Life is so unpredictable at one moment someone can be in no distress and before you know it, they are no longer in this world. In my experience while doing my practicum at the Jackson Main SICU (Surgical Intensive Care Unit) I have encountered an event that I can’t forget. I had this patient that I had previously taken care of before watched her condition fluctuate over the weeks because she was a long term patient. A little background of the patient include that she was a pre liver transplant that had NASH with contact precaution for a handful of things The patient is not really doing well and the organ systems are beginning to slowly shut down. The patient has a tracheotomy and is on a ventilator. Her past medical history included DM, hyperlipidemia, and Asthma. The patients’ health …show more content…
had been deteriorating over the past few weeks. She would get partially better, but suddenly get worse. Just recently on one of my shifts early in the morning as I had arrived to the unit I found out that she had been coding all night. I was with the night nurse discussing every possibility to try to help her out.
We had medication in mind but couldn’t give it because the patients’ condition was too unstable. As we were awaiting for the family to arrive, I could see the daughter really concerned. My patient was at that stage of her illness that basically she was alive because of the medications that we kept giving her. The only solution was for the family to pull the plug and get her off the life support. The daughter was just awaiting her brothers’ arrival so they could do it together. This experience really made me realize that the gift of life is so fragile and precious. The patient was nearly gone and was mechanically viable. Once the patients’ son had arrived, they had closed the doors and finally pulled the plug where all medication and air ventilation went to a complete stop. The patient passed away within seconds. The heart monitor went to asystole and she was no longer with us. I wasn’t in the room, but was outside observing the tough moment for the family and friends that were there for her last moments. There was a brief pause for a while and out of respect the staff had given the family support and
space. I personally hadn’t experienced this situation in the past, so I had learned a lot from it. Within a course of two hours the body was wrapped and sent to the morgue and the room was cleaned out. A new patient admission arrived post 3 hours after her death and that was the end of that situation. This incident was important to me because I had previously taken care of this patient. It is important for every nurse to learn how to deal with this situation. “Nurses developing skills and knowledge in this area will enable them to help patients and their families make smoother transitions.” (Moir, C., Roberts, R., Martz, K., Perry, J., & Tivis, L. J. 2015 p. 6) I had built a rapport with the patient so seeing her in this state until she passed away had really touched me. She had been interactive when I had first started practicum and as I’m about to finish my my time on the unit, she happened to pass away before my eyes. Her skin and appearance was much worse than I had seen her before. I realize that this is all part of life. This experience has not only taught me to be aware but also take a brief moment to appreciate life. Life will go on.
As a nursing student, I have had some exposure to death during patient care. My first encounter with direct death was witnessing a patient after attempted resuscitation efforts die in the emergency department. As I observed others reactions, I noticed I was the only one who seemed fazed by the preceding events and the end result, although I didn’t show it outwardly. During my Aging and End of life clinical rotation, I have been exposed to a near death experience with a family and I had the rewarding experience of forming a relationship with the patient’s wife during the short hour I was in their home. From reading the accounts in this book, it confirmed to me the importance of catering to the needs of the family and the dying as an important issue to address as they are critical to overall care.
This can be seen in the case study as ethical and legal arise in resuscitation settings, as every situation will have its differences it is essential that the paramedic has knowledge in the areas of health ethics and laws relating to providing health care. The laws can be interpreted differently and direction by state guidelines may be required. Paramedics face ethical decisions that they will be required to interpret themselves and act in a way that they believe is right. Obstacles arise such as families’ wishes for the patients’ outcome, communicating with the key stakeholders is imperative in making informed and good health practice decision. It could be argued that the paramedics in the case study acted in the best interest of the patient as there was no formal directive and they did not have enough information regarding the patients’ wishes in relation to the current situation. More consultation with the key stakeholders may have provided a better approach in reducing the stress and understanding of why the resuscitation was happening. Overall, ethically it could be argued that commencing resuscitation and terminating once appropriate information was available is the right thing to do for the
“Medical futility is a complex concept as there is no universally accepted definition.” (Chow, RN, ANP-BC, 2014) Futility was found among the group of colleagues on the ICU floor to mean a considerable use of resources without hope for recovery. The most common answers as to why medically futile care was provided were due to demands from family members and disagreements among team members regarding their plan of action. A major concern in these situations is that family members are left to make decisions without any health care knowledge. Communication is key here; critical care team members and family members have to try to overcome the difficult situation they have been placed in to figure out what is the best plan. The palliative care team should have been brought in sooner in L.J.’s case because on top of the lack of communication, “the case happened at the beginning of an academic year when new medical residents and fellows were just becoming oriented in the hospital system.” (Chow, RN, ANP-BC,
Obviously, the patient remains the sole priority during a situation of this magnitude, but providing a comfortable environment to not only the patient but also anyone else who may present is part of the job as well. Although it may sometimes be painful to watch a family member who is suffering, just their presence alone can bring peace of mind to the patient by reminding them that they are not alone through a scary process. A family presence during resuscitation has become more accepted by families, contributes to an improved level of comfort for the patient, and it pushes the medical professional to act quickly and correctly. It may not be true for every family, but it is important that patients do not feel abandoned in their time of need and also that members of the family feel that they were there for their loved ones. The presence of family during resuscitation is beneficial for the patient and it encourages the medical professional to strictly follow
The cases used for analysis in the current paper were based on a larger study of 14 cases conducted by Seymour in 1997. The data was from two different hospital ICUs within the same city in 1995 and the first two months of 1996. It was purposive sampling, so for participants to gain entry into the study they had to be in a critical condition and at a high risk of death. Along with this, patients had to be over the age of 18, not ‘brain dead’, and have a next of kin appointed. Participants were chosen who were critically ill as they were judged as being able to highlight the interactions that would occur between health care professionals and surrogates- next of kin and their health care team.. Participants who fitted these criteria were approached once they had been in ICU for no less than 24 hours and no more than 72 hours. Since particip...
