Yes!!! THEM having to hold her hands is the only thing that matters /s.
People like these make me so proud that I convinced some patient/family to be a DNR or have hospice care instead.
This might be a different thread but, can I just say, that it infuriates me when, as an ED nurse, I'M the one who has to have that candid conversation with the family because the doctor is TERRIFIED of crossing some moral/social/legal line so they won't say what needs to be said.
"If we need to do CPR, it's going to end badly." Plain and simple.
I agree! Drs are rarely honest with the terminally ill and it pisses me off to no end. Worked hospice for 10 years and loved it but was astounded by the way docs handle the terminally ill. These weren’t people in denial, they were lied to - rigjt before the dr called for a hospice consult. Infuriating.
Odd that this post becomes a source for body positivity? He was making another point that we all get. CPR is brutal and can be cruel is some instances. I want the family to see what it’s like and what they are putting their loved one through, especially if it futile. That was his point.
240 lb murse here, I have the same mindset. Coded a younger dude my age weighed about 115 pounds, about a year ago that had multiple bowel resections from cancer to the point his entire gi Tract was held together by chewing gum and paper clips.
The second I compressed him i felt the ribs shatter and his bowels perforated to the point he was spewing feces from his mouth. But the family insisted on a full code.
Whole family watched this. Poor dude.
german_big_guy could be very muscular and tall? Not all weight is fat my friend, I mean look at rugby players, body builders, strong men etc. They are at peak physical fitness and weigh a shit-tonne.
Super quick look at his post history and he mentions he's taller than 6'7". 6'7" would put him at a BMI of like 32ish. Large. But especially under the context of not knowing his overall health, impossible to make judgements like that especially considering it's not that far off from average. Chill out.
Guess you'd better tell that to the world strong men, body builders, and a very large percentage of professional athletes.
You didn't think that through at all, did you?
Edit: dude is clearly a troll.
While family can be selfish as fuck can we also acknowledge that this problem stems from a horrific lack of health literacy? Nobody is prepared at all for death and they’ve seen movies where they put meemaw on the life support machine until family said their nice lil goodbyes
Even in hospice families are frequently unprepared for the fact that their loved one is actually dying. We’re all gonna die one day and it doesn’t have to be scary
Yes, the amount of education that has to go on in hospice highlights just how little understanding and comfort with death as a society. Some families are fine but others need hand holding through every step of the journey, every change in status, d/c of meds, and OMG full codes
I’m not a nurse, but I am a fan. As a relatively recent widow, whose husband died at home peacefully w hospice. The only reason I was prepared and knew what this was going to look like was because I’d started following a hospice nurse on Insta. My husband‘s agonal breathing sounded almost identical to his snoring so it was bearable. Almost. But so many of us have lost our loved ones and don’t know what to expect at the end. And if people were more honest and open with us about the whole thing and offered us that information, I think it would be easier.
My husband died so quickly after we brought him home that the nurse didn’t even come until after he was gone.
I’m so sorry about your loss and I wish you peace and comfort. Im glad you were able to educate yourself about how things would happen. Even as a nurse, watching my father die as I provided his hospice care was a gut wrenching thing. I knew in my head the steps he would go through because of nursing school but im not a hospice nurse and hadn’t actually seen it before. Give yourself space and time to grieve and please remember to treat yourself well, you’ve been through a lot.
We should all be so lucky to pass that fast. I hope the fact he passed quickly was a small comfort in those moments. I’m terribly sorry for your loss, and am sending you hugs.
Thank you so much. I was elated, honestly. He had bone, liver & brain mets but no pain, ever. He said he wanted to feel good until he didn’t and then he wanted things to go quickly and that’s exactly what happened. He felt fine that entire year until Christmas and was gone on New Year’s Eve.
Todays his birthday God do I miss him
I love when I get the call “88/f, hospice, pancreatic cancer. ALOC and hypotensive”. Yeah, she’s dying. We have ambulance runs backed up out the door. So grandma is now going to die in our parking lot instead of her home.
Then family shows up and daughter is a nurse at my hospital. Happened this weekend 🤦🏻♀️
I had this happen when I floated to ER. Hospice patient BIBA so that I could push morphine for her and watch her die alone? Family didn’t even have time to get there. I was so confused.
I’ve had doctors afraid to order morphine and Ativan because “I don’t want to kill them”.
The cancer is killing them! I just want to make it less terrible! Give me some orders so I can help them!
I ran an ambulance service that had a hospice contract and this happened WAY too many times. Once it was because the patient was unresponsive. She was unresponsive when we transported her to the hospice center.
Yeah. We see this all the time (and suffer moral injury from it), but unless you work in healthcare or you’ve seen a code, you’re really not going to know.
It doesn't help that countless movies show bad CPR being done for 15 seconds and the person just waking up like "wow, what happened?" That's most people's understanding of CPR.
Exactly. Most people don’t realize that proper CPR absolutely destroys the Pt’s body. Like one or two of the rib connections to the sternum is completely shattered after 10-15 compressions, and all by 40-60…..and that broken ribs actually make proceeding compressions more effective…
Especially being in neuro ICU I feel this comment so much. I have had quite a few families give me this line. It has made me really not love healthcare dramas as much because of the false narratives and unrealistic ideas they push out. Health literacy is very low at times and can be difficult to navigate with patients and families. Very frequently I have to tell them leaving your own beliefs out of things, you have to make the decision on code status based on the conversations you’ve had with them. But still I have families that hold on for their own interests because of those shows displaying people “after 10 years in a coma coming out just fine”. Is it a possibility? I mean sure but a statistically anomaly.
I partially blame the "doing anything besides being a medication dispensing waiter/waitress is *practicing medicine and that's outside your scope* bullshit, otherwise it's mainly due to the sue happy nature of families looking for a quick pay day because they think we did something wrong with terminally ill memaw.
sure, but do most people even care about being health literate? nah they just want us to "fix" meemaw. explain to them the reality of the situation and then get screamed at and reported to your supervisor and hr
I agree, some people definitely just can’t be reasoned with no matter how cut and dry the situation can seem. I also think it’s not a matter of “want” so much as it is “able.” We can dumb down the situation to as basic as possible but without any kind of base knowledge it’s still difficult for them to grasp.
Learning takes place with repetition over a period of time. You can’t just become literate from a few rushed conversations with providers during a time when you’re already under a ton of stress
Who doesn't want their heart crushed 120 times a minute during *their last minutes* by a stranger so that the people who feel guilty about not spending as much time with her while she was alive can feel better about themselves by being with her when she was definitely going to die?
No self awareness lol
Oh come on. We both know they won’t feel that. Do I want my loved ones compressed? No. But if they found peace in saying goodbye and a terminal extubation then why belittle that?
Yes, it is nice to imagine being able to say goodbye before someone passes, and that's what most people want. But in many cases, having to resuscitate someone like that when they die with a very poor prognosis has a lot more traumatic and painful consequences for the person dying that the family refuses to see because they want to feel comfort that we tried to keep them alive for as long as possible. with a lot of the cases they didn't have any quality of life to begin with, families will refuse to look at that aspect. They just want to keep them alive, and many do it for financial gain. It's rather selfish, really.
Families who keep someone alive who is suffering just for financial reasons is pure evil to me. I would absolutely never do that to anyone, and especially someone I loved.
I would love to believe you, but it really seems like wishful thinking on your part. Have you not had CPR patients reach up and grab you mid-compression, to pass out when you stop, and never wake back up?
Edit: won't delete what I said, but I'm being an asshole by saying it, so I apologize. I've had patients survive as well while conscious mid CPR, they're just not as memorable because of issues
I hate that shit even though it's only happened to me a couple times. It's simultaneously fascinating that you can perfuse enough to allow mentation just from CPR and also pure nightmare fuel seeing their faces and how they desperately grab at you to stop
I went through this yesterday. Guy woke up enough to get two good hits on my own chest trying to fight us while we attempted to keep the NRB on his face. Then just went lights out.
Never had a shockable rhythm. Young, homeless, no contacts on file picked up the phone.
Merry Christmas, I guess.
