On the floor we coded a sweet LOL who was admitted 2 weeks ago for
cellulitis of her hand. She is a copder so she got atrovent q6. We got
to know her & like her alot.
Her husband was also a patient of ours who just passed away yesterday.
We got called to her room. Long story short, she is now intubated, in
the ICU.
Her family came in & said that she was supposed to be a dnr, but there
was nothing official in her chart.
How sad. Now she's trying to be with her husband. But, by god, we
don't let people die.
I am emotionally exhausted today. So it was chips, salsa & a glass of
wine for dinner.
Off to bed to do it all again tomorrow.
6 comments:
At the last place I was at, we had a husband and wife, both in their late 80's and COPDers on vents at the same time. It was really sad. The wife was intubated first and then a week later the husband was intubated, almost as if he knew she wasn't coming off the vent. They ended up dying within a couple of hours of each other.
A little bittersweet and a whole lot a erie!
That is sad. I also have never understood why, even if a patient is admitted with their DNR papers signed and on the chart, there has to be a Dr's order for DNR status. Even if it is the pt's wish to withold life-sustaining measures, the doctor still has to place an order saying we can do that. In what circumstances would it be okay for a doctor to us to start CPR if the pt wishes not to?
Sorry, touchy subject. The last code I did compressions in, the patient was on Hospice, but for some reason, about two hrs prior, the doc canceled the DNR order. Pt dies, family at bedside, and the nurse calls Code Blue. His daughter is in the room, screaming, "WHY ARE YOU DOING THIS TO HIM?! HE IS READY TO DIE."
Thank goodness after a few minutes of compressions the ER doc arrives to the code and orders the pt DNR. However, he died three days later, so his desire to be a DNR wasn't validated to the fullest extent.
That's one of the things that pisses me off the most about our job. We can't just let people die in peace like they want. We have to keep messing with them.
It's all based on what is ordered. Sometimes it feels like we help a patient die when the doc writes to D/C IV, D/C tube feeding, Morphine nebs, turn pt q1h.
And other times it's like we can't just let a patient die. They'll have DNR papers on the chart but no DNR order.
A sore spot with me, as well. There is no good reason to violate a written legal document that makes it clear that the patient has made an informed decision to refuse care.
Again, the medical ethical conundrum.
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