless the inventors of Ativan, Haldol, Morphine, and other similar drugs.
Patient 5- Actively dying man, in terminal restless delirium. Hallucinating. Trying to slide out of bed, reaching up and calling for people who had passed to the other side already. Many PRN doses of Ativan and Morphine, trying to balance not too much drugs to make him stop breathing, with enough to make him comfortable. Very nice family at bedside. At the end of the day they told me, "God bless you and the work you do."