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The other end

By Theresa
Posted on

I had the conversation with my parent.

I am far too often on the other end of the purpose of this movement - families who haven't talked about their wishes and so desperately wish they had.
I am a Registered Nurse in an intensive care unit. In the three and a half years I have worked in this ICU, I have seen countless individuals pass away and have had really difficult discussions with many of their family members. Our job as nurses in the ICU is to do our best to heal and stabilize our patients, which often involves putting these patients on life support – ventilators, large central IVs with medicines to artificially sustain blood pressure, dialysis, and at times providing CPR and electrical shocks to restart a patient’s heart. These things are all extremely uncomfortable and often painful, but when a family requests that “everything be done” for their loved one, it is what we are required to do. I remember so many times when a family member would tell us “do everything you can to keep them alive! Definitely put them on a breathing machine…definitely shock their heart…definitely put them on dialysis…but we absolutely do NOT want them to be put on life support!” They don’t realize that all of their instructions are what life support is! Families almost never seem to have a good understanding of what “life support” is – and I think that increasing knowledge of these facts would help so many families be able to respect their loved one’s wishes. The media – movies, television, etc. – make CPR appear to be a very gentle, humane procedure – when in reality, it causes nightmares for the doctors and nurses who are providing it. It requires that the patient’s chest be pressed down 1-2 inches each compression, which so often results in many broken ribs, especially in the elderly. The staff is only allowed to perform CPR for 2 minutes at a time, because it is so physically exhausting. I myself have had sore arms the day after performing CPR, as if I had done an intense workout. It needs to be understood that CPR is anything but gentle in order to be effective. Even if the heart does restart, the lack of blood flow to the brain and other organs ends up being more damaging, and the patient becomes worse than they were before the CPR. I truly believe that more family members would decline to have CPR performed on their loved one if they saw what it actually looks like in “real life” as opposed to in the movies. Lastly, in my relatively short time as an ICU nurse, I’ve lost count of the number of family members who, during a “decision meeting” with the nurses and physicians, have said to me, “I really wish we had talked about this when we had the chance.” I cannot stress enough how important these conversations are. I am far too often on the other end of the purpose of this movement – families who haven’t talked about their wishes and so desperately wish they had. This project is so, so important – and I plan to help spread the word as best as I can. Thank you!

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