so last weekend on my unit we received an ER admit: 100 year old female ruled IN for a hemorraghic stroke. SBP in the 200s, on a Cardene drip. Oh, she's a DNR. Throughout the night, the HR would dip down, then come right back up, BP was still ridiculous... we were getting ready to call the morgue!
Fast forward a week, I come back to work expecting for this patient to have moved on.... WRONG! This DNR patient had an NGT put in. She had been combative a few days before (her CT scan showed a GROWING intracranial bleed and developing hydrocephalus). I'm guessing she'd been dosed with Ativan before the CT result had been released. Well anyway, she slept for over a day and finally elicited a response when the NGT was put down and she was trying to swat it out of her nose. She'll do that every once in a while, meaning about twice a shift. Next day I took care of her the only response I was able to elicit was a moan about the Peri spray being cold. But other than that, nothing. She didn't even try to swat the NGT out of her nose. Here's the kicker.... she went in for a PEG tube placement today.
This is a patient I felt guilty about having to draw blood from... put a peripheral IV in... why are we invading her body with surgery??!! I feel like her children are committing crimes by putting her through an extended hospital stay, complete with needles, tubes and surgery.
Am I the only one who feels this way? My favorite PCA and I think the docs are trying to milk the insurance. lol.
