I'll keep to lay terms, but I have to explode this now or I'll boil over elsewhere and make a bad situation worse.


I see horrible things in the Emergency Room. From a guy who blew off his own head with a shotgun that somehow lived for a week before croaking to the anxious new parents bringing in a newborn with a cold and being relieved that it isn't serious.

Early this morning we had a hospice patient rushed in by her daughter. HOSPICE means it's a person who is terminally ill and only receiving treatment for comfort. There was no DNR(Do Not Resuscitate) order(which means no shocking their chest or doing anything if their heart stops). So we had to code this poor mom with end stage lung cancer who was obviously taking her last breaths. She had her wishes written down, but no ORDERS and by law that means we have to treat her as if she's a patient we can save.

We got her heart beating again, sent her upstairs to have a tube shoved down her throat to help her breathe and all those ugly, unpleasant things every dying person probably fears.

The stupid doctor sat down with the daughter and didn't explain to her that her mother was DYING! He just explained the procedures, and again by law I could not discuss this matter with the poor young lady. Her mother is 78 years old, didn't want tubes and just wanted to die at home.

Well, this lady JUST died not twenty minutes ago during yet another code.

A code is ugly. There's chest compressions, needles, tubes, yelling, it is the polar opposite of a peaceful death. I found her covered in feces and urine and bruises where she had IV's. I was the one who cleaned her up, folded her hands on her stomach and had her all ready for the rest of her family to come say goodbye.

A goodbye they were robbed of because of the daughter who just could not let go.

That mom is out of pain at last. But she did not have a good death.

The dying process in a terminal illness is almost like being in labor. There are physical and emotional signposts that tell you where a person is. As labor progresses the woman(if she isn't medicated with an epidural to block pain or whatever) might focus more inward on the workings of her body. In the same respect a dying person also turns inward. Even if they are unconscious and unresponsive they are still working inwardly on the final processes before their body stops.

Just like labor can be made horrible by too much unnecessary interference, death can be made horribly and unnecessarily painful by too much interference. That lady, I'll just call her Lisa Somebody, is a prime example.

Everybody do yourselves a favor, and make a living will. If you EVER find yourself in a situation where you are terminally ill and hope for a good death, PLEASE, PLEASE, PLEASE make sure you have a DNR. Nobody should have to go through what I saw.

My thoughts are with you having for to deal with all that. We had a DNR for my father-in-law who was dying of colon cancer. He'd already had a colonostomy, bag and all, and didn't want to do through anything else. My mother-in-law and sister-in-law took turns keeping him comfortable, supported and happy until the end, with the help of some TERRIFIC hospice workers (srsly, those ladies practically became part of our family!). He died peacefully at home, proclaiming to all that he was having the best death a person could possibly have.

Thank you for bringing the issue of DNRs and living wills to the fore. It is NECESSARY that you put these things in place BEFORE you become incapacitated!!! DO NOT assume that your family will accede to your wishes, or even be ABLE to do so. DO NOT make ANY assumptions about your care if you should be faced with a terminal illness.

My husband and I both have living wills and DNRs. My mother has one as well, as does my mother-in-law. It only makes sense to do this so that your family isn't burdened at a time like that with guessing what you might or might not want done.

Above all, it makes life SO MUCH easier on the medical personnel tasked with caring for you at the end. I shudder when I hear stories like this and, again, my heart goes out to you, Trouble_In_Shangri_la, for having to deal with such a horrible situation!!

~~Wiccan~~

I really believe a lot of the families who keep 92 year old granny or 101 year old gramps alive is guilt. They weren't there for them when they could talk, so they want to try to do all they can in the name of "help" when they're doing the opposite.

It's very, VERY sad.

I've had to code a 102 year old man with Alzheimer's so advanced that he had no idea who he was, where he was or that he even existed. Poor guy coded three times before whatever Powers that Be said "ENOUGH" and yanked him to Heaven.

It happened on Christmas day, and his family got to watch. They were not prepared and were probably traumatized.

Look at poor Terri Schiavo and the spectacle made of her last days. In the end nobody was home after all.


A lot of my work frustrations came out in Embrace the Silence. I should have added in my feelings about people keeping others alive when there is no quality of life. Just because we CAN doesn't mean we SHOULD!

I understand and agree completely. The same holds true for beloved pets, quite frankly. Just because we have the money and technology to prolong life, does not mean that we should do so when there is no QUALITY to that life.

To me, it is horribly difficult to hear of people taking all these heroic measures to prolong their loved one's lives when the reality is that their loved one isn't really THERE any more. That's why DNRs and living wills are SO VERY important. You can't always reason with distraught family members, even if you had the ABILITY or the LEGAL RIGHT to do so. It's a terrible place for a health care provider to find themselves in and, for that, you have my utmost sympathy!!
:/
~~Wiccan~~

Good advice Shangri_la, sorry you had to go through that but I am glad you have the courage to not only do your best, but also endure the worst.

Poor Trouble_In_Shangri_la. That is a tough day at work. I have dealt with those frustration from the other end of the problem. Dealing with the relatives who can not let go of a dying loved ones. It sucks tryign to convince another family memeber to follow the wishes of thier dying loved ones. What a diaster that is. Makes family get-togethers afterwards really akward. To ease the burden of your mind many people do talk with family and loved ones about what to do in these situations(atleast in my family). It made for a very akward conversation my parents had with me when I was little. No ten year old wants to hear aobut that kind of thing involving their parents, but If something were to happen we were prepared and knew thier wishes. I recently wrote a paper on end-of life-issues in regards to DNR's, living wills and even Washington and ORegon's "death with Dignity" acts. Heartbreaking things to think about, but good information to know. On behalf of patient's every where, we thank you for your tireless efforts, work and compassion. I may not be able to completely sympathize with your plight but I understand the frustrations of dealing with family members who can not let go andor accept the inevitable (not sure on spelling for that last word).
Thank you for your caring of us here at Dokuga and all others. Nursing is a very noble profession.
PS Wiccan, its really is true for pets too.