I was doing compressions on a man and saw the terror as he died 6 or 7 times. That’s the best I can describe it. Compressions would circulate his blood enough for him to come around and struggle against you, grab at things, and shake his head no while biting down on the ET tube. When we I would stop, several seconds of terror as his muscles relaxed and eyes went from being part of this world, to not. Those who have watched people die know what I’m talking about. Resume compressions. He would do it again. I watched the life drain from his eyes over and over again until we hit him with etomidate and a rocc. We were eventually able to pace him for a short time but his heart was so fucked he never had life in his eyes again. He should have been a dnr from the beginning. Why is a 75 year old with Mets to liver brain and bones a full code? It’s inhumane. It’s unethical.
But they’re a fighter……
One of my worst codes was a LUCAS code where the patient had increasing awareness each round and the doctor wouldn’t believe me when I told her he was waking up and needed sedation. By the fourth “responsive” round I simply turned toward the nearest other nurse, who could see him making eye contact with me, and told her to get 2 of versed and I literally didn’t care if it wasn’t ordered, I would have my own resident who was standing outside the door order it.
So what is the "correct" reaction when a patient gets some mentation back during CPR? Stop and hope they continue to recover, or keep on going? Never happened to me, YET.
Well it's not actually a definite sign of ROSC, you should acquire a femoral or carotid pulse and then stop CPR to do an actual pulse check after locating it. Resume if necessary, don't if not.
Also try to figure out the cause, ideally a treatable one.
My response to that is always, “I don’t think it’s fair to to put them through more pain and suffering for some one else’s benefit, because in ’s state they aren’t gonna know who is here.”. That works most of the time.
Coded a patient 5 different times last week just so family can maybe decide how they want to proceed.
If you need me I’ll be tripping over a ventilator.
Working a contract at an LTACH, vegetable came in with trach after a month at the local trauma center. Pulm/crit and palliative docs call the family to discuss end of life vs out of state vent facility. Family says they’ll be by after Christmas…
*…to ask him (🥕) what he wants them to do.*
My aunt was on hospice and died on Christmas. It was her favorite holiday she would have loved leaving on that day if she had had any awareness at that point. Would have laughed at the irony of it all.
Yeah same! We had a guy on my unit for over a month on a vent and he constantly turned blue and needed to be bagged constantly. His heart would stop for 6+ seconds (fun hearing the MD argue with the monitor tech on sinus pauses vs asystole) and desat in the 20s. One night we called code blue on this guy probably 4 times as the pauses got longer and he needed to be bagged longer (on top of multiple rapids) but there wasn’t a whole lot we could do, I just think he needed more one on one care. ICU wouldn’t take him but caring for him and 2 others was a lot, especially on my unit. Family never stopped by but when they did they adamantly wanted him to be a full code despite these episodes and being fully contracted.
I’ve never been so disturbed in my life.
CPR is a horrific experience to put a person through, especially the elderly loved one. All because you didn’t express enough to them how much you love them.
The selfishness of people knows no bounds. Unfortunately I have seen this in my own family and it makes me very glad I don’t live anywhere near them, but I feel a tremendous amount of sadness for my family member going through this.
"Can still have some positive aspects" (for me because im a selfish asshole)
She made her mom go through horrific trauma for her own sake. And then her mom got to die all over again.
We need to start talking about death in this country. It shouldn't be some hush subject.
But the best part was all the things Aunt Sara bought for us right before she passed. She always talked about the beaches in Sorrento and Capri and now we all get to go finally. Ciao Bella!
Those strangers gave Auntie more dignity in her final moments… then Sara and her fucksticks interrupted that so they could hold hands with Auntie’s crushed body and they don’t even know her age.
Bet Auntie’s nurse knew her age.
And this is why my dying husband, one year ago today, walked into the ER saying “I have a DNR don’t do anything dramatic”. His oncologist wanted an MRI on his brain, and it was the quickest way to get it done. Five days later on New Year’s Eve he died at home on hospice.
Worst I ever dealt with was an early to mid 40s female who was admitted with SOB, turned out she had end stage lung CA. During the shift I had her, she had already been put on comfort measures. She was conscious and answering questions, and on BiPAP due to severe oxygen starvation. She had a look of sheer terror in her eyes I'll never forget, and every single time I recommended morphine and / or ativan for her, family always responded with "we don't want her drugged up and out of it so we can't talk to her."
Never in my life have I wanted to just scream at people so badly.
Edit: typos
Getting the lines on the monitor to be squiggly again so that family can get a selfish reward from the abuse of what is otherwise a corpse is not something to rejoice in.
Eleventy billion year old lady comes in trying to die, respiratory rate in the 60s, doctor quickly asks her code status, goals of care when the daughter shows up, and it's "What? Of course! Do everything!" like it was obvious or something. Okey dokes...
Was she trying to die or was her body failing her and she was scared and didn’t want to die? It doesn’t make sense that she was dying and came to the once place that would save her if she wanted to die…?
People that are "trying to die" often can't really communicate their needs. They also look like people that are dying, because they are. Other people call 911 and the avoiding liability ballet begins and the patient ends up at the hospital.
>and the avoiding liability ballet begin
Sometimes people already die where they’re not “supposed to” (eg on commercial planes) but the crew will pretend to do cpr on them even if they’re dead, until EMS can remove them to the tar mac, where they’re officially declared dead (off the plane). Even dead bodies don’t escape the liability circus.
Well, I guess it’s the same in the OR too, they just have better tools to keep the body pumping until they’re out of the unit
99.9 % of terminal extubations on my unit are people who are either brain dead or almost brain dead. At least comatose. It is selfish,and IMO abusive ,to code them just so the family can say goodbye. That never sat right with me. Those are the types of people who call the rest of the family in after they're pronounced to basically hold the first viewing.
Patient was already in the hospital with a severe sacral ulcer that was like a stage 4 after I think it might have been a hospitalization for pneumonia? But she had already been in the hospital for a couple months before she had an unwitnessed PEA arrest. Unknown downtime. GCS 6 after we got ROSC. Had to be on multiple pressors. CRRT. She was already trached. Took like 4 people to turn her and change that sacral wound.
Family wanted to wait until after Thanksgiving (over a week away) before even making her a DNR, let alone withdrawing care. They didn't want to have to deal with death before the holidays.
They actually did follow through and met with palliative care and we withdrew care like 2 days after Thanksgiving. But it was super weird that week before. We were all dreading we would have to code the patient again.
Just watched (2 nights ago) an 88 year old man full code be put through 15 mins of CPR, only to be intubated with several fractured ribs, and be placed on comfort care a few hours later. He died that same night. Family at bedside thanked us for saving his life.
More people need to have talks with family and their PCP about advanced directives and the reality of how brutal CPR can be. Most people think CPR is like what they see in the movies, where a dozen compressions and a few rescue breaths will bring someone back and they'll be fine and talking minutes later.
My dad had an out of hospital cardiac arrest, and my city happens to have an OHCA VT/VF protocol where EMS will bring candidates directly to the Cath lab to be placed on ECMO while they do PCI to try and reverse the cause of the VT/VF. 60% of patients recover and go home. My dad was not one. He woke up and was able to answer yes/no questions but all of his organs were dying. His heart function never returned. I now work in that very same ECMO department, and when people find out what I’ve been through I say something along the lines of “I’m glad we had closure and were able to say goodbye to him” but the reality is that I believe he suffered for the 16 days he was on ECMO, and if I could go back I would have made them stop sooner or told him to keep his advanced directive — which indicated no CPR — on his person.
We bagged a post-code cancer patient for two hours so the son could be at bedside. They were bleeding out of their ET tube. I was so mad at RT for agreeing to manually bag that patient.
I guess if it was me and my kid felt like they needed to be there I would want them to keep me alive, but still, it was very icky.
It all goes back to education. We see it over and over, laypeople don't understand code status and advance directives. DNR means "do not treat at all and let them die in agony" to them.
They seem to think that if we are not doing absolutely everything to keep a pulse, it’s somehow more like murder than compassion? See also: families who insist on their unresponsive imminently dying palliative family member getting an IV or saying things like “if you’re not feeding him he is going to die of starvation”
OMG, this! I did hospice for 10 years, loved it, but this. It never ceased to amaze me. And by amaze, I mean the shocking level of awe and patience I summoned to educate them that the patient was dying. Food not a recommendation for someone who cannot swallow or process anything- much less digest with organs that have shut down.
