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Exactly.
Because the default is for medical personnel do to absolutely everything.
Which sometimes works against the will of God, as He attempts to bring the patient up to Heaven to be seated at his right hand.
I don't like fucking with God's will.
Codes are horrible, almost violent in a way. Nothing of course like portrayed on TV, another pet peeve. They aren't crazy and disorderly but methodical and relatively quiet. (that's not dramatic enough, I suppose... and don't get me started on them shocking asystole...)
Just curious, what do you think of the trend of allowing families to view the code in progress?
I once coded a woman in her thirties with metastatic breast cancer that had spread throughout her body. Because she was young, the meds we were giving her were kick starting her heart and it would beat for a while until the med wore off, then the code would start again.
During the intubation, the vomited and the vomit ran down over her face and into her eyes, which were open (she was unconscious this entire time).
After coding her about 5 times through the night, the family had finally decided to stop the coding and let her go (the metastatic breast cancer was terminal - she had no chance of cure).
When everything was done, and we were cleaning her up, I looked at her eye that was still open...
The acidic vomit from the intubation had eaten a hole right into her eyeball.
isn't that what I said in the first sentence?people also don't understand that there are different levels of DNR, one could want limited life saving care but still be DNR.
I think better planning for end of life care is very important right now with baby boomers already starting to develope different forms of dementia. Their families need to be better informed of what will happen near the end along with the people who have the disease. Here is one article that talks about the cost and the people who are taking care of family members with the disease unpaid probably do to the high cost of taking care of someone with dementia.
18% of all boomers expected to develop Alzheimer's - USATODAY.com
Do not resuscitate does not mean do not treat.
I know exactly what DNR means and the different forms, I had to know what 80 different people's dnr status was or where to find it at any time.
Why everyone should have an advance directive (or Why I hate people)
A patient recently had a sudden change in condition. I notified the doc who asked for the patient's son's phone number so he could find out about code status and what he wished for us to do.
Doc calls back a bit later and said the man was now a DNR, we'd just make him comfortable... and the son was on his way in, quite upset. Doc was on his way in as well.
About 10-15 minutes later, son calls; he acknowledged he didn't want his dad on life support or coded, and says doc told him his dad might not make it through the night. I told him I didn't know; he may, he may not. At that point son got very agitated and told me he WANTED us to code dad, and he would be there soon. So I called doc back and told him the DNR was rescinded.
Son and his wife show up. Son goes into dad's room and starts shaking the hell outta the bed, yelling "Dad! Dad!"
'Course, dad didn't respond at all.
I go in and they both start asking me about the machine. Not dad. The fucking machine. I try to explain to them what would happen if dad stopped breathing and such but they kept asking about the machine... how long it would keep him alive, how did we get him on it, couldn't we just send him to ICU and get him on it right now...
I was getting more and more confused. They kept asking for all these details about the machine but obviously no matter how simple the explanation, they hadn't a clue what I was saying. It was quite obvious that their family tree didn't fork, if you know what I mean. I told them that even if he were on the machine, that only kept him breathing; if his heart stopped nothing would keep him alive---the machine didn't do that.
That's when son looked at me really desperate-like and said, "But we're going on vacation in the morning!"
My mouth must have dropped open, or something in my eyes... because son's wife chimes in, "We're already packed and ready to go!!!"
She then looked at her dad-in-law and says, "well, I guess this is important too..."
Son then says, "Can't you just put him on the machine for a week until we get back?"
That's when I had to walk away.
In 25 years, I've never heard anything like that. I was completely stunned and didn't reply except to mutter that the doc was on his way.
OMG.
Doc came in and talked to them (I was a witness) and he was soooo good. Was honest and told son he thought dad was going to die within the next few days, and that even if he did go on the machine, it wouldn't change the outcome.
Son left to discuss this with wife, came back and gave the consent for DNR. Both looked quite pissed off. Then he got upset because I took the BP and sat monitors off. He wanted to know how in the hell he (the son) was supposed to know when dad was dead.
Enter another stunned silence. So I slipped the oximeter back on so he could see the pulse and sat readings.
