Tuesday, September 9, 2014
Had work over the weekend. It sucked. Had to take care of a person who came as a direct admit from another hospital's ER to our unit that really should have gone to the stepdown ICU - as in RR of 34 with nasal flaring and major abdominal and shoulder breathing (just shy of sternal indrawing) so ya, pretty serious! ABG's came back as respiratory acidosis, however, person was DNR (including no intubation - YAAYYY finally!) but even said "If I knew dying would be this difficult I would have signed up for something different!" WHAT DO YOU SAY TO THAT?!!! I mean, they're 85 years old - so it's not like they haven't lived a good long life!
I tried to get ahold of family - called the contact number and left a message. Got a different phone number for a different family member - tried that one and was told it was the wrong number/person - and the other person was in another country several hundred miles away by plane and didn't want us to call them. We have to abide by their choices.
Next day, come in to find out that I would be now transferring this person to where they should have gone in the first place. Family has shown up. On the way to the SIMCU we talk about what would happen once we arrive - that the person would be put onto bipap since ma/pa decided to be a DNR - they didn't take that information well - they were shocked that this person would choose this without consulting the family! How incredulous of them! I explained that this was decided at several different points along the way - before any extreme fatigue and hypoxic confusion set in - spoken about to SEVERAL different HC professionals. That I (as well) spoke to ma/pa about this and was confirmed that no heroic attempts be made to save their life. What the family was so upset about was that one of the children was in another country and should this person die, that this would be a very bad thing and that THIS part should have been discussed first so that this person would be given the opportunity to make it should things turn south.
THAT part I could understand. But again, I had to stress to the family that the ultimate choice was still up to ma/pa and that all they could (we included) do was speak to ma/pa about their decision and maybe postponing it a bit until said family member could arrive at bedside since they were doing so poorly and required such measure as the bipap to be able to continue breathing.
Situations like this make me wish that I was finished my BSN and could follow this story. The little ol ma/pa was a sweet ol soul who I enjoyed taking care of. They had a bit of a spit fire about them. I hope that should they decide to maintain the DNR that the suffering is minimized. I think dying from a respiratory issue is a terrible thing since you are so acutely aware of air hunger when unable to breathe anymore. ya never know, ma/pa could pull a miracle out of a hat and turn a corner - crazier things have happened!
On an entirely separate note - almost started bawling this evening.... saw that Kate Middleton is pregnant with baby #2 - yay for them but boy does it make me feel blue (and green).... one of the girls is pregnant at work, I was happy for her.... then I found out one of my pals is also pregnant (was told just this past weekend)..... I'm really jealous (I'd say envious but I think I'm past that point). I WANT A BABY!!!! I WANT IT TO BE MEEEEEEE!!!! I know that when hubby decided no babies for us that I was crushed, but I figured that I could get over it. I'm not so sure. I want what everyone else is having but me. I know getting my BSN takes precidence but how do you balance the needs and the wants?! So ya, I was gutted by the news of everyone else getting the chance to be pregnant and have babies and I don't. It sucks and I just want to crawl under my blankies and wallow in self pity. Maybe I just will.
at 9:09 AM