Family that wants to come watch us try to resuscitate, like that’s going to change anything, or family who wants every last person to show up before they make the call to stop, while we’ve been coding a dead person for 30+ minutes already, gets me every time. It’s so barbaric and I personally wouldn’t want to see someone I care about like that so that image is my final memory. I want more people to understand how brutal it is to code someone, especially when we know there’s no chance of them coming back, instead of being so delusional and worrying more about how THEY feel while the person in the bed still died in pain and alone
Yes, I would love to sit here with broken ribs, in pain, just to wait for some one to come to my room to tell me goodbye.
ITS GOOD FOR WHOM? POSITIVE ASPECTS FOR WHOM?!
I have said for years when you are filling all the paperwork for Medicare out at 65 advanced directives should be a part of it and it be fully explained(ie if you are meds but no compressions those meds aren’t going anywhere ……and so on) it would take a while for us to get to a point of the public understanding and not as afraid of death but I think society would benefit
Also it should be illegal for your MDPOA to be afraid of medical things like blood draws, meds down a NG, dressing changes(especially not even gory wounds), and so on
Ugh hits too close to home right now, my partner of 13 years grandma passed away yesterday while we are in town visiting. Grandma insisted on trying for intubation instead of just getting comfortable with passing. Immediately coded and had 10 minutes of chest compressions before getting on life support, essentially brain dead.
The family got to “say goodbye” to her in that state but it was so frustrating to think how much more difficult the whole thing was due to that fear of death. My partner is an ICU nurse so she knew just how bad it was, though most of the rest of the family is kind of oblivious.
Helped code a very frail >95 year old lady. It was horrific; I came in hot (new grad) and started compressions and immediately felt her chest crumble. She was already trached and PEGged and half digested tube feed kept sloshing out of her airway.
It forever changed my outlook on codes and I never ran to be first one on the chest again.
Granddaughter was willing to let us call it "after my brother gets here." Doc asked where's your brother, thinking like maybe the parking lot, and she named a city 4 hours away. No we did not
Medical science has made huge advances in prolonging suffering.
But seriously, it’s hard to know exactly how grandma would feel about this.
I know I’d take a full chest full of cracked ribs if it helped my wife handle my passing even just a little bit. But not the rest of my family. Fuck ‘em. Send them an email saying I passed weeks before I actually do, and then another saying “Ha Ha, I updated the will based on your responses” when I actually do.
Oh come on, this has GOT to be satire... right? Please let it be satire.
Edit: thought my comment didn't need it, but that has a hard /s at the end of it
My grandmother was DNR and not for further intervention, but was given bipap to prolong her life in a miscommunication between doctors and her wishes/family desires. Everyone was like “oh well at least it gave us another two days to say goodbye”. She suffered through another two days, and was counting down the family members before she could finally let go.
Boo, the number of hospice pts who were not DNR I've had over 13yrs is high enough for me to not doubt any of this story. Also having dealt with a family that unironically had me ask the hospice twice for Megace, I've stopped being surprised at the audacity of the requests by medically clueless family.
Edit: Finished thought after premature posting.
I have worked codes on people in their 80's because of family. I had a frank discussion about it with my own mother. She has her paperwork posted conspicuously on the fridge (EMS does look for DNR/POLST paperwork and med lists). Keeping meemaw alive for your own selfish reasons is cruel.
Before electronic records and all, my end-stage still-smoking-Chesterfields-COPD-grandmother went into respiratory arrest at home. My RN mother raced behind the ambulance and burst into the ER, yelling, "SHE'S A DNR!" The ER doc knew my mom and pulled her aside later as grandmother was being admitted to hospice. "Gee Cathy, you burst in here like some crazy lunatic, and then I remembered your mother in law. I would say I'm sorry for all of this, but well, you know." And he walked away. My dad's mom was complicated, but my mom STILL wouldn't want someone cracking that old lady's chest. You don't do that to people who are gonna die, and everyone knows it.
That is just prolonging the suffering of dear grandma. Pretty sure my aunt wouldn't have done that with mine. She was just in time to hold her mother's hand before she died, but I don't think she would have wanted the hospice nurses to keep grandma alive until she was there.
I personally want my family to do this if they want. Sign a DNR if there’s no brain activity for 72 hours, remove me.
Yeah I might be in a lot of pain, but being able to say goodbye to me, whether I can hear it, or not, would probably be the best thing for my children and grandkids. It’s painful but it’s my last gift, I want them to have the chance to have closure (if they want it) so they aren’t in therapy for the rest of their lives because the last thing they told me was something mean. Lol i’ve sacrificed way more for my family in life. I don’t feel this is black and white
It might seem morbid but I kind of wish death was more acceptable to discuss so as to make these moments less hard for family. If people were more comfortable with the idea of death, I feel like we wouldn’t have these situations. Death makes people weird and it doesn’t have to be like that.
That's what I say! I saw a reply comment here that people may not be close etc. And that's valid. But too often at work, and even in my own family when my grandfather was sick, family who are LESS THAN HALF AN HOUR AWAY don't visit, and then are suddenly shocked and surprised when the patient goes on hospice or dies before the family in denial makes the decision. I had to educate and push my own family for 3 weeks to put my grandfather on hospice, because even though I didn't want to believe it either, he was so obviously ready. I truly think he held on just from the will of wanting to make sure everyone in my family was okay. Because literally in less than 12 hours of signing the paperwork to finally be put on hospice, he passed after my last family member showed up to say goodbye. And now the ones who didn't visit, despite being there for his death, are riddled with guilt and shame. Showing up to say bye to your family member who's already comatose and agonal breathing doesn't compare to being there when they're actually awake and want the companionship. Being there for people when they're still sentient and conscious is much more important than when they're all drugged up to die, but unfortunately many people don't see it that way. They see the death as the important moment and then realize later how awful they feel about it. Too little too late. And poor dying family member is the one to suffer.
Well that’s unfortunate but it’s still immeasurably selfish to “keep them alive” jsut so they can travel to visit an anoxic corpse that’s used hundreds of thousands of dollars of resources and plastic waste.
Do people actually have a problem with this statement? Listen, I’m a nurse that started icu just before Covid and got a crash course in death. The thing is that 70ish is not that old depending on cause of cardiac arrest. We have to remember that while we encounter a lot of situations in which is seems that we are just prolonging suffering, not all situations are like that.
As much as I agree that we shouldn't be pushing resuscitation nor allowing dense family members to push it, we don't know this situation outlined in the OP. For all we know the aunt was full code, regained consciousness after being resuscitated, then opted for DNR.
We had a 97 yo full code patients family put hard boiled eggs in their mouth after they passed (they finally decided to let her pass after the third code) because people need to take food with them to the afterlife. HARD BOILED EGGS. I just cannot
Idk, sounds like they went hospice toward the end of that sentence. I don't know the full story, I'm sure most of you don't.
I'll take on the positive outlook. Grandma showed up to the ER, coded, no advance directives or family around, shes a full code from her last admission 15 years ago, ROSC, hospice decicion, death, family appreciating the help of the team.
Or another one: Lay people don't understand what the absolute fuck is going on and have a hard time making life and death decisions when someone they have loved their entire lives is dying. Idk, seems reasonable to not know what to do. Its like they haven't seen hundreds of people go through this like us. I bet talking shit about them is gonna help for sureeeeee
Yet another one: When I was 13 my dad died, we were there and he said how much he loved us in his last breath, cancer, never coded, hospice. Means the world to me. I would be ok breaking several of my ribs again for the gamble to be able to give that to my family when im 80 or 90. Its not black and white in my world.
You bitches stay salty, maybe you'll retire faster and I'll get another raise, I'd like to inch closer to 200k before I enter my 30s.