This is why I hate people; they never fail to amaze me. Just when I thought I'd heard it all. It's obvious why he rescinded the first DNR.
this why where I worked we had care meetings on residents once a month with their families if they were close to the end and every few months if not. If their health condition changed they would have a care meeting.Why everyone should have an advance directive (or Why I hate people)
A patient recently had a sudden change in condition. I notified the doc who asked for the patient's son's phone number so he could find out about code status and what he wished for us to do.
Doc calls back a bit later and said the man was now a DNR, we'd just make him comfortable... and the son was on his way in, quite upset. Doc was on his way in as well.
About 10-15 minutes later, son calls; he acknowledged he didn't want his dad on life support or coded, and says doc told him his dad might not make it through the night. I told him I didn't know; he may, he may not. At that point son got very agitated and told me he WANTED us to code dad, and he would be there soon. So I called doc back and told him the DNR was rescinded.
Son and his wife show up. Son goes into dad's room and starts shaking the hell outta the bed, yelling "Dad! Dad!"
'Course, dad didn't respond at all.
I go in and they both start asking me about the machine. Not dad. The fucking machine. I try to explain to them what would happen if dad stopped breathing and such but they kept asking about the machine... how long it would keep him alive, how did we get him on it, couldn't we just send him to ICU and get him on it right now...
I was getting more and more confused. They kept asking for all these details about the machine but obviously no matter how simple the explanation, they hadn't a clue what I was saying. It was quite obvious that their family tree didn't fork, if you know what I mean. I told them that even if he were on the machine, that only kept him breathing; if his heart stopped nothing would keep him alive---the machine didn't do that.
That's when son looked at me really desperate-like and said, "But we're going on vacation in the morning!"
My mouth must have dropped open, or something in my eyes... because son's wife chimes in, "We're already packed and ready to go!!!"
She then looked at her dad-in-law and says, "well, I guess this is important too..."
Son then says, "Can't you just put him on the machine for a week until we get back?"
That's when I had to walk away.
In 25 years, I've never heard anything like that. I was completely stunned and didn't reply except to mutter that the doc was on his way.
OMG.
Doc came in and talked to them (I was a witness) and he was soooo good. Was honest and told son he thought dad was going to die within the next few days, and that even if he did go on the machine, it wouldn't change the outcome.
Son left to discuss this with wife, came back and gave the consent for DNR. Both looked quite pissed off. Then he got upset because I took the BP and sat monitors off. He wanted to know how in the hell he (the son) was supposed to know when dad was dead.
Enter another stunned silence. So I slipped the oximeter back on so he could see the pulse and sat readings.
This is why I hate people; they never fail to amaze me. Just when I thought I'd heard it all. It's obvious why he rescinded the first DNR.
Some people fail to understand that advance care planning doesn't necessarily equate to making a person a DNR. An advance directive can also instruct providers to perform life-sustaining measures, or specific treatments and procedures (such as tube feedings, for example). It doesn't have to include a 'living will' portion at all. That's why it's called a directive.
Exactly.
Because the default is for medical personnel do to absolutely everything.
Which sometimes works against the will of God, as He attempts to bring the patient up to Heaven to be seated at his right hand.
I don't like fucking with God's will.
Codes are horrible, almost violent in a way. Nothing of course like portrayed on TV, another pet peeve. They aren't crazy and disorderly but methodical and relatively quiet. (that's not dramatic enough, I suppose... and don't get me started on them shocking asystole...)
Just curious, what do you think of the trend of allowing families to view the code in progress?
Surprisingly (for most people I'd think), our oncology unit had a good deal of codes. We also took medical overflow, so that accounted for many, but cancer patients get coded too.Codes are horrible, almost violent in a way. Nothing of course like portrayed on TV, another pet peeve. They aren't crazy and disorderly but methodical and relatively quiet. (that's not dramatic enough, I suppose... and don't get me started on them shocking asystole...)
Just curious, what do you think of the trend of allowing families to view the code in progress?
I once coded a woman in her thirties with metastatic breast cancer that had spread throughout her body. Because she was young, the meds we were giving her were kick starting her heart and it would beat for a while until the med wore off, then the code would start again.
During the intubation, the vomited and the vomit ran down over her face and into her eyes, which were open (she was unconscious this entire time).
