Awww...thanks for asking about me, Ann.. You
are the always kind, NHAnn.
Rough day at work today kept me there late. It's the kind of day that makes you think....
I had a 75 yr old patient, hasn't been doing too well, and slipping a little each day, with multiple medical problems. His family has kept him a full code. This morning the doc talked to them about it again, mentioning his slim chances for recovery, and they said they'd have to think about it. (I realize making your loved one a No-Code is a pretty hard decision for some people.) Anyway, this afternoon, 2 nursing assistants are working with this guy and I am out in the hallway talking with his daughter about his code status. She tells me she "thinks" the family has decided to make him a No-Code. While we talk about it(I can't go to the doctor with a "thinks" and ask for that order...big legal trouble), the monitor tech comes running down the hall and tells me his heart rate has slowed to 45. At first, I think his leads have come off, cause of the aides messing with him--otherwise, those aides in the room would have yelled for me--I was right outside of his door and they knew it....until I get to his bed and see that this man is as blue as a blueberry. One of the aides says "He's having trouble breathing". Our response? "He's NOT breathing" and I holler "Call the code" as I run to the daughter.
I tell her his heart has stopped...does she want him coded? No--definitely not (so, now you tell me

).
Now we have a problem. This guy does NOT have a No-Code order, but, the family does not want him coded and he is in a code situation. So,legally, we have to call the code, and the daughter can stop it once the ER doc arrives to run the code While that is happening, I am on the phone
trying to get in touch with this guy's fool doctor (and he is a fool) to get the order for the no-code.
After 4 minutes of listening to a recording and music, I finally get a person, ID myself and tell her I need to talk to this doctor NOW and why. It takes another 7 minutes to get him on the phone.

. Of course, by this time, the code team has arrived, and my supervisor is telling the ER doc that the family does not him to be coded. After talking with her, the ER doc writes the order and the code is called.
I, meanwhile, am still listening to this recorded music.
Thankfully, the man recovered spontaneously, and was still alive when I finally left. He was non-responsive.
BUT...and here's the moral of my story...afterwards, when I am talking to the daughter and telling her what's going on with dad, she tells me that the family made the decision early this morning to make him a No-Code, but, she couldn't bring herself to tell me

.
I realize this is a tough thing to do, but, is it any easier to watch me crack dad's ribs (and hear that crack, sounding like chicken bones on these elderly people) with that first compression? Is it easier to watch the ER doc stick that intubation tube down his throat as they ready him to be hooked up to the vent? Is it easier to realize, that with each compression, those ribs I broke may be puncturing his lungs, or, his heart? All the while knowing this as not what your family (or your loved one) wanted? ANd folks, the sad truth is, IF we are are able to bring your elderly loved one back, the average life span after that is 3 months....probably on life support
I know we all love our families and we want to keep them as long as possible. But, you know, there comes a time when it just isn't possible and we have to realize that. God didn't make these bodies to last forever. Why make them suffer so horribly, when death should be peaceful? Why hold on to someone who's tired of holding on and fighting the good fight and just wants to rest?
Why not make those wishes known before this even becomes an issue. What if that daughter had left before this happened? She was actually getting ready to leave when we started talking. Then all of the above would have happened to her dad....and nobody wanted it.
My husband is already aware of my wishes... If my condtion is ever terminal or vegatative---No Code.
Ok--off of my soapbox now....