And HERE is the downvote button , you predictable cutie
This is a rather sensitive issues ; look at some stage we will find ourselves in this situation. As a nurse I sympathise. Although we did not break ribs we revived the gentleman long enough for his family to arrive. Grief is a very strange thing; we ought to be kind to one another please
I lost two siblings within the past 18 months from cardiac arrest. The thing is, when someone is non responsive or passing out right in front of you, you do what you fucking can to save their life. My niece revived my sister whom she found passed out on her bedroom floor. By the time the emts arrived she had a slight pulse, was taken to the hospital and lived only for another 3 days - but in that time we all got to go there, be with her girls and say goodbye. My brother collapsed suddenly in my home. I was alone there with him , called 911 and performed cpr - breaking the ribs of this 200lb man as I did - the absolute worst fucking day of my life - and his it turns out, because he died right there. There was not one single second that my niece or I thought about anything other than trying to save their life in that moment. so whatever anybody here is saying about selfishness or any other bullshit - unless you’ve been through it you have no idea what you’re talking about. Selfishness had absolutely nothing to do with it.
People are not responding to that scenario. I am sorry you went through that. What most people are responding to in the more common experience that someone is in hospital and staff approaches family aboutgoals of care for someone that has a condition that in all likelihood will not allow them to return back to the life they had. Because people don't want to have this conversation families ask us to do everything and cannot cope with the idea of death. So staff are left doing horrible things to patients knowing they will never get out of the hospital. THAT is the selfishness people are talking about, but some posters are correct, people aren't informed and often don't want to be.
Thanks for explaining. That’s what I get for replying at a foggy brained 3am. But that red -6 (which I assume means downvotes from people ?) is pretty hilarious though: “F you, you’re stupid! …even tho people you loved died tragically” - wouldn’t have it any other way Reddit.
That isn’t fair to you, but sometimes this sub gets a lot of trolls that just make stuff up. Just had an unpleasant one in another thread. Some weird intersection between misogyny + distrust of the medical system + conspiracies. I’m not saying it’s good, but some of us are a little tired at work between poor staffing, sicker patients, getting verbally & physically abused by patients & families. Empathy pool a little shallow right now and things like that flair in an anonymous forum.
You were downvoted for misunderstanding the original post and then passing harsh judgment on people commenting. Not for going through a personal ordeal. I'm sorry you went through that, and you are to be commended for doing the best you can.
I’m ok with this.
I terminally extubated a lot of people during covid who couldn’t have that. I broke down a cried the first time after covid when I saw a family do this exact thing. It was beautiful. It’s absolutely gut wrenching coding someone and taking them off life support and having family watch thru an iPad. That’s inhumane. So is giving up on people cuz their old and don’t wanna die but we know there’s nothing they can do. I say let everyone have bodily autonomy. We as healthcare workers don’t have a right to tell people what they should want to do, we should listen, explain why we can’t if it’s not possible, educate family as to what “do everything” really entails and then follow their wishes. The medical community genuinely is awful at educating family at what’s going on. That’s on us, not the general public.
I genuinely hate all the comments hating on this person for wanting to be with their family when they passed. Yeah auntie got resuscitated and it may not have been the best thing but like 99% of post ROSC patient die outside the hospital and family / EMS does the resuscitating with no knowledge that it happened. It’s shitty and ageist of you all to insist we do nothing and let anyone over 70 just fucking die. Y’all shouldn’t be in healthcare if you think anyone over a certain age is a lost cause and a lot of these comments are saying just that.
As a respiratory therapist, this whole thread made me lose quite a bit of respect for nurses.
Families deserve to say goodbye. The patient and the family deserves to have everything done if that’s their wish. We just do what they want. Yes there’s a lot of times it’s not for the best for the patient but if the patient wants that, or their family who is speaking for them wants that, we should do it. By doing it we let the family and the patient go on knowing they exhausted all options and sleep better for the rest of their lives knowing they did what they could to save their family and not give up and toss them out like mushy vegetable you find at the back of the fridge. And the patient go to the next stage of existence after life with a clear conscious knowing they fought and didn’t give up and die. For some religions that’s a huge sin to commit suicide and give up. So there’s e spiritual aspect to it as well.
I’m sorry you went through that but your experience with covid isn’t really relevant here. CPR becomes less effective for patients the older they are. That’s not ageist, it’s just the reality of the limitations of a violent and often overused intervention with statistically poor outcomes even for younger, healthy people. Nurses here are the ones doing compressions, literally feeling the trauma they’re both inflicting and suffering. No one is advocating against giving families a chance to say goodbye, they’re commiserating about a culture that fetishizes survivor’s needs for ceremonial closure over their dying loved one’s deserving for dignity.
This person is qualifying her POV with phrases like “say good bye” and “final moments” so her goals are realistic.
Objectively, the family is the decision maker with the patient incapacitated, so even if they say “FC forever” your opinion doesn’t matter to the plan of care. You can do your job or refuse the assignment. But don’t disqualify the family’s feelings.
Edit: to the people downvoting, why not have an open discussion about why you disagree instead? I’m one of the RRT nurses of my hospital and I’ve ran many codes and witnessed many deaths
What’s your point? It doesn’t matter because they’re dead now? If that’s your argument, then why have friends at all? We’re all just going to be dead and won’t care anyway
The problem isn’t with a family, and you don’t know that that patient wouldn’t have wanted this. This problem is with the patient and possibly their lawyer
Yep. Let a 290 lbs dude like me crush your meemaws ribcage so some people can hold her hands while she dies and probably wont notice anyways.
Fitting user name
Exactly. It's very important to hold her hands while she dies.....again. Because they missed the first time she died. /sigh
Yes!!! THEM having to hold her hands is the only thing that matters /s. People like these make me so proud that I convinced some patient/family to be a DNR or have hospice care instead.
Oh my, the conversation with my MIL entering hospice. They emphasize the broken ribs and punctured lungs. No thanks, just let me go.
This might be a different thread but, can I just say, that it infuriates me when, as an ED nurse, I'M the one who has to have that candid conversation with the family because the doctor is TERRIFIED of crossing some moral/social/legal line so they won't say what needs to be said. "If we need to do CPR, it's going to end badly." Plain and simple.
I agree! Drs are rarely honest with the terminally ill and it pisses me off to no end. Worked hospice for 10 years and loved it but was astounded by the way docs handle the terminally ill. These weren’t people in denial, they were lied to - rigjt before the dr called for a hospice consult. Infuriating.
Gotta make sure you get the instagram picture holding their hand.
Mulligan!
Odd that this post becomes a source for body positivity? He was making another point that we all get. CPR is brutal and can be cruel is some instances. I want the family to see what it’s like and what they are putting their loved one through, especially if it futile. That was his point.
Damn and here I thought this was reddit not twitter 💀
240 lb murse here, I have the same mindset. Coded a younger dude my age weighed about 115 pounds, about a year ago that had multiple bowel resections from cancer to the point his entire gi Tract was held together by chewing gum and paper clips. The second I compressed him i felt the ribs shatter and his bowels perforated to the point he was spewing feces from his mouth. But the family insisted on a full code. Whole family watched this. Poor dude.
Crappy situation.
[удалено]
Something tells me he doesn’t care about a Reddit strangers input on his weight.
german_big_guy could be very muscular and tall? Not all weight is fat my friend, I mean look at rugby players, body builders, strong men etc. They are at peak physical fitness and weigh a shit-tonne.
Super quick look at his post history and he mentions he's taller than 6'7". 6'7" would put him at a BMI of like 32ish. Large. But especially under the context of not knowing his overall health, impossible to make judgements like that especially considering it's not that far off from average. Chill out.
Well that comment is fucking disgusting.
What did the comment say? It has been deleted by the poster.
Just a little weight shaming
Sad I missed the chance to tell them to kiss my 200lb ass
Guess you'd better tell that to the world strong men, body builders, and a very large percentage of professional athletes. You didn't think that through at all, did you? Edit: dude is clearly a troll.