After coding her about 5 times through the night, the family had finally decided to stop the coding and let her go (the metastatic breast cancer was terminal - she had no chance of cure).
When everything was done, and we were cleaning her up, I looked at her eye that was still open...
The acidic vomit from the intubation had eaten a hole right into her eyeball.
That is terrible!
I am lucky that most of the people I saw pass away were no code.
I did have a lady who got her "second wind" and ate all her food one night which she never did. Well she ended up aspirating due to health reasons. When I found her on my last rounds she had the dark brown thick vomit coming out of her nose and mouth.
But like Emma said it isn't crazy like on tv, you just take care of them and think about it later. I couldn't believe how calmed I stayed with that lady and she was the first one I took care of as they died. She is a prime example of why morphine is so great. She had been gasping for air and seemed to be in pain, as soon as the morphine hit she was calm and passed away quickly and with no pain.
what a bitch!Surprisingly (for most people I'd think), our oncology unit had a good deal of codes. We also took medical overflow, so that accounted for many, but cancer patients get coded too.I once coded a woman in her thirties with metastatic breast cancer that had spread throughout her body. Because she was young, the meds we were giving her were kick starting her heart and it would beat for a while until the med wore off, then the code would start again.
During the intubation, the vomited and the vomit ran down over her face and into her eyes, which were open (she was unconscious this entire time).
After coding her about 5 times through the night, the family had finally decided to stop the coding and let her go (the metastatic breast cancer was terminal - she had no chance of cure).
When everything was done, and we were cleaning her up, I looked at her eye that was still open...
The acidic vomit from the intubation had eaten a hole right into her eyeball.
That is terrible!
I am lucky that most of the people I saw pass away were no code.
I did have a lady who got her "second wind" and ate all her food one night which she never did. Well she ended up aspirating due to health reasons. When I found her on my last rounds she had the dark brown thick vomit coming out of her nose and mouth.
But like Emma said it isn't crazy like on tv, you just take care of them and think about it later. I couldn't believe how calmed I stayed with that lady and she was the first one I took care of as they died. She is a prime example of why morphine is so great. She had been gasping for air and seemed to be in pain, as soon as the morphine hit she was calm and passed away quickly and with no pain.
I was the resource nurse for nights on our unit, and everyone would comment on how calm I was. Which I was during the code. Once it was over I shook like a leaf.
We coded a visitor once; she left the patient's room to go to the bathroom and as soon as she stepped out into the hall she went over like a tree. We brought her back, transferred her to the unit and she proceeded to make a complaint because we'd torn her new blouse when initiating CPR.
Another reason I hate people.
Codes are horrible, almost violent in a way. Nothing of course like portrayed on TV, another pet peeve. They aren't crazy and disorderly but methodical and relatively quiet. (that's not dramatic enough, I suppose... and don't get me started on them shocking asystole...)
Just curious, what do you think of the trend of allowing families to view the code in progress?
I once coded a woman in her thirties with metastatic breast cancer that had spread throughout her body. Because she was young, the meds we were giving her were kick starting her heart and it would beat for a while until the med wore off, then the code would start again.
During the intubation, the vomited and the vomit ran down over her face and into her eyes, which were open (she was unconscious this entire time).
After coding her about 5 times through the night, the family had finally decided to stop the coding and let her go (the metastatic breast cancer was terminal - she had no chance of cure).
When everything was done, and we were cleaning her up, I looked at her eye that was still open...
The acidic vomit from the intubation had eaten a hole right into her eyeball.
OMG! I will have to remember that the next time that I intubate someone. I've cleaned puke off many arrests, but I've never seen that happen. Holy $*%$! Yes codes are very traumatic. They are very messy. And I would venture to say that most of the people making these outlandish claims, have never seen one.
I don't have showtime, but I've seen clips... and have considered getting a subscription just to be able to see that show.what a bitch!Surprisingly (for most people I'd think), our oncology unit had a good deal of codes. We also took medical overflow, so that accounted for many, but cancer patients get coded too.That is terrible!
I am lucky that most of the people I saw pass away were no code.
I did have a lady who got her "second wind" and ate all her food one night which she never did. Well she ended up aspirating due to health reasons. When I found her on my last rounds she had the dark brown thick vomit coming out of her nose and mouth.
