Reply With QuoteAnd for all you uninformed:
G-et
O-ut of
M-y
E-mergency
R-oom
Patient Wishes? Get real Iam. If those patients had the faintest idea of what was in store for them, do you think that they would consent?
And for all you uninformed:
G-et
O-ut of
M-y
E-mergency
R-oom
What this issue needs is a very large amount of patient/family education starting at or before age 18. The saddest cases I see are the young adults who have had a catastrophic event and the family wants everything done (no LW in place). Most turn into potatoes and have no QOL and little dignity (in the 18 months I've been in my unit, I could probably show you numerous ones of these).
Take some time and go visit an LTAC (or better yet, work in one for a while). You will see what a lack of a LW and education does.
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Old_School said:
And for all you uninformed:
G-et
O-ut of
M-y
E-mergency
R-oom
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An oldie but a goodie!!!
Iam..to your questions:
1. No. It is not ethical to deny medical treatment to someone else simply to favor another, UNLESS it is a triage sort of situation where the recipient is deemed most likely to die despite treatment efforts. I don't necessarily mean triage on a battlefield here.
2. If a patient can speak or somehow answer in a decisional manner for him/herself then by all means the opinions of others should not override the patient. To do so otherwise when a patient is decisional is illegal, is it not?
3. No
4. No
I have never worked in ER did not know what GOMER meant also not getting the point here. But if you have no idea what is wrong with the pateint how can you make a decision not to treat some one? As far as number 2 goes I have run into that situation. and was curious to know how others would handle situation like that. To me it puts the nurse in a risky situation. With the order to do CPR and then don't family can come back and sue, if they do cpr family can come back and sue. I agree that we need to provide more education regarding what happens after a code is initiated. What are stats regarding outcomes. I have seen some that look promising for some and not so for others. I did a rotation in NICU and hace seen many babies revived and live a normal life. I cared for a 15 year old in a nursing home after she was in a coma for 3 weeks. I am sure it was expensive but she came back to normal. She was ventalated , trach the whole bit. I had a 96 year old lady in a nursing home that they were going to let go, she had pneumonia, family realy didn't want to let her go, so she changed doctors we started IV antibiatics 3 days later that woman opened her eyes and said " Boy, I thought I was a goner" she lived for 2 more years in this retirement community. This was a very tough lady, she enjoyed every minute of her life even in the nursing home. The problem here was that the family had to foot the bill for the ABT because medicare doesn't pay unless you go to the hospital for 3 days.
what I am seeing is people stealing even health care. Best part is the one that worked for it doesn't get it. This country is so infested with illegals that they will do any thing to any one. And us Americans just let it happen. They steal our jobs, they steal the food right out from our mouths. How about this one a 52 year old woman with health issues forced out of her profession, then gets kicked out onto the streets, no food, no money. She'll probably end up in your ER, dehydrated, condition twice as bad, then you will send her back out to go through this all over. Best part is that you will provide care for the illegal first. Why is that. Why can we not take care of our own. What if I told you this woman is an RN would that make any difference to you probably not. Which means that you do it to your own.
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lam said:
I have never worked in ER did not know what GOMER meant also not getting the point here.
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The point is ER personnel are overworked and understaffed. They don't mind busting their a$$ for a patient that can be salvaged and returned home. But after a couple of hundred sepsis/dehydration, resp failure/pneumonia(MRSA) NH specials, you kinda know how the story will play out. They will be good soldiers and treat but they are not happy. I guess calling the patient a GOMER helps them cope.
O_S
They usually come to the nursing home with MRSA, That's what I was talking about I don't see why we couldn't treat them at the nursing home and not even send them out. usually the dehydration is associated with an infection like UTI. I know what you mean, I had a lady with pneumonia, came to us with severe malnutrition, weight 67 lbs. developed pneumonia, had o2 all the time took mask off sats dropped to <80, so I put the o2 back on sats came up to 90% doc wanted her sent out to er to be eval. so I called to transport her. DON gets upset because I didn't call 911 and have all the sirens etc. pt. was 99 years old, she said we could have saved her if I sent her out quicker. She died a couple of days later at the hospital. She was a full code. I felt she was living on borrowed time as it was. She was not in resp. distress when she left the facility. would say a half hour made that much difference? "99 Years old"
Guess I wasn't making myself very clear. When I said LTAC, I was referring to 'Long Term ACUTE Care,' not 'Long Term Care.' IMO, 2 very different animals! The difference in the patients is the LTAC patients don't need ICU care but are still to complicated for the regular floor. They are usually long term vent depentant patients. These patients usually end up in a NH when they are finally weaned from the vents.
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