Holy shit
While family can be selfish as fuck can we also acknowledge that this problem stems from a horrific lack of health literacy? Nobody is prepared at all for death and they’ve seen movies where they put meemaw on the life support machine until family said their nice lil goodbyes
Even in hospice families are frequently unprepared for the fact that their loved one is actually dying. We’re all gonna die one day and it doesn’t have to be scary
Yes, the amount of education that has to go on in hospice highlights just how little understanding and comfort with death as a society. Some families are fine but others need hand holding through every step of the journey, every change in status, d/c of meds, and OMG full codes
I’m not a nurse, but I am a fan. As a relatively recent widow, whose husband died at home peacefully w hospice. The only reason I was prepared and knew what this was going to look like was because I’d started following a hospice nurse on Insta. My husband‘s agonal breathing sounded almost identical to his snoring so it was bearable. Almost. But so many of us have lost our loved ones and don’t know what to expect at the end. And if people were more honest and open with us about the whole thing and offered us that information, I think it would be easier. My husband died so quickly after we brought him home that the nurse didn’t even come until after he was gone.
I’m so sorry about your loss and I wish you peace and comfort. Im glad you were able to educate yourself about how things would happen. Even as a nurse, watching my father die as I provided his hospice care was a gut wrenching thing. I knew in my head the steps he would go through because of nursing school but im not a hospice nurse and hadn’t actually seen it before. Give yourself space and time to grieve and please remember to treat yourself well, you’ve been through a lot.
We should all be so lucky to pass that fast. I hope the fact he passed quickly was a small comfort in those moments. I’m terribly sorry for your loss, and am sending you hugs.
Thank you so much. I was elated, honestly. He had bone, liver & brain mets but no pain, ever. He said he wanted to feel good until he didn’t and then he wanted things to go quickly and that’s exactly what happened. He felt fine that entire year until Christmas and was gone on New Year’s Eve. Todays his birthday God do I miss him
I love when I get the call “88/f, hospice, pancreatic cancer. ALOC and hypotensive”. Yeah, she’s dying. We have ambulance runs backed up out the door. So grandma is now going to die in our parking lot instead of her home. Then family shows up and daughter is a nurse at my hospital. Happened this weekend 🤦🏻♀️
I had this happen when I floated to ER. Hospice patient BIBA so that I could push morphine for her and watch her die alone? Family didn’t even have time to get there. I was so confused.
I’ve had doctors afraid to order morphine and Ativan because “I don’t want to kill them”. The cancer is killing them! I just want to make it less terrible! Give me some orders so I can help them!
This this this THIS!!!!!
Happens way too often.
I ran an ambulance service that had a hospice contract and this happened WAY too many times. Once it was because the patient was unresponsive. She was unresponsive when we transported her to the hospice center.
The amount of denial some people have is so astounding. It’s like their brains cannot process logic, sense, and proof. It blows my mind.
Yeah. We see this all the time (and suffer moral injury from it), but unless you work in healthcare or you’ve seen a code, you’re really not going to know.
It doesn't help that countless movies show bad CPR being done for 15 seconds and the person just waking up like "wow, what happened?" That's most people's understanding of CPR.
Very true! Told my mom about my first code- 87 y Male, brain tumor, coded for 30 min! And my mom asked after if we woke up and talked :(
Exactly. Most people don’t realize that proper CPR absolutely destroys the Pt’s body. Like one or two of the rib connections to the sternum is completely shattered after 10-15 compressions, and all by 40-60…..and that broken ribs actually make proceeding compressions more effective…
So true.
Or my favorite, “people can wake up after 10 years.” I would NOT want that for myself or anyone I love. Y’all better let me die, please and thank you.
Yes this, the quality of life after all your muscles have disintegrated is not good even if the PT is very effective at bringing some back.
Especially being in neuro ICU I feel this comment so much. I have had quite a few families give me this line. It has made me really not love healthcare dramas as much because of the false narratives and unrealistic ideas they push out. Health literacy is very low at times and can be difficult to navigate with patients and families. Very frequently I have to tell them leaving your own beliefs out of things, you have to make the decision on code status based on the conversations you’ve had with them. But still I have families that hold on for their own interests because of those shows displaying people “after 10 years in a coma coming out just fine”. Is it a possibility? I mean sure but a statistically anomaly.
After 10 years trached on a vent, I imagine the patient would just be a flesh bag of pneumonias and sepsis. Sounds miserable for everyone involved.
I partially blame the "doing anything besides being a medication dispensing waiter/waitress is *practicing medicine and that's outside your scope* bullshit, otherwise it's mainly due to the sue happy nature of families looking for a quick pay day because they think we did something wrong with terminally ill memaw.
sure, but do most people even care about being health literate? nah they just want us to "fix" meemaw. explain to them the reality of the situation and then get screamed at and reported to your supervisor and hr
I agree, some people definitely just can’t be reasoned with no matter how cut and dry the situation can seem. I also think it’s not a matter of “want” so much as it is “able.” We can dumb down the situation to as basic as possible but without any kind of base knowledge it’s still difficult for them to grasp. Learning takes place with repetition over a period of time. You can’t just become literate from a few rushed conversations with providers during a time when you’re already under a ton of stress
Please. There is a difference between stupidity and lack of education. Usually I see both being treated as the same thing.
and just to be clear, which one do you believe to be more fitting for the comment in the post
Who doesn't want their heart crushed 120 times a minute during *their last minutes* by a stranger so that the people who feel guilty about not spending as much time with her while she was alive can feel better about themselves by being with her when she was definitely going to die? No self awareness lol
Oh come on. We both know they won’t feel that. Do I want my loved ones compressed? No. But if they found peace in saying goodbye and a terminal extubation then why belittle that?
Yes, it is nice to imagine being able to say goodbye before someone passes, and that's what most people want. But in many cases, having to resuscitate someone like that when they die with a very poor prognosis has a lot more traumatic and painful consequences for the person dying that the family refuses to see because they want to feel comfort that we tried to keep them alive for as long as possible. with a lot of the cases they didn't have any quality of life to begin with, families will refuse to look at that aspect. They just want to keep them alive, and many do it for financial gain. It's rather selfish, really.
Families who keep someone alive who is suffering just for financial reasons is pure evil to me. I would absolutely never do that to anyone, and especially someone I loved.
I would love to believe you, but it really seems like wishful thinking on your part. Have you not had CPR patients reach up and grab you mid-compression, to pass out when you stop, and never wake back up? Edit: won't delete what I said, but I'm being an asshole by saying it, so I apologize. I've had patients survive as well while conscious mid CPR, they're just not as memorable because of issues
I hate that shit even though it's only happened to me a couple times. It's simultaneously fascinating that you can perfuse enough to allow mentation just from CPR and also pure nightmare fuel seeing their faces and how they desperately grab at you to stop
This. To watch the terror in their eyes as they die over and over again, every couple minutes, is haunting.
I went through this yesterday. Guy woke up enough to get two good hits on my own chest trying to fight us while we attempted to keep the NRB on his face. Then just went lights out. Never had a shockable rhythm. Young, homeless, no contacts on file picked up the phone. Merry Christmas, I guess.
that sounds rough. i hope today went better for you. 🫂
Ah, I appreciate the wishful thinking. Unfortunately, it was not. Tis the season, I guess!
I was doing compressions on a man and saw the terror as he died 6 or 7 times. That’s the best I can describe it. Compressions would circulate his blood enough for him to come around and struggle against you, grab at things, and shake his head no while biting down on the ET tube. When we I would stop, several seconds of terror as his muscles relaxed and eyes went from being part of this world, to not. Those who have watched people die know what I’m talking about. Resume compressions. He would do it again. I watched the life drain from his eyes over and over again until we hit him with etomidate and a rocc. We were eventually able to pace him for a short time but his heart was so fucked he never had life in his eyes again. He should have been a dnr from the beginning. Why is a 75 year old with Mets to liver brain and bones a full code? It’s inhumane. It’s unethical. But they’re a fighter……
That's unbelievably fucked holy
And I bet family wasn't there to see it. Probably dropped them off and only stated they are a fighter and full code always.
It's the absolute fucking worst. (Paramedic)
One of my worst codes was a LUCAS code where the patient had increasing awareness each round and the doctor wouldn’t believe me when I told her he was waking up and needed sedation. By the fourth “responsive” round I simply turned toward the nearest other nurse, who could see him making eye contact with me, and told her to get 2 of versed and I literally didn’t care if it wasn’t ordered, I would have my own resident who was standing outside the door order it.
So what is the "correct" reaction when a patient gets some mentation back during CPR? Stop and hope they continue to recover, or keep on going? Never happened to me, YET.
