Prolonging life.

jam du jour: The Heart Of The Matter - Don Henley

I had a busy day at clinicals today (busy may even be an understatement to describe my day). It was a day where my clinical instructor became my best friend for about four hours, hah.

I'll never forget this case, because it really put into perspective the idea of prolonging life (and because I had to do a run down of the hospital's code procedure with my clinical intructor). You know, the idea of being full code or DNR, otherwise known as Do Not Resuscitate. As I received report during the change of shift, the first words out of the night shift nurse's mouth was "this patient is dying." My heart sunk. Not only is it a sad reality that you go from taking care of a patient to hopefully get them back to normal functioning to providing hospice care. Needless to say, this was not what I had in mind for my first med pass day (15 meds, plus an extra five to aid in her dropping blood pressure) and second day on the unit. This patient is still full code, much to the dissatisfaction of her son, who realizes that it is not right to keep her full code, as well as her own treatment team and the staff. There's more to the story but I'm not going to go much more into it, HIPPA regulations and all, but that's the gist of the situation.

It made me think about what I would do in this situation; if I were comatose, having gradual multi-system failure, solely relying on a vent, and deteriorating right before my loved ones' very eyes, would I want my life to be prolonged? Or if it were my own loved ones, my parents or anyone in my family for example, what would I do? It's hard to switch that full code to DNR, but sometimes it may be the right way to go. There's more that I want to say, but I should really start studying for my tests.

I did happen to find this blog about full code vs. DNR which I found interesting. I advise you to read it; it's a pretty short and a good read: DNR vs. Full Code.

I must admit that it has been a long time since a case made me ponder this much. Needless to say, I spent my day reporting vitals, giving meds, changing decubitis dressings, providing comfort measures, monitoring vitals, suctioning, turning, AM care, and, when things looked like they were going south for a period of time, taking part in the efforts to keep this patient alive. Afterall, just because you are told a patient is dying or even if you know that is the only prognosis, you don't stop providing care. Nurses, student nurses, whatever you may be, you don't stop. Put aside your own belief on the case of full code or DNR; even if you think that they should be DNR though they are full code, that's not your call. Do all that you can do so that you can tell the family that you did everything in your power to save them. You don't stop.