Hospice

There's a patient on my unit who is now on "full hospice care" She's obviously dying. I go in to check on her during rounds and have to stand and watch for a full 15 seconds in order to see her catch her breath.

Two nights ago, I was sitting with a patient who came to us with norovirus and her agitation got increasingly worse - especially when I tried to get her to lie down. Then she started gurgling and coughing and sounding generally not good. Upon transport to the ER downstairs, suction became necessary and the greenest stuff I've ever seen come out of person made its appearance. She was transferred to the big hospital and died the next day.

When I started working on a psych unit, I never thought that I'd be facing extensive geriatric/nursing home type situations. It's so...sad. But not in the "I just want to cry" sense. It's not really emotional for me; there's a disconnect in my brain that doesn't allow for emotion to get involved. I try to make these people comfortable; I do everything I can to help them, and then I move straight to the acceptance stage. There's a sort of check in my brain saying that someday, all of this is going to come back to me and I'm going to become a flipped out basket case........I hope not. It's my goal to ease the suffering and make the unnaturalness of death and the transition to it less painful - for the patient AND the patient's family. That last part is kind of difficult when the unit is on isolation due to norovirus exposure.

Tomorrow is my first BioMedical Ethics class. I got a peek at the syllabus tonight and we will be discussing things like living wills and advanced directives this semester. Now that it's out of the hypothetical and into reality for me I think it's going to feel like more of a fuzzy area. Guess we'll see...