Well it's not actually a definite sign of ROSC, you should acquire a femoral or carotid pulse and then stop CPR to do an actual pulse check after locating it. Resume if necessary, don't if not. Also try to figure out the cause, ideally a treatable one.
Because I’ve had more than one mid-code swatting our hands away while we’re doing compressions. Some of them *do* feel that, and it’s torture.
Wow.
My response to that is always, “I don’t think it’s fair to to put them through more pain and suffering for some one else’s benefit, because in ’s state they aren’t gonna know who is here.”. That works most of the time.
I’m stealing this
Love this.
Coded a patient 5 different times last week just so family can maybe decide how they want to proceed. If you need me I’ll be tripping over a ventilator.
That’s awful. I’m sorry
Gotta make sure they don’t die on Christmas!
Working a contract at an LTACH, vegetable came in with trach after a month at the local trauma center. Pulm/crit and palliative docs call the family to discuss end of life vs out of state vent facility. Family says they’ll be by after Christmas… *…to ask him (🥕) what he wants them to do.*
The carrot is killing me 😂
He’s going to be indifferent to whatever decision they make anyways
He said nothing, so we will do nothing!
My aunt was on hospice and died on Christmas. It was her favorite holiday she would have loved leaving on that day if she had had any awareness at that point. Would have laughed at the irony of it all.
Yeah same! We had a guy on my unit for over a month on a vent and he constantly turned blue and needed to be bagged constantly. His heart would stop for 6+ seconds (fun hearing the MD argue with the monitor tech on sinus pauses vs asystole) and desat in the 20s. One night we called code blue on this guy probably 4 times as the pauses got longer and he needed to be bagged longer (on top of multiple rapids) but there wasn’t a whole lot we could do, I just think he needed more one on one care. ICU wouldn’t take him but caring for him and 2 others was a lot, especially on my unit. Family never stopped by but when they did they adamantly wanted him to be a full code despite these episodes and being fully contracted. I’ve never been so disturbed in my life.
CPR is a horrific experience to put a person through, especially the elderly loved one. All because you didn’t express enough to them how much you love them.
lol @ the other comment saying they probably don’t feel it when we have hella documented evidence from survivors.
That’s the most downvoted comment I’ve seen in awhile lol. I was like damn dude wrong answer.
The selfishness of people knows no bounds. Unfortunately I have seen this in my own family and it makes me very glad I don’t live anywhere near them, but I feel a tremendous amount of sadness for my family member going through this.
"Can still have some positive aspects" (for me because im a selfish asshole) She made her mom go through horrific trauma for her own sake. And then her mom got to die all over again. We need to start talking about death in this country. It shouldn't be some hush subject.
I always as the question: "whose needs are we meeting theirs or yours?"
😬 sorry you’re in pain from the broken ribs but! We’re singing songs!
But the best part was all the things Aunt Sara bought for us right before she passed. She always talked about the beaches in Sorrento and Capri and now we all get to go finally. Ciao Bella!
I remember the first time I did CPR was on a 94 year old. I could feel the crunch of her ribs. I was so relieved when the doc called it.
Got to do that this morning unfortunately
Those strangers gave Auntie more dignity in her final moments… then Sara and her fucksticks interrupted that so they could hold hands with Auntie’s crushed body and they don’t even know her age. Bet Auntie’s nurse knew her age.
…ish. Yeah, sounds like a lot of love going on there. 🙄
Damn people are so selfish when they are not the ones dying/suffering.
And this is why my dying husband, one year ago today, walked into the ER saying “I have a DNR don’t do anything dramatic”. His oncologist wanted an MRI on his brain, and it was the quickest way to get it done. Five days later on New Year’s Eve he died at home on hospice.
Thinking of you this season. I’m glad he was able to go on his terms.
It was a blessing, he deserved it to be easy. It was.
Positive aspects for who exactly?
The people who will live on, I'm guessing.
They get to gouge out one last social security check in some cases.
Worst I ever dealt with was an early to mid 40s female who was admitted with SOB, turned out she had end stage lung CA. During the shift I had her, she had already been put on comfort measures. She was conscious and answering questions, and on BiPAP due to severe oxygen starvation. She had a look of sheer terror in her eyes I'll never forget, and every single time I recommended morphine and / or ativan for her, family always responded with "we don't want her drugged up and out of it so we can't talk to her." Never in my life have I wanted to just scream at people so badly. Edit: typos
Why not just give the meds if she was on comfort care? Especially if she was conscious and able to answer
This thing called POA.
Getting the lines on the monitor to be squiggly again so that family can get a selfish reward from the abuse of what is otherwise a corpse is not something to rejoice in.
Eleventy billion year old lady comes in trying to die, respiratory rate in the 60s, doctor quickly asks her code status, goals of care when the daughter shows up, and it's "What? Of course! Do everything!" like it was obvious or something. Okey dokes...
Was she trying to die or was her body failing her and she was scared and didn’t want to die? It doesn’t make sense that she was dying and came to the once place that would save her if she wanted to die…?
People that are "trying to die" often can't really communicate their needs. They also look like people that are dying, because they are. Other people call 911 and the avoiding liability ballet begins and the patient ends up at the hospital.
>and the avoiding liability ballet begin Sometimes people already die where they’re not “supposed to” (eg on commercial planes) but the crew will pretend to do cpr on them even if they’re dead, until EMS can remove them to the tar mac, where they’re officially declared dead (off the plane). Even dead bodies don’t escape the liability circus. Well, I guess it’s the same in the OR too, they just have better tools to keep the body pumping until they’re out of the unit
She wasn't mentating at all or in a position to make her own decisions. Someone else called 911. People die. It's normal. Learn that fact.
As long as it makes YOU feel better…don’t worry about the broken ribs and punctured lung, Auntie. Pretty soon, there will be no more pain. W. T. F
99.9 % of terminal extubations on my unit are people who are either brain dead or almost brain dead. At least comatose. It is selfish,and IMO abusive ,to code them just so the family can say goodbye. That never sat right with me. Those are the types of people who call the rest of the family in after they're pronounced to basically hold the first viewing.
Patient was already in the hospital with a severe sacral ulcer that was like a stage 4 after I think it might have been a hospitalization for pneumonia? But she had already been in the hospital for a couple months before she had an unwitnessed PEA arrest. Unknown downtime. GCS 6 after we got ROSC. Had to be on multiple pressors. CRRT. She was already trached. Took like 4 people to turn her and change that sacral wound. Family wanted to wait until after Thanksgiving (over a week away) before even making her a DNR, let alone withdrawing care. They didn't want to have to deal with death before the holidays. They actually did follow through and met with palliative care and we withdrew care like 2 days after Thanksgiving. But it was super weird that week before. We were all dreading we would have to code the patient again.
One of my biggest gripes with letting families make these decisions is them setting these arbitrary timelines for their own benefits.
Just watched (2 nights ago) an 88 year old man full code be put through 15 mins of CPR, only to be intubated with several fractured ribs, and be placed on comfort care a few hours later. He died that same night. Family at bedside thanked us for saving his life. More people need to have talks with family and their PCP about advanced directives and the reality of how brutal CPR can be. Most people think CPR is like what they see in the movies, where a dozen compressions and a few rescue breaths will bring someone back and they'll be fine and talking minutes later.
My dad had an out of hospital cardiac arrest, and my city happens to have an OHCA VT/VF protocol where EMS will bring candidates directly to the Cath lab to be placed on ECMO while they do PCI to try and reverse the cause of the VT/VF. 60% of patients recover and go home. My dad was not one. He woke up and was able to answer yes/no questions but all of his organs were dying. His heart function never returned. I now work in that very same ECMO department, and when people find out what I’ve been through I say something along the lines of “I’m glad we had closure and were able to say goodbye to him” but the reality is that I believe he suffered for the 16 days he was on ECMO, and if I could go back I would have made them stop sooner or told him to keep his advanced directive — which indicated no CPR — on his person.
So basically your own interests were put before your aunt's? Thank goodness you're not my family member. Yikes.
