Thursday, January 7, 2016

Every Nurse's Nightmare: A Dying Patient With a Frantic Family and No DNR in the Emergency Room

Shared with permission: I think I would be accurate in saying this is every nurse's nightmare.

The 86 year old female comes to the ED via the ambulance ...from her nursing home. She is fragile and frail and non-responsive. Her eyes have a fixed glazed stare. She is in a fetal position, brittle bones, decubitus ulcers everywhere. Her few family members come bursting through the ED doors screaming: 'DO EVERYTHING. And against our morals, against our compassion, against the need to have dignity to this little ladies' last days on earth, we present her with rapid CPR compressions, we feel her tiny ribs crunch and break, her blood pressure is 60/30 and she barely has a thready pulse. And we give her epinephrine and atropine and we continue to compress her chest deep and fast, and her heart rate speeds up to a chaotic fibrillation ... And we scream 'All Clear' as we force an electrical current through her heart..... And we watch her have seizures and loss of oxygen to her brain and leave her with a faint thready pulse and too much time for no oxygen to her brain.... And she 'survives' these insults that we force upon her, leaving an anoxic brain in her contratured body.

And the family is pleased: 'Praise God', He brought her back... It is God's will. She'll live to be 100. And we the ED nurses, we the ICU nurses bow our heads, because we know we brought pain and torment and assault to this tiny malnourished lady who once had a vibrant life.... Who once had a full life... But slipped into the tunnel of dying... Almost peacefully until her family forced us nurses and us doctors to bring her back with intense pain and torment.... And instead of going to heaven... Instead of being in heaven and resting in peace... WE condemned her to a living hell.

Prepare your moms and dads, grandmoms and grandpas and allow them to drift peacefully into that other world. It is not heaven on earth... It is a hell. A hell that is hell-bent, filled with pain and misery.

Your turn.

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