I know death is never easy especially for immediate family but I believe it is necessary to respect the patient's wishes. Recently we had a patient who was dying of lung cancer and decided he wanted to be a DNR because he was tired of the battle. On the last day of his battle the wife was very upset and wanted the doctor to undo the DNR but was unsuccessful because the doctor told her she had to respect his wishes. Later that night he died and the son went bezerk. He fought with his sister and demanded we do an autopsy because he believed the respiratory therapist killed him(nevermind the fact he was actively dying of end stage cancer). He was told the autopsy would cost $2500 and he said he would pay it. Then he decided he wanted the crime lab to do the autopsy so the funeral home decided they didn't want anything to do with the family. The body was taken to the morgue and the family was left with the responsibility of getting the body transported out by the next morning. Needless to say the family left three hours later but I am sure the drama continued.
My guess is this was his way of coping with his dad's death. People react different ways and usually need someone to blame! I can't imagine what would have happened if the patient had not made his wishes clear up front. I believe it is better to be prepared especially if you are terminally ill. It relieves the family of painful decisions and can also but not always avoid drama.
All comments are greatly appreciated!!!!!!!!
Hair vs. Chemo
14 years ago
well i agree with you totaly and i respect you for having to handle these kind of situations! It takes a lot to still have respect for the family when they are acting without respect towards you!
ReplyDeleteAlso agree .. part of the coping process maybe. I've observed several similar situations and worse. I'm not sure I could agree that its normal but it certainly is common. I've had many incredibley positive experiences with very down to earth people but the world seems full of disfunction and I say its important that everyone establish some legal guarantee to there wishes for ourselves in this situation. Sometimes DNR or Advanced Directives is all that prevents the family or guardian from deviating from the patients wishes. Its a shame really. I see Nurses doing more to protect themselves from the explosion of this sort of situation when "we should" be doing more to care for the patient and make them comfortable. USed the DNR and Advanced Directives as my "sheild and lance" in battle on occasion. Also seen lots of misconduct in every aspect of the healthcare system which serves more to derail our best efforts and creates suspicion and paranoia. What can you do but try to cope and survive it all.
ReplyDeleteI always sort of braced myself for it to some degree when I noticed even a hint of conflict. It can create some powerful anxiety and stress in the Nursing staff and care team in general. Important to educate when you can and make an honest effort to keep everyone concerned well informed of changes, progress, or decline in this case. Communication and documentation is vital but sometimes there are just to many other distractions to cover all the bases and despite our best effort, its just going to go where its going to go and the Nurse can find her/himself struggling to cope as well. Maybe someday in the not so distant future all of humanity will resonate with the same glorious sound of spiritual perfection and heaven on earth will become a reality rather than something we just hope for but place little confidence in. In the meantime .. a little Xanax couldnt hurt. :)