Saturday, November 22, 2003
Feeling very tired... Not exactly sure why. I have probably got 8hrs sleep on average last night. 5hrs the two nights before that. Just feel really lethargic today. Days off are the saving grace.
On to the gripe for the day.
I don't understand why doctors are so reticent to palliate someone. Palliation is pretty much making someone comfortable so they can die with dignity. Before you think it, no this is not euthanasia, it is different. Palliation is used with people who are not going to get better, medicine can not help these people apart from making them comfortable if they require it. It is about quality of life, not quantity, and getting them as pain free and comfortable as we can counts.
Was looking after a woman last night... in her 90's, had fallen and fractured her hip, ok so not normally a death sentence by any means. But she had pretty much shattered the top of her femur, so they could not put an artificial hip in. They did a procedure to remove the shattered bits, and she will never be able to walk again. She deteriorated since the operation, its a lot for a 90 something year old body to cope with. Rallied a few times out of her unconscious state and was talking and eating and drinking although mostly confused. She was pretty much unconscious through yesterday, unable to eat, drink or take medications, little response except when she was having pressure care(entails rolling from side to side to take pressure off bony bits of the body) which obviously hurt cause her leg has no joint to her body any longer. No analgesia other than oral written up, and the doctor would not write up any injectable drugs, therefore no pain relief.
So the doctor reviews her, staff ask about palliation, the doctor says... oh she may rally again and be able to tolerate her medications etc. But if she hasn't eaten or drank anything by 5pm start up some subcutaneous fluids. So we start up the fluids as ordered, she wakes, we give her sips of water but she is not awake enough for anything else. She goes very deeply asleep/unconscious during the next few hours so that by the time we leave she does not even moan as we move her. *sighs* We could have made her so much more comfortable. This is when nursing gets really really frustrating.
Gonna catch some z's now. Laters!
On to the gripe for the day.
I don't understand why doctors are so reticent to palliate someone. Palliation is pretty much making someone comfortable so they can die with dignity. Before you think it, no this is not euthanasia, it is different. Palliation is used with people who are not going to get better, medicine can not help these people apart from making them comfortable if they require it. It is about quality of life, not quantity, and getting them as pain free and comfortable as we can counts.
Was looking after a woman last night... in her 90's, had fallen and fractured her hip, ok so not normally a death sentence by any means. But she had pretty much shattered the top of her femur, so they could not put an artificial hip in. They did a procedure to remove the shattered bits, and she will never be able to walk again. She deteriorated since the operation, its a lot for a 90 something year old body to cope with. Rallied a few times out of her unconscious state and was talking and eating and drinking although mostly confused. She was pretty much unconscious through yesterday, unable to eat, drink or take medications, little response except when she was having pressure care(entails rolling from side to side to take pressure off bony bits of the body) which obviously hurt cause her leg has no joint to her body any longer. No analgesia other than oral written up, and the doctor would not write up any injectable drugs, therefore no pain relief.
So the doctor reviews her, staff ask about palliation, the doctor says... oh she may rally again and be able to tolerate her medications etc. But if she hasn't eaten or drank anything by 5pm start up some subcutaneous fluids. So we start up the fluids as ordered, she wakes, we give her sips of water but she is not awake enough for anything else. She goes very deeply asleep/unconscious during the next few hours so that by the time we leave she does not even moan as we move her. *sighs* We could have made her so much more comfortable. This is when nursing gets really really frustrating.
Gonna catch some z's now. Laters!
10:07 PM
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Writing since January 2003!
web-counter? Maybe one day
BJ T now was S
Born in April on the 21st!
Australian but living in the USA.
Allison
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