Have I ever told you the story of why I left Pediatric Intensive Care?
I walked into work one day and one of our little patients went into respiratory arrest right as I finished getting report on her. We spent the next 12 hours saving the life of this poor little girl.
The patient had been born with problems (though all these years later I have no idea what they were) and was blind and deaf. In fact, she was non-responsive. She had been in the hospital since birth. Her mother was already pregnant with child number four and hadn't been to see her in several months. It was her father who had been faithful in holding vigil and wanted everything possible done for her.
It wasn't the intensity of the day that sent me running. It wasn't the profound sadness either. It was the fact that we put this 6-month-old through hell for the entire shift. Sure we kept her alive, but I felt no pride in that. I was so conflicted during the entire shift. I worked my tail off to keep this child alive while praying the entire time she would die and wake up in heaven.
She finally died, but not for another two weeks. Not until we had spent a few hundred thousand more dollars and put that child through every imaginable horror.
It was ethics that finally made me resign. It seemed wrong that all I truly wanted for this child was release from this life though I worked heroically to keep her in it. I finally decided a good PICU nurse should only think about life, so I moved to Colorado and started a career in Family Practice.
I would handle such internal conflict differently now. Maturity of self and career gives one perspective only time allows for. The truth is, much of life is filled with ethical dilemmas, but we, as medical professionals, seem to face them on a routine basis.
Have you had some situations like mine? How did you handle them? Do any of them still haunt you?
I came across the story of another nurse who faces a similar conflict. You can find it at http://well.blogs.nytimes.com/2009/03/18/a-nurses-distress-over-a-dying-patient/?hp
It's so helpful to all of us when we see ourselves in other people's stories. It makes us feel like we're not alone, wrong, or just plain crazy. Take a few minutes and share your story with us.
 |
|
|||||||||||
 |
||
search realityrn
sign up for weekly cartoons, tips, and blog posts
Register to win a pair of RX Medical Silver Fox Crocs
|
|
|
 |
April 8th, 2009 at 8:45 am
Like the writer,I have felt very conflicted with regard to what we do as nurses to promote life when it seems better to let death take a more natural course. Often families will intervene to sustain life when there is no quality and no hope for a better outcome. My earliest and most memorable experience came when a young woman with Cystic Fibrosis was being prepped for an abortion. I did not feel, as a matter of conscience I could be involved in the prep, altho I had no issues with her after care. I asked for an assignment change, and the whole staff went ballistic. One of my colleagues even went so far as to call the Nursing Board during the shift. When it was confirmed that I was within my ethical right as a nurse, the prep was done by the charge nurse and I cared for her post-operatively. At other times, I have watched colleagues call a’slow’code and it turned out to be best for the patient. Other times I have observed pain meds withheld because “how do you know what they’re feeling, they’re dying anyway.” It’s always a matter of ethics over medicine and often we do what is mandated by the family as well as the facility. To me, it is always a fine line. And, as stated by the writer, one learns with experience.
May 2nd, 2009 at 11:29 am
i am curious as to who makes the call about aggressive treatment. In this case, did the father want it, was the father made aware of the possible suffering and the likely prognosis.
Were you bound by law?
Can you tell us a bit more about the father/mother and their wishes and understanding of things and who was responsible for deciding how far treatment should go.
May 2nd, 2009 at 2:57 pm
I’ve worked in the ICU all my years (six years, but it sounds a lot better when I say–all my years)as a nurse. I have seen the medical torture we put people through. Such an experience would be even harder in the PICU.
There is one thing to keep in mind about nursing vs. medicine. Medicine (MDs, DOs, NPs)always, eventually fail. Always. Nursing, done right, never fails. Even if all we do is provide comfort and care to the end of life.
The secret to a good life is knowing when it’s through. Not many know that. Most people put physical life before honor and glory–what a horrible thing to do.
By the way, Andrea, you and your high morals regarding that young woman–good job 🙂