You are doing gods work... semi rant, wondering what its like for the rest of you

TexRN08 · Sep 15, 2011

This is why I find it so counter-intuitive when people say that withdrawing life support measures is wrong b/c it's "playing God"

flo136 · Sep 16, 2011

I guess it depends if you believe in God!

I agree we do prolong things now in ICU. And I do feel sad for those patients when you, and they, know the inevitable is coming. The hopelessness of it. But I am relieved when they do die, because ICU is a miserable place sometimes.

Y'know- I often think 4 hours a day in a shop would be just great. Not thinking, or knowing, about ICU.

But if you look at the stats for discharge out of ICU, and mortality, it's pretty optimistic. :nurse:

rn/writer, RN · Sep 16, 2011

I feel for you, Sirapples. There is a big difference between saving someone's life and forcing them to live.

Most people use the phrase, "playing God" when they think of ending someone's life. But you're right to point out that yanking someone back from death's door by any means possible just because we can also bears a striking resemblance to usurping the role of the deity.

Allowing someone whose body is worn out and collapsing in on itself to die with some measure of peace and dignity is not a failure. It isn't a lapse of care. And it certainly isn't murder. Calling an end to heroics and providing comfort measures in their place is a kindness, one I hope is waiting for me if I'm ever in that position.

Sirapples · Sep 16, 2011

Im glad Im not the only one that feels this way. I tell you what... when I get in my 60-70 Im putting in my will that the first person that forces the dr to remove a dnr and signs that paper that removes dnr status shall at that point forfit anything in my will.

detroitdano · Sep 19, 2011

Yes, it gets disgusting, but you have to really take pleasure in that 1 out of 50 who turn around and do well. If you think you're going to save everyone, or all families are sane, it will wear on you. Just document your actions well so that insane family taking you to court in 4 years has nothing to go on.

PMFB-RN, RN · Sep 19, 2011

So I was out the other night with my girlfreind who is charge nurse at boston medical center on a surgical floor. I work in an icu, I have been here for almost 2 years.
Discussion comes up about work and someone listens in on us and says to me.. you work in the icu? you do gods work.
I cant say this is true unfortunatly. I feel like I am stopping god from allowing the death with dignity part to happen. I dont know what its like for the rest of you, but I find a lot of chronic cases. These patients come in that are like 85, long histories, and you know that if they really had a choice in the matter they would rather die with dignity,... but instead end up trach, peg, with a picc, and just keep coming back untill they code for the 3rd time in 2 days and finally its stopped after being maxed out on 3 pressors and they code again. (I saw this happen once.) I often ask myself why?
I look at it like this... that I have learned a lot keeping patients alive that should not be and have been able to apply that to patients who are acutly ill and turn them around.. but I think this is like 1 out of every 50 patients Ive seen, and its a bit much. IT seems like sometimes our purpose is to just see how far we can keep people alive no matter what the concept of life is.
Also after I got over the initial... holy **** a vent, and wow 10 iv lines at once, and how pressors work, Im finding a lot of routine to this job. Yes often we are busy as hell, but the other half the time its... enter the vitals every hour, document document document until your fingers hurt. Draw the blood, reposition, do the bedbath, do the suction.
I like being an icu nurse. I was a nurse for 7 years before. Tele, medsurg, agency, and as soon as I started my first day of orientation in the icu, it was a humbling experience. It was like starting nursing school all over again where I knew nothing, where I used to be one of the strong nurses on the floor. Ive learned so much more than I ever thought...
But I will be honest, this job is not what I thought it would be.

*** Well said. My experience is the same. I sure as heck never think of myself as doing "god's work", of course nobody ever specifies which "god" they are talking about. Maybe I am depending on whose "god" they are talking about.

Day after day I see patients who have NO HOPE of having any sort of qualiety of life, those who could not be kept alive outside the ICU. We do invasisve, painful prcedures on these poor people. It bothers me a great deal. Several times I have refused to code particular patients in the interest of being the patient advocate and doing "no harm". I expceted to hear about if officialy but so far never have.

I wonder why it is our society simply can not talk about end of life issues. People suffer due to our unwillingness to talk about the end of life.

montinurse, BSN · Sep 19, 2011

I remember one shift I prayed the entire time that my frail, 80lb alert oriented lady would not code so I didn't have to break her ribs. Chronic COPD, failure to thrive, chronic issues, etc and only 60-70 years old... I could see every single bone and tendon in her body. I double checked with her that day that she wanted FULL CODE-YUP, that's what she wanted!

BacktoBasics · Sep 22, 2011

All nurses do “Gods work”. “For we are God’s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do”- Ephesians 2:10. I can expand that idea into other professions that everything we do is to the glory of God but that’s another discussion.

God has a plan for everything and everyone. Believe me he has enough power that if he wanted someone to pass, he would do it. I firmly believe that every patient will teach me a lesson. Compassion, love, patience . . not only for patients but for their families. You gave the example of a patient who was trach, pegd coded multiple times, etcs…I’m sure that situation will make you a better nurse for it. Maybe that was God’s plan?

Bottom line is, God works through us- you just have to pray for it.

rn/writer, RN · Sep 22, 2011

God doesn't overrule our free will. Not everyone believes in a Supreme Being or is interested in serving him. He doesn't pull rank. We live in a fallen world where many times the innocent suffer while the guilty seem to thrive.

I'm sure God can redeem some good from just about any bad situation. That doesn't make it any less terrible or hard on the victims.

It's difficult to think of exhausted patients with tortured bodies and clouded minds being forced to stay alive because relatives can't or won't say goodbye. But as long as docs are afraid of self-serving lawsuits, they'll probably acquiesce to the unreasonable demands of litigious family members and keep those plugs firmly lodged in the sockets.

Someday, there will be an accounting, but a lot of scores will go unsettled until that time.

Biffbradford · Sep 22, 2011

If you and your family want everything done for yourself, and you've got the insurance to pay for it, then why shouldn't you? There are so many things going on in the ICU that you could argue whether they are being done for the right reasons or not, but that's not what you're getting paid for. When the time comes for you or someone in your family to be put in that position, then you'll have you chance to 'do things right' in your view.

Oh! The stories I could tell!

PMFB-RN, RN · Sep 23, 2011

If you and your family want everything done for yourself,

*** That situation never causes me a moral or ethical delimma, it is also rare in my experience. If my patient wants everything done I am happy to do it and will advocate for their wishes. The situation that really bothers me, and is far more common in my experience is when assumtions are made about the care of a person who can not make their wishes known, or even worse when the patient's wishes are known but their family overides the patient's wishes as soon as the patient can no longer communicate their wishes (like when intubated).