I don't like sizing patients for cane poles.
I don't like telling a patient it's time to stop fighting the good fight.
But, sometimes, it's the right thing to do.
End stage cancer. You didn't tell your family. You didn't want anyone to know how sick you really were. Now you won't stop throwing up. You can barely breath. I have to ask how much help you want.
If I put you on a ventilator, you will never come off again.
If I do chest compressions, electrical shocks, give drugs and get your heart back what kind of life would I be giving back to you?
Sometimes I have to have that discussion for the first time with a patient because they didn't want to have that discussion before. Family doesn't know what the patient would want because they thought they still had time. Had counted on the six months, the year, the two years they were told.
What happens after? I don' t know that I've ever been asked that before. Did you talk about burial plans? Cremation? Services? You have to let us know what the patient would have wanted.
There's a short window now to get it figured out because I've already written for the morphine. Soon they won't be having any pain at all...
Child of Morpheus
Take me to your sweet euphoria
Child of Morpheus
Hold me in my dreams
Tranquil angel
Falling with no fear of landing
Child of Morpheus
Close my eyes for me.
- Inkubus Sukkubus
4 comments:
(((Veronica))). You know, I don't know why more people don't talk about end of life issues sooner than later, especially if someone has end stage cancer. I guess people live in denial a lot or something. I don't know. But it must be tough to state the truth that has been there all along and people just didn't want to see it or get it out on the table so to speak. Kind of like the proverbial elephant in the room. We all see it but don't acknowledge it. The last few days of my mom's life she was on morphine (but she didn't die of cancer, fungal pneumonia). I think it was a good thing.
betty
I worked on a cancer floor for 10 years and have had that conversation many times. It sucks. I have had that conversation with my sons now so they know what I would want if the time comes I can't tell them. better sooner, then too late.
It must be very difficult to be in that situation. This is a good reminder for all of us to talk, at least to some extent, to our families about our end-of-life wishes, even if we aren't ill. We're doing ourselves, our families, and the medical staff a favor.
Hospice care is such a good thing but often used too little, too late. So many doctors see a hospice referral as a sign of defeat instead of a way to help the patient come to terms with the situation. So sorry you have to have these last minute conversations, it makes a hard situation even harder.
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