Not really a question nor a thought provoking thread. More so a vent or even maybe a reaffirmation that this job can be very fulfilling at times; even in the smallest or ****iest way. I took two patients, and family’s, through the long process from “full code” to palliative care.
Pt 1: metastatic cancer, ascities, liver failure. Now septic although talking, and completely conversant. Still on “palliative chemo” per onc notes. Beginning of MOD’s with new renal failure. I get that patients/families don’t often here what we say and take their comments with a grain of salt; but state I am the first to to tell them the cancer was “terminal”. After a long discussion with son, daughter and patient about what I would need to do to treat they realized they all were tired of fighting. Got a hug from the entire family as they went up to the hospice floor.
Pt 2: elderly patient with ESRD who missed dialysis twice. K+ Was 7.6. Eventually increasing weakness/debility and was brought in for a fever. This was really initiated by patient. When family stepped out and I was talking to the patient they brought up that they missed dialysis because they were tired of it. Tired of the lifestyle and tired of living with that burden and was content to have lived a long fulfilling life. Very long discussion with the children and she was eventually discharged home with supportive end of life scripts. I don’t think all the children were happy but the son came up and gave me a genuine thank you.
Luckily both these were at the end of my shift when my patient load kept decreasing and I had the time to really go through options. Left 2.5 hours after my shift, but has been one of my most fulfilling. Both were documented full code PTA. No real medicine involved, no really tough decision making; but two patients I felt like I really helped and made a difference. I’ve got a beer in hand and the next 7 days off. I love the rescitations and the critical care but something special about walking someone through end of life.
That’s all.
Pt 1: metastatic cancer, ascities, liver failure. Now septic although talking, and completely conversant. Still on “palliative chemo” per onc notes. Beginning of MOD’s with new renal failure. I get that patients/families don’t often here what we say and take their comments with a grain of salt; but state I am the first to to tell them the cancer was “terminal”. After a long discussion with son, daughter and patient about what I would need to do to treat they realized they all were tired of fighting. Got a hug from the entire family as they went up to the hospice floor.
Pt 2: elderly patient with ESRD who missed dialysis twice. K+ Was 7.6. Eventually increasing weakness/debility and was brought in for a fever. This was really initiated by patient. When family stepped out and I was talking to the patient they brought up that they missed dialysis because they were tired of it. Tired of the lifestyle and tired of living with that burden and was content to have lived a long fulfilling life. Very long discussion with the children and she was eventually discharged home with supportive end of life scripts. I don’t think all the children were happy but the son came up and gave me a genuine thank you.
Luckily both these were at the end of my shift when my patient load kept decreasing and I had the time to really go through options. Left 2.5 hours after my shift, but has been one of my most fulfilling. Both were documented full code PTA. No real medicine involved, no really tough decision making; but two patients I felt like I really helped and made a difference. I’ve got a beer in hand and the next 7 days off. I love the rescitations and the critical care but something special about walking someone through end of life.
That’s all.