I was working the other week, and one of my co workers had a patient who had been going downhill. It was such a sad story - the husband and wife came to Canada from out east to visit their children and the husband had a stroke and the wife forced her husband to come to my hospital. He of course was admitted. Now of course when ppl go on holiday they don't (always) think to get health insurance so now that they're at my hospital, there's no way to pay for the care and so the hospital goes after the children's ability to pay.
During grand rounds I learn that this person has been going through cycles since coming to the hospital - that his doctor had been trying to make him healthy enough so that he could get on a plane to go back to his parent country. Unfortunately, he would get well for about a week and then would start to spike a temperature and would have to be held up and begin a round of antibiotics, and that would be the cycle. It was like EVERY time he was well enough to get a clean enough bill of health as is required by airlines to allow sick ppl onto their airplanes, he would spike another temp and wouldn't be able to go back.
The shift I worked, I was told by the nurse taking care of him that he wasn't doing well, his BP was REALLY poor but his O2 was alright, but that he didn't look good. Thankfully the family had made him DNR so at least if things went awry we wouldn't have to pound on this poor patient's chest to revive him and keep him alive for longer than he needs to be.
The nurse came out and explained that she thought he would die during that particular shift and felt that there wasn't anything that could be done to alleviate any suffering. She called the on-call doc, who just happened to be one of my favorite docs and he ordered some dilaudid for him and some scopolamine as this med dries up secretions and the "death rattle" is less so the family isn't as upset by it.
The doc agreed that he was in the final throes of dying and that it wouldn't be long before he died. I was talking to the doctor and a couple of the other nurses when the wife comes out to the nursing station speaking Hindi - a language that not enough of us speak but we did have a couple of ppl on at that time and we pulled one of them (the male of the two) to translate as the wife was trying to speak to the doctor and pull him back into the patient room. Now when we pulled the male nurse to translate the face he was making was hilarious and it was almost as though he had NO idea why we were grabbing him and it was hilarious so I laughed.
I found out when the doc came back to the station was that her husband had just breathed his last breath and was coming out to indicate this.
I felt soooooooooooo bad that one of the last things that this woman may remember will be laughing when her pain was excrutiating. I am not someone who enjoys seeing another person in pain. I wish I coudl have spoken the language with enough fluency to apologize for any pain that I may have inadvertently causing her.
Morale of the story - get health insurance whenever you travel, you never know what's going to happen and you really do need to be covered. And never laugh at ANY point in time if someone is dying on your unit, because it may be perceived in another manner in which you meant it. ESPECIALLY if someone speaks another language. They have NO idea why you're laughing, and nothing is funny when your loved one is dying.
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