December 08, 2005

Patient A

You arrive for the first of three shifts in a row and find that you are assigned to Patient A.

You discover the following about Patient A’s history:

Patient A came to the hospital for a very serious operation.

An event occurred in the hospital which has left Patient A in a persistent vegetative state.

Patient A’s spouse has decided to keep him alive at all costs.

Folks, this is no Terry Schiavo. We’re not just talking about IV fluids and a feeding tube. Patient A requires just about every form of artificial life-sustaining measures that you can think of. Patient A doesn’t live in a nursing home. Patient A lives in the ICU.  The goal of the caregivers in the ICU is not to cure Patient A; it is to stabilize this patient enough so that he may live in a chronic facility.

Patient A is infected with not one, but several strains of multi-drug resistant bacteria. These strains have been cultured from multiple sites. In the course of his care he has been treated with just about any antibiotic that you can think of.

Patient A’s body is an Olympic training ground for microorganisms.

Patient A is on maximum precautions; he requires one-on-one nursing care. The nurse who cares for him may not enter the room of any other patient, and other nurses on the unit may not enter his room.

You find that caring for this patient really makes you think. You have a lot of time to think. You are performing Q 4 hour assessments and nothing ever changes. After a day and a half you feel that you are resigned to the situation; that is, you are finished with being blown away by the sheer futility of it. And the spouse tells you that she has a stability ball at home, for when patient A is ready to do physical therapy.

 

 

 

Posted by PixelRN at 17:02:43 | Permanent Link | Comments (6) |
Comments
1 - Situations like this make me so sad. I dont know whether I should envy the spouse for her optomism or pity her for her naivety. But, assuming the steps you are taking to keep Patient A alive fall within his wishes, there is nothing you can do, but do your job to the best of your ability and hope that the pain and suffering that he and his family are suffering will end soon....one way or another.

Good luck to you and Patient A.

Dustin B.
http://azx-raytechstudent.blogspot.com (Comment this)

Written by: Dustin B. at 2005/12/08 - 18:45:41
2 - We have one in our unit. 170 days, so far. The family buys him shoes and puts the box on the bed so he can "see" the shoes he will have when he is ready to get up and walk. It is a strane road we walk. (Comment this)

Written by: Laura at 2005/12/10 - 04:00:54
3 - It is infuriating to me that a family can monopolize hospital resources for a patient who will never recover. (Comment this)

Written by: birdy at 2005/12/12 - 08:32:26
4 - I feel like I want to be angry but I think the more appropirate feeling is of sadness. Sadness for the patient, sadness for the nurses who know this fight is futile and sadness for his wife who is holding on to hope because that is all she has left.


I really liked your story and your blog is great, I am glad I found it.....Will visit again soon. (Comment this)

Written by: Unimum209 at 2006/01/06 - 04:58:13
5 - I inderstand how you are thinking and feeling you communicated it really well. I can see your compassion do your best your engagement with Patient A and family will be of benifit.
like your blog
regards (Comment this)

Written by: Alby Morris at 2006/01/26 - 12:08:02
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