But like Emma said it isn't crazy like on tv, you just take care of them and think about it later. I couldn't believe how calmed I stayed with that lady and she was the first one I took care of as they died. She is a prime example of why morphine is so great. She had been gasping for air and seemed to be in pain, as soon as the morphine hit she was calm and passed away quickly and with no pain.
I was the resource nurse for nights on our unit, and everyone would comment on how calm I was. Which I was during the code. Once it was over I shook like a leaf.
We coded a visitor once; she left the patient's room to go to the bathroom and as soon as she stepped out into the hall she went over like a tree. We brought her back, transferred her to the unit and she proceeded to make a complaint because we'd torn her new blouse when initiating CPR.
Another reason I hate people.
YOu watch Nurse Jackie on Showtime? It is the first show I have seen that is remotely closer to what really happens in health care.
BTW, I did edit my response to clarify. Sorry I wasn't clear to start withisn't that what I said in the first sentence?people also don't understand that there are different levels of DNR, one could want limited life saving care but still be DNR.
I think better planning for end of life care is very important right now with baby boomers already starting to develope different forms of dementia. Their families need to be better informed of what will happen near the end along with the people who have the disease. Here is one article that talks about the cost and the people who are taking care of family members with the disease unpaid probably do to the high cost of taking care of someone with dementia.
18% of all boomers expected to develop Alzheimer's - USATODAY.com
Do not resuscitate does not mean do not treat.
I know exactly what DNR means and the different forms, I had to know what 80 different people's dnr status was or where to find it at any time.
Why everyone should have an advance directive (or Why I hate people)
A patient recently had a sudden change in condition. I notified the doc who asked for the patient's son's phone number so he could find out about code status and what he wished for us to do.
Doc calls back a bit later and said the man was now a DNR, we'd just make him comfortable... and the son was on his way in, quite upset. Doc was on his way in as well.
About 10-15 minutes later, son calls; he acknowledged he didn't want his dad on life support or coded, and says doc told him his dad might not make it through the night. I told him I didn't know; he may, he may not. At that point son got very agitated and told me he WANTED us to code dad, and he would be there soon. So I called doc back and told him the DNR was rescinded.
Son and his wife show up. Son goes into dad's room and starts shaking the hell outta the bed, yelling "Dad! Dad!"
'Course, dad didn't respond at all.
I go in and they both start asking me about the machine. Not dad. The fucking machine. I try to explain to them what would happen if dad stopped breathing and such but they kept asking about the machine... how long it would keep him alive, how did we get him on it, couldn't we just send him to ICU and get him on it right now...
I was getting more and more confused. They kept asking for all these details about the machine but obviously no matter how simple the explanation, they hadn't a clue what I was saying. It was quite obvious that their family tree didn't fork, if you know what I mean. I told them that even if he were on the machine, that only kept him breathing; if his heart stopped nothing would keep him alive---the machine didn't do that.
That's when son looked at me really desperate-like and said, "But we're going on vacation in the morning!"
My mouth must have dropped open, or something in my eyes... because son's wife chimes in, "We're already packed and ready to go!!!"
She then looked at her dad-in-law and says, "well, I guess this is important too..."
Son then says, "Can't you just put him on the machine for a week until we get back?"
That's when I had to walk away.
In 25 years, I've never heard anything like that. I was completely stunned and didn't reply except to mutter that the doc was on his way.
OMG.
Doc came in and talked to them (I was a witness) and he was soooo good. Was honest and told son he thought dad was going to die within the next few days, and that even if he did go on the machine, it wouldn't change the outcome.
Son left to discuss this with wife, came back and gave the consent for DNR. Both looked quite pissed off. Then he got upset because I took the BP and sat monitors off. He wanted to know how in the hell he (the son) was supposed to know when dad was dead.
Enter another stunned silence. So I slipped the oximeter back on so he could see the pulse and sat readings.
This is why I hate people; they never fail to amaze me. Just when I thought I'd heard it all. It's obvious why he rescinded the first DNR.
this why where I worked we had care meetings on residents once a month with their families if they were close to the end and every few months if not. If their health condition changed they would have a care meeting.