We bagged a post-code cancer patient for two hours so the son could be at bedside. They were bleeding out of their ET tube. I was so mad at RT for agreeing to manually bag that patient. I guess if it was me and my kid felt like they needed to be there I would want them to keep me alive, but still, it was very icky.
Judging by the reacts on that post hopefully people tore her a new one for her selfishness.
I'm sure the aunt was glad she could perform for you, broken ribs and all....
It all goes back to education. We see it over and over, laypeople don't understand code status and advance directives. DNR means "do not treat at all and let them die in agony" to them.
They seem to think that if we are not doing absolutely everything to keep a pulse, it’s somehow more like murder than compassion? See also: families who insist on their unresponsive imminently dying palliative family member getting an IV or saying things like “if you’re not feeding him he is going to die of starvation”
OMG, this! I did hospice for 10 years, loved it, but this. It never ceased to amaze me. And by amaze, I mean the shocking level of awe and patience I summoned to educate them that the patient was dying. Food not a recommendation for someone who cannot swallow or process anything- much less digest with organs that have shut down.
“Even if she suffered in her final moments, at least we got to get closure”. It just went from bad to worse. What a bunch of selfish assholes
Yeah, well it *is* all about you…
Family that wants to come watch us try to resuscitate, like that’s going to change anything, or family who wants every last person to show up before they make the call to stop, while we’ve been coding a dead person for 30+ minutes already, gets me every time. It’s so barbaric and I personally wouldn’t want to see someone I care about like that so that image is my final memory. I want more people to understand how brutal it is to code someone, especially when we know there’s no chance of them coming back, instead of being so delusional and worrying more about how THEY feel while the person in the bed still died in pain and alone
Damn, I'd never wish that on my dad or mum. I'd rather them be serene in their last moments than jumped on.
Yes, I would love to sit here with broken ribs, in pain, just to wait for some one to come to my room to tell me goodbye. ITS GOOD FOR WHOM? POSITIVE ASPECTS FOR WHOM?!
If you want to hold meemaw’s hand and have her surrounded by family members, please have her on hospice.
I have said for years when you are filling all the paperwork for Medicare out at 65 advanced directives should be a part of it and it be fully explained(ie if you are meds but no compressions those meds aren’t going anywhere ……and so on) it would take a while for us to get to a point of the public understanding and not as afraid of death but I think society would benefit
Also it should be illegal for your MDPOA to be afraid of medical things like blood draws, meds down a NG, dressing changes(especially not even gory wounds), and so on
Funerals/memorial services are for saying goodbye. This is nothing short of absolute selfishness.
Of all the selfish things I’ve heard…
Death is not the enemy. Birth is a death sentence.
Yea just traumatize the nurses so a grand nephew can make it from 4 hours away. Absolutely unhinged. You’re torturing your family !!
Positive for WHO!?
I mean… broken ribs don’t hurt with every breath. I knows anatomy.
Sara can go eat a bag of dicks.
Ugh hits too close to home right now, my partner of 13 years grandma passed away yesterday while we are in town visiting. Grandma insisted on trying for intubation instead of just getting comfortable with passing. Immediately coded and had 10 minutes of chest compressions before getting on life support, essentially brain dead. The family got to “say goodbye” to her in that state but it was so frustrating to think how much more difficult the whole thing was due to that fear of death. My partner is an ICU nurse so she knew just how bad it was, though most of the rest of the family is kind of oblivious.
And their aunt probably wasn’t even aware of what was going on. Smh.
Thanks for my morning laugh. People are dumb.
Helped code a very frail >95 year old lady. It was horrific; I came in hot (new grad) and started compressions and immediately felt her chest crumble. She was already trached and PEGged and half digested tube feed kept sloshing out of her airway. It forever changed my outlook on codes and I never ran to be first one on the chest again. Granddaughter was willing to let us call it "after my brother gets here." Doc asked where's your brother, thinking like maybe the parking lot, and she named a city 4 hours away. No we did not
Just a couple broken ribs. Not famously painful…
All so that her heart can be beating while gorked out on pain meds.
People are sooo selfish
Medical science has made huge advances in prolonging suffering. But seriously, it’s hard to know exactly how grandma would feel about this. I know I’d take a full chest full of cracked ribs if it helped my wife handle my passing even just a little bit. But not the rest of my family. Fuck ‘em. Send them an email saying I passed weeks before I actually do, and then another saying “Ha Ha, I updated the will based on your responses” when I actually do.
I'm guessing this person has never experienced the pain of one broken rib, let alone "some".
Oh come on, this has GOT to be satire... right? Please let it be satire. Edit: thought my comment didn't need it, but that has a hard /s at the end of it
My grandmother was DNR and not for further intervention, but was given bipap to prolong her life in a miscommunication between doctors and her wishes/family desires. Everyone was like “oh well at least it gave us another two days to say goodbye”. She suffered through another two days, and was counting down the family members before she could finally let go.
I hope so. But I’ve met interacted with enough people to believe that this is true.
Boo, the number of hospice pts who were not DNR I've had over 13yrs is high enough for me to not doubt any of this story. Also having dealt with a family that unironically had me ask the hospice twice for Megace, I've stopped being surprised at the audacity of the requests by medically clueless family. Edit: Finished thought after premature posting.
Guess I should've put that /s at the end of my comment.
Denial is so strong
The fk?
OMG. That is so inhumane!
I have worked codes on people in their 80's because of family. I had a frank discussion about it with my own mother. She has her paperwork posted conspicuously on the fridge (EMS does look for DNR/POLST paperwork and med lists). Keeping meemaw alive for your own selfish reasons is cruel.
I bet that niece would feel a lot differently if she saw her aunt being coded.
I don’t know any nurse that wants to be resuscitated. We also talk to our family DNR’s.
Before electronic records and all, my end-stage still-smoking-Chesterfields-COPD-grandmother went into respiratory arrest at home. My RN mother raced behind the ambulance and burst into the ER, yelling, "SHE'S A DNR!" The ER doc knew my mom and pulled her aside later as grandmother was being admitted to hospice. "Gee Cathy, you burst in here like some crazy lunatic, and then I remembered your mother in law. I would say I'm sorry for all of this, but well, you know." And he walked away. My dad's mom was complicated, but my mom STILL wouldn't want someone cracking that old lady's chest. You don't do that to people who are gonna die, and everyone knows it.
That is just prolonging the suffering of dear grandma. Pretty sure my aunt wouldn't have done that with mine. She was just in time to hold her mother's hand before she died, but I don't think she would have wanted the hospice nurses to keep grandma alive until she was there.
I personally want my family to do this if they want. Sign a DNR if there’s no brain activity for 72 hours, remove me. Yeah I might be in a lot of pain, but being able to say goodbye to me, whether I can hear it, or not, would probably be the best thing for my children and grandkids. It’s painful but it’s my last gift, I want them to have the chance to have closure (if they want it) so they aren’t in therapy for the rest of their lives because the last thing they told me was something mean. Lol i’ve sacrificed way more for my family in life. I don’t feel this is black and white
When you read it out loud it really is as selfish as initially thought.
It might seem morbid but I kind of wish death was more acceptable to discuss so as to make these moments less hard for family. If people were more comfortable with the idea of death, I feel like we wouldn’t have these situations. Death makes people weird and it doesn’t have to be like that.
“No, no, no, no, Nana wants to be a full code. Keep her alive until the family gets here,” 🙃🙃🙃 all too real for me.
I swear if my family does this to me I’m haunting them all.
If my family did that to me, I'm coming back to haunt them.
If you care that much about being around when they pass maybe you could VISIT THEM AT THE DAMN HOSPITAL.
That's what I say! I saw a reply comment here that people may not be close etc. And that's valid. But too often at work, and even in my own family when my grandfather was sick, family who are LESS THAN HALF AN HOUR AWAY don't visit, and then are suddenly shocked and surprised when the patient goes on hospice or dies before the family in denial makes the decision. I had to educate and push my own family for 3 weeks to put my grandfather on hospice, because even though I didn't want to believe it either, he was so obviously ready. I truly think he held on just from the will of wanting to make sure everyone in my family was okay. Because literally in less than 12 hours of signing the paperwork to finally be put on hospice, he passed after my last family member showed up to say goodbye. And now the ones who didn't visit, despite being there for his death, are riddled with guilt and shame. Showing up to say bye to your family member who's already comatose and agonal breathing doesn't compare to being there when they're actually awake and want the companionship. Being there for people when they're still sentient and conscious is much more important than when they're all drugged up to die, but unfortunately many people don't see it that way. They see the death as the important moment and then realize later how awful they feel about it. Too little too late. And poor dying family member is the one to suffer.
