I left work this morning and prayed that my patient be dead when I return this evening.
It felt wrong.
Praying for him/her to still be alive feels worse.
My patient is sick.
So very very very sick.
And the family is in denial.
They want the doctors to do everything they can.
And they have.
There is nothing left to be done.
My heart aches for the family.
They love their family member so much and they can't see that he/she is dying.
I wish my patient would get better.
But that's impossible.
Next to impossible, at least.
I want him/her to have a peaceful death.
Surrounded by family and loved ones.
That won't happen.
When I left my patient this morning he/she was incoherent and responding to only pain stimuli.
Temperature was 39.7.
I couldn't get a pulse or a blood pressure.
Respirations were 36 per minute.
Blood sugar was 28.6.
That may not mean much to you, but it means he/she is sick.
So very very very sick.
And on the way to the OR in a last ditch effort to appease the family.
I know the family isn't ready to say goodbye.
I would love for them to come to terms with what is happening with their loved one.
I would love to facilitate the grieving process.
But I'm torn.
I am a nurse and my patient comes first.
They have to.
The family unit is considered my "patient", but the one in the hospital bed is my priority.
And this particular patient is sick.
And the family needs to let him/her go.
I'm sad to say that we keep many people alive too long.
I don't want to sound insensitive or heartless.
I have never lost anyone very close to me and I don't know how difficult it is to be a family member clinging to a loved one you aren't ready to say goodbye to.
But I do know what it is like to sit there and watch a patient suffer because their family can't let go.
I do know how terrifying and painful it is to watch every move make someone writhe in pain.
I have looked into the eyes of a person knocking on death's door and pleading with me to take their pain away.
I have watched people gasp for breath and panic when they feel the next isn't coming.
I have also seen people peacefully passing from life into death.
I have seen families accept the inevitability and focus on sharing the last moments with the one passing.
I have seen families celebrating life until the last breath is drawn, helping their loved ones ease away.
A loving and accepting family won't necessarily make death less painful or terrifying for themselves or the patient, but they can certainly make it... I can't think of the word.
Death is never easy, but it can be beautiful.
This is what I hope for this family, though I am not expecting it.
At the end of the day, I hope my patient is at peace.
And I hope his/her family is there to support each other when the time does come.
I am writing this after being up for more than 24 hours so my thoughts may seem cloudy. For this I apologize. I do not mean to offend anyone and I hope you won't think less of me. Feel free to ask questions or leave any comments you may have.
6 comments:
tough. very tough. but I understand where you're coming from. very tough.
I can definitely see your side of things Ashley, and I'm not a nurse. I have had several people I was close with pass away, and I found the worst thing to do was watch them suffer. As hard as it is on friends and family, I think it's better to just let them go in peace.
Of course, when someone isn't a Christian it makes it alot more difficult!
On my mom's last day, we prayed for her to die. I told my dad to tell her that she could go now. I couldn't say the words to her myself but I know she needed to hear that. So, so hard to watch a loved on die. So, so thankful for eternal life.
Hey ash, I agree with everything you've said. I encounter this so often at work, it doesn't feel right to do things for the family that we know won't help the patient, the feeling of causing more harm than good isn't right. The patient in the bed is the priority, but advocating for the patient can be so hard when the family members are in denial (and we can't always blame them!).
I remember a specific case a month or two ago where finally after talking all day with different family members and building good rapport, the family told me they wanted to re-start antibiotics, put the patient back on high flow, IVF, etc, and keep the patient alive for another 24-48 hours so that family from overseas could come say their goodbyes. Long story short, called the doc, doc came back. But it was a comment i made where I said something the lines of "If you're family member (the patient) could communicate with you, would he say that he wants to continue like this or would he say that he wants to be let go peacefully with you there supporting him rather than pushing him to do more and survive longer." it was something along those lines, i don't remember exactly. I think it hit a spot with them. But of course every family is different. When the patient can no longer communicate or respond and every movement and intervention is painful and you can see the wincing in their body, it just isn't fair. It's not right. The young patients are especially hard to have this happen with, but its all hard.
I hope the family can find some peace that the passing of their loved one can be made into a beautiful and calm time. If/when they realize that, it will be a blessing.
Thanks for sharing ash.
And as a side note...anyone who reads this.. have that conversation with your loved ones!! About how far you want to go. We don't want to think about death, but it is a reality for everybody at some point. I've told my parents multiple times that if i was to have ________ happen to me tomorrow, i don't want ____ or _____ done. Not to say we know for certain what exactly we want, but it helps to open the doors of discussion.
Lauren I agree with everything you said. It is important to have those discussions with your family. It's important to consider quality of life over quantity.
How do you want to spend those precious last days on earth?
What kind of life would you have after whatever life-saving measures were taken to prolong that life?
Do you understand what those life-saving measure entail?
This gave me a lot to think about! How is your tender heart healing...?
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