These meetings would include the family members, guardians, the RCC, a nurse, and a NAC/CNA. It helped the family members know exactly what was going on and what kind of care they needed along with helping them prepare for the end.
Exactly.
Because the default is for medical personnel do to absolutely everything.
Which sometimes works against the will of God, as He attempts to bring the patient up to Heaven to be seated at his right hand.
I don't like fucking with God's will.
Codes are horrible, almost violent in a way. Nothing of course like portrayed on TV, another pet peeve. They aren't crazy and disorderly but methodical and relatively quiet. (that's not dramatic enough, I suppose... and don't get me started on them shocking asystole...)
Just curious, what do you think of the trend of allowing families to view the code in progress?
I have mixed feelings about it. It is definitely more difficult to concentrate. I'm personally not a big fan of it, but if it helps someone to get closure...then so be it.
I love the show! For it shows how admistrators have no clue what it is going on.I don't have showtime, but I've seen clips... and have considered getting a subscription just to be able to see that show.what a bitch!Surprisingly (for most people I'd think), our oncology unit had a good deal of codes. We also took medical overflow, so that accounted for many, but cancer patients get coded too.
I was the resource nurse for nights on our unit, and everyone would comment on how calm I was. Which I was during the code. Once it was over I shook like a leaf.
We coded a visitor once; she left the patient's room to go to the bathroom and as soon as she stepped out into the hall she went over like a tree. We brought her back, transferred her to the unit and she proceeded to make a complaint because we'd torn her new blouse when initiating CPR.
Another reason I hate people.
YOu watch Nurse Jackie on Showtime? It is the first show I have seen that is remotely closer to what really happens in health care.
Not really needed...heirs, by definition have a monetary incetive in having their folks off themselves sooner rather than later.So do you suppose Obama will offer monetary incentives to the relatives of old folks who off themselves?
The propaganda mills have been working hot and heavy on this one.
Yep.
*laughs* you social engineers make me laugh sometimes really and I find your debates if anything entertaining. However, the epic fail part because the head of some National Hospice group says its not what it is? Well I guess you told me huh? If you had bothered to read the whole thing Robert you would have seen that its about amending the SSA to make those requirements and thus leading Seniors into those sessions rather than letting them make whatever decisions they want to make on their own. At the risk of not repeating myself for all you who have no clue on the constitution, I will simply point you to the page in the legislation where the language is contained. If you choose to see that as an innocent then by all means be my guest.
The propaganda mills have been working hot and heavy on this one.
Yep.
Emma, here you are, intelligent, and clearly well versed in healthcare, but cannot see the clear dots that have to be connected.
Totalist philosophies have, as their hallmark, been for 'the people,' but opposed to the individual.
That is the clear difference as compared to democracy.
Here we have an administration which claims to provide better healthcare at a lower cost. Logic and experience must tell you that the material quoted by Navy has as its money saving key the reduction of services, and we can see who will shoulder the reduction.
One of the posts above actually posits that old folks really want to die, and the language is just trying to codify their wishes.
Shocking and absurd.
Let me pose a hypothetical, but one based on history in the healthcare field, and you tell me the different future that you can see:
The probable, not definite, not possible, but probable, result of the instituting of the ObamaCare Healthcare Plan. The 'Public Option,' and ultimately all plans will use capitation to save money:
1. Capitation, also called bundling, is a fixed payment remitted at regular intervals to a medical provider by a managed care organization for an enrolled patient.
a. The primary care physician gets a fixed payment based on the number of patients signed up by him, or assigned to him.
b. The payment is whether or not the patients are seen. So if the payment is $10, but it costs the doctor $50 to see the patient, he will limit the number of public plan patients he sees.
c. The patient will require a referral to see a specialist, and the program will deduct payment from the doctor for each such referral.
d. Thus the primary care physician is incentivized not to see patients nor to refer to specialists.
2. While this was the procedure in the early days of HMOs, to institute it today does not recognize current demographics.
a. While younger patients can withstand longer waits for an appointment, and would probably recover from a flu, or sprain, this is not the case for our older population.
b. The nature of the complaint often involves more serious medical problems, as the elderly have more diabetes, circulatory, and malignancies.
c. While current medical environment requires more frequent visits, the plan in question inveighs against this.
