Friday, July 27, 2012

big day back

Yesterday was my first day leaving Moose to go to work. He was under the excellent care of his nurses and doctors, but still. It was stressful. Also, I had a long night rocking him and sleeping in the chair.

At 0800, my admission rolled through the doors with no warning or report. A code from the floor, so the whole code team rolled in, with the other 50 med students/gawkers hot on their tails. Oh, and the patient was head to toe covered in blood. As were the members of the code team, and her bed, and her equipment. It was really a sight. After getting her into the room, she lost a pulse again. At least, I couldn't palpate one. I'm not a great femoral pulse palpator though. But anyway, we did more compressions and 1 of epi, we got a good pulse and sinus tachy. It took several of us to organize and clean her up, but we finally got her stabilized and presentable.

Then let the family fun begin! Everyone, especially husband, seemed to agree that with her advanced stage IV cancer, she had already been nearing the end and would not want to spend it on "life support". Ok, that's great, we would withdraw. But no, wait, oh my god, there is a new DPOA form from last night in her file, where she (very strangely) had switched her DPOA from her husband to her best friend, and detailed out that she wanted to stay on a vent until 12 months had passed. What?! Totally different from what her family and friends had discussed with her.

Hours of detective work later, it was determined that she had had altered mental status at the time, some nurse or someone had helped her fill it out, but it was not complete and therefore not legal, and everyone was able to agree that she would not want to live out what remained of her life on life support.

So we withdrew.

Whew. What a day.

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