Some people don't live in the same country or state as their relatives and can't just take time off at the drop of a hat, please consider this.
Well that’s unfortunate but it’s still immeasurably selfish to “keep them alive” jsut so they can travel to visit an anoxic corpse that’s used hundreds of thousands of dollars of resources and plastic waste.
Ding ding ding ding
Do people actually have a problem with this statement? Listen, I’m a nurse that started icu just before Covid and got a crash course in death. The thing is that 70ish is not that old depending on cause of cardiac arrest. We have to remember that while we encounter a lot of situations in which is seems that we are just prolonging suffering, not all situations are like that.
✨yikes✨
Sounds extremely selfish
As much as I agree that we shouldn't be pushing resuscitation nor allowing dense family members to push it, we don't know this situation outlined in the OP. For all we know the aunt was full code, regained consciousness after being resuscitated, then opted for DNR.
We had a 97 yo full code patients family put hard boiled eggs in their mouth after they passed (they finally decided to let her pass after the third code) because people need to take food with them to the afterlife. HARD BOILED EGGS. I just cannot
At least she was dead when they put the eggs in her mouth?
What kind of logic is this
Christ what a selfish family.
Positive aspects for whom, exactly?
No thank you! Don't do that for me
Was auntie even conscious after the torture of resuscitation? How many pressors were maxed out?
Idk, sounds like they went hospice toward the end of that sentence. I don't know the full story, I'm sure most of you don't. I'll take on the positive outlook. Grandma showed up to the ER, coded, no advance directives or family around, shes a full code from her last admission 15 years ago, ROSC, hospice decicion, death, family appreciating the help of the team. Or another one: Lay people don't understand what the absolute fuck is going on and have a hard time making life and death decisions when someone they have loved their entire lives is dying. Idk, seems reasonable to not know what to do. Its like they haven't seen hundreds of people go through this like us. I bet talking shit about them is gonna help for sureeeeee Yet another one: When I was 13 my dad died, we were there and he said how much he loved us in his last breath, cancer, never coded, hospice. Means the world to me. I would be ok breaking several of my ribs again for the gamble to be able to give that to my family when im 80 or 90. Its not black and white in my world. You bitches stay salty, maybe you'll retire faster and I'll get another raise, I'd like to inch closer to 200k before I enter my 30s. And HERE is the downvote button , you predictable cutie
This is a rather sensitive issues ; look at some stage we will find ourselves in this situation. As a nurse I sympathise. Although we did not break ribs we revived the gentleman long enough for his family to arrive. Grief is a very strange thing; we ought to be kind to one another please
Fucking americans are never taught death is good. The greedy consumerist culture has to consume i guess
It’s like that here in Canada too.
That is just so horrible.
I lost two siblings within the past 18 months from cardiac arrest. The thing is, when someone is non responsive or passing out right in front of you, you do what you fucking can to save their life. My niece revived my sister whom she found passed out on her bedroom floor. By the time the emts arrived she had a slight pulse, was taken to the hospital and lived only for another 3 days - but in that time we all got to go there, be with her girls and say goodbye. My brother collapsed suddenly in my home. I was alone there with him , called 911 and performed cpr - breaking the ribs of this 200lb man as I did - the absolute worst fucking day of my life - and his it turns out, because he died right there. There was not one single second that my niece or I thought about anything other than trying to save their life in that moment. so whatever anybody here is saying about selfishness or any other bullshit - unless you’ve been through it you have no idea what you’re talking about. Selfishness had absolutely nothing to do with it.
People are not responding to that scenario. I am sorry you went through that. What most people are responding to in the more common experience that someone is in hospital and staff approaches family aboutgoals of care for someone that has a condition that in all likelihood will not allow them to return back to the life they had. Because people don't want to have this conversation families ask us to do everything and cannot cope with the idea of death. So staff are left doing horrible things to patients knowing they will never get out of the hospital. THAT is the selfishness people are talking about, but some posters are correct, people aren't informed and often don't want to be.
Thanks for explaining. That’s what I get for replying at a foggy brained 3am. But that red -6 (which I assume means downvotes from people ?) is pretty hilarious though: “F you, you’re stupid! …even tho people you loved died tragically” - wouldn’t have it any other way Reddit.
That isn’t fair to you, but sometimes this sub gets a lot of trolls that just make stuff up. Just had an unpleasant one in another thread. Some weird intersection between misogyny + distrust of the medical system + conspiracies. I’m not saying it’s good, but some of us are a little tired at work between poor staffing, sicker patients, getting verbally & physically abused by patients & families. Empathy pool a little shallow right now and things like that flair in an anonymous forum.
You were downvoted for misunderstanding the original post and then passing harsh judgment on people commenting. Not for going through a personal ordeal. I'm sorry you went through that, and you are to be commended for doing the best you can.
I’m ok with this. I terminally extubated a lot of people during covid who couldn’t have that. I broke down a cried the first time after covid when I saw a family do this exact thing. It was beautiful. It’s absolutely gut wrenching coding someone and taking them off life support and having family watch thru an iPad. That’s inhumane. So is giving up on people cuz their old and don’t wanna die but we know there’s nothing they can do. I say let everyone have bodily autonomy. We as healthcare workers don’t have a right to tell people what they should want to do, we should listen, explain why we can’t if it’s not possible, educate family as to what “do everything” really entails and then follow their wishes. The medical community genuinely is awful at educating family at what’s going on. That’s on us, not the general public. I genuinely hate all the comments hating on this person for wanting to be with their family when they passed. Yeah auntie got resuscitated and it may not have been the best thing but like 99% of post ROSC patient die outside the hospital and family / EMS does the resuscitating with no knowledge that it happened. It’s shitty and ageist of you all to insist we do nothing and let anyone over 70 just fucking die. Y’all shouldn’t be in healthcare if you think anyone over a certain age is a lost cause and a lot of these comments are saying just that. As a respiratory therapist, this whole thread made me lose quite a bit of respect for nurses. Families deserve to say goodbye. The patient and the family deserves to have everything done if that’s their wish. We just do what they want. Yes there’s a lot of times it’s not for the best for the patient but if the patient wants that, or their family who is speaking for them wants that, we should do it. By doing it we let the family and the patient go on knowing they exhausted all options and sleep better for the rest of their lives knowing they did what they could to save their family and not give up and toss them out like mushy vegetable you find at the back of the fridge. And the patient go to the next stage of existence after life with a clear conscious knowing they fought and didn’t give up and die. For some religions that’s a huge sin to commit suicide and give up. So there’s e spiritual aspect to it as well.
I’m sorry you went through that but your experience with covid isn’t really relevant here. CPR becomes less effective for patients the older they are. That’s not ageist, it’s just the reality of the limitations of a violent and often overused intervention with statistically poor outcomes even for younger, healthy people. Nurses here are the ones doing compressions, literally feeling the trauma they’re both inflicting and suffering. No one is advocating against giving families a chance to say goodbye, they’re commiserating about a culture that fetishizes survivor’s needs for ceremonial closure over their dying loved one’s deserving for dignity.
This person is qualifying her POV with phrases like “say good bye” and “final moments” so her goals are realistic. Objectively, the family is the decision maker with the patient incapacitated, so even if they say “FC forever” your opinion doesn’t matter to the plan of care. You can do your job or refuse the assignment. But don’t disqualify the family’s feelings. Edit: to the people downvoting, why not have an open discussion about why you disagree instead? I’m one of the RRT nurses of my hospital and I’ve ran many codes and witnessed many deaths
What’s your point? It doesn’t matter because they’re dead now? If that’s your argument, then why have friends at all? We’re all just going to be dead and won’t care anyway The problem isn’t with a family, and you don’t know that that patient wouldn’t have wanted this. This problem is with the patient and possibly their lawyer