It was a quiet and pleasant Saturday afternoon when I was doing my rotation at the surgical medical unit at Holy Cross Hospital. It’s time to get blood sugar levels from MM, a COPD patient. His BiPAP was scheduled to be removed before his discharge tomorrow. When I was checking the ID badge and gave brief explanation what I needed to do. The patient was relaxed, oriented and her monitor showed his SPO2 was 91, respiratory rate was 20. His grandchildren knocked the door and came in for a visit. I expected a good family time, however, the patient started constant breath-holding coughing and his SPO2 dropped to 76 quickly. With a pounding chest, the patient lost the consciousness. His grandchildren were scared and screaming,
(2007). The 'Standard' of the 'Standard'. A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU. The New England Journal of Medicine, 356(5), 469-478. Patton, D. (2004).
My journey to finally realizing of becoming a student in this RN Executive Program has been a long journey filled with excitement and disappointing periods. I 've started this quest in the Summer of 2015 and here I am, two years later, starting my first class in the program, Nursing 301.
I’ve sat and watched while patients asked for something and four hours later they were still waiting or asking again for something for pain. Once a patient passes away, they were just another statistic, less they had to deal with. Upon realizing this, I decided it was time to find a different job, so I too, resigned my position. I wanted to be with a company that put the patients’ needs above everything else. No, I wasn’t a registered nurse, but I was attending nursing school at the time, working for a local hospital. A patient lying in a hospital bed, I consider a friend or family member of my own, while I’m their
I am calling from PMH (Princess Margaret Hospital). Mrs. Bijoux dropped the phone and ran to her children’s room. When she reached her son’s room he was not there, she kneeled down on the floor and recites a prayer “Lord please let my son be okay”. Immediately, she called her family to pick her up and drive her to the hospital. When she arrived at the hospital, she saw her lifeless son on the ventilator in pulmonary distress with blood stains over his clothes.
Being accountable to me as a professional is saying yes to the call and responsibility we have to bear out. It is a responsibility we take for ourselves and for others who rely on us to be present in any situations. The mission requires an openness to relationship with others. The consistency of performing at a higher level each time the job is done and strive to give all for the greatest good. In collaboration with others involved. That bond can strengthen when everyone involved intersect their effort to the same purpose. The skills acquired over the years as a bedside nurses give me an opportunity to be dependable and trustworthy. Knowing what to do in difficult situations and being intuitive is a plus. It can help in a managerial position
To give up so much to save one man’s life is moving and emotional, and I really felt attached to every single event in the story. I feel I can relate to this sort of situation. When I was in hospital after breaking my jaw, I received a lot of support from my peers. My football team always wished me well in the Facebook chat group, the entire Oliphant house wrote me a “get well soon” card, and I had plenty of family members and friends visiting me while I was in the ward. That really meant a lot to me mentally and emotionally, and it would have been completely different
Nursing has been a long time childhood dream. Some may choose nursing for so many other reasons, for me nursing is my passion and I believe I have a caring personality which is a key point of nursing. Coming from a country that had been in a civil war for long since I was a little child, and growing up in that kind of situation, seeing everyday people die for even minor things because of no doctors or nurses available, left me with deep sadness and wanting to make difference in the lives of so who are in need. This experience had planted in mea caring natures that I want to make use of it. Coming to America has made my dream of becoming a nurse come true. I was able go to college while having a family as well. I have always admired what nurses do for their patients. Doctors only see patients for few minutes but nurses stay with patients 24, 7 therefore; physicians only make diagnosis while nurses heal the patient.
We as health care professionals need to work side by side with the families to provide the best care and decisions that are right by our patients. We have to be mindful of the cause and effect our course of treatment depicts for our patients. No individual wants to live in pain or misery, we all want to be healthy and happy and are willing to go great lengths to achieve this goal. Death is the final stage of life, but as we live and get older we start to prepare for death as to not fear death but accept it. Health care professionals may benefit from the opportunity to acknowledge, normalize and integrate death and dying into the continuum of life, both for themselves as well as their patients. (Sinclair, 2011) With advancements in technology and medicine we are living longer and fuller lives, and given time quality of life will only continue to improve.
First, I would like to start by stating that my expectation of a nurse is that he or she must be a good communicator, emotionally strong, empathetic, patient and calm, pay attention to detail and have good physical endurance. I feel that I possess these qualities which would make me very successful as nurse in the future. I have dream about being a nurse since I was a little girl and as a young adult, I still have the desire to be a nurse so I can help others. My desire to become a nurse evolves from past experiences that have taken place in my life; for example, my father’s death, my illness, personal experience and interaction with the hospital staff, specifically, the nurses.