Day 16

Today I had the day off, finally got outside to explore this part of New York! It is pretty here but I am still waiting for spring to kick into full gear. I am tired of being cold all the time!

During my drive I had time to think about what had happened yesterday at work.

There was a patient that was not doing well, they were on a high flow oxygen nasal cannuala and they were still not managing to reach at least 90%. They were breathing more heavily through their mouth, so to buy time I placed a non-rebreather on them as well (a oxygen mask that covers your mouth and nose). The next step would be to intubate them and I was trying to avoid that.

This individual was older, confused, and unable to follow commands. They were not in a place to be making decisions for themselves. Given the probability of us needing to eventually intubate them, we called the family to discuss what they would like us to do. The doctor let them know that their family member had a poor prognosis if they were to be put on the ventilator and other aspects of their condition.

Then came the part where the children of this individual had to decide what they think their parent would want them to do. I have watched people go through this process several times. Do you let staff intubate? Do you put them on comfort measures? Do you have us do everything in the case of a code blue? Or do we let them pass without intervention? These are hard questions and hard choices for family members to make.

The family came to a consensus eventually, and we were asked to not do any resuscitation measures. I do not expect to see that patient when I return later this week. I hope they pass in peace.

I think it is important that everyone have those conversations with loved ones, so that you do not have to guess, you will just know what they want. It can help relieve the emotional distress that making a decision like that can bring. Better just to know, and hope you never have to use that information.

Britt.