night shift
doing 7 days of night shift (9.30pm-8.30am). this is Night 3. so far so good, in terms of the workload (as u can see i am sitting in front of a computer and not exactly doing anything work related) and the daily routine. i'm very thankful that i have actually been able to sleep during the day which is not something i used to be able to do.Certified 2 deaths already over the last 3 days. both patients were NFR (not for resuscitation) ~ a decision agreed upon by the family after informed discussion that, in the event of a cardiorespiratory arrest, no active resuscitation measures would be taken up. If no NFR order was made, i'd have received a MET call (along with all the other handful of doctors on at the hospital at night) at the time the patient arrested and take part in a vigorous attempt to resuscitate the patient which often is unsucessful.
An NFR order does make it much easier for the medical staff (i'm admitting this with some sense of guilt) but also makes the final stage of the process of dying much or dignified for a patient whose death is inevitable. The patients have usually been "dying" slowly in front of everyone's eyes for the past weeks (and that's why an NFR would be suggested by the treating medical team), thumping them in the chest and putting lines in them in the final stage would just be too traumatic. One of the nurses was remarking to me just then how a patient died the other day and they spent 30min trying to resuscitate them, while knowing that it wouldn't make any difference (and even if it did the patient's quality of life would still be minimal) because the patient had been deterioating over the past few weeks and had been semi-unconscious for the past couple of days. But everyone still had to go thru the mechanical process of "trying to revive" the patient, and the patient themself had to go thru an ?unnecessary process.
Of course, the family sometimes does not want to agree to an NFR because they don't want to be "involved" with the patient's death. they do not want to be "responsible" for it, because what if the resuscitation could actually turn things around but they said no?? a big decision to make. Do we have a right in this? are we trying to play God? But ultimately, if they're meant to go, they're meant to go. So it makes no difference?
posted by zhinger @ 2:32 am
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