My day at work

[il Padrino Ute]

Originally Posted by MikeWaters

I briefly volunteered in an AIDS hospice. I was told by the staff that most often the patients "chose" to die alone. I.e. if someone was with them, they would most often die when the family or friend or staff left for a time (i.e. go get a meal).

I don't know if this was their folklore, if there was some truth to it.

Interesting. I can't comment on it, as I've never heard that.

In my experience as a funeral director, the families that were with their loved on at the time of passing at the hospital or care center were much more calm while arranging the funeral than those who were not. Perhaps the reality of the passing was easier to accept for those who were there.

[ewth8tr]

Originally Posted by MikeWaters

I briefly volunteered in an AIDS hospice. I was told by the staff that most often the patients "chose" to die alone. I.e. if someone was with them, they would most often die when the family or friend or staff left for a time (i.e. go get a meal).

I don't know if this was their folklore, if there was some truth to it.

That's exactly what our hospice care worker said as well. My Mom went into a coma though the night before and didn't open her eyes or move again until the seconds before she died. My sisters, my Dad, her Mom, her sisters and my Wife were all at her side when she died.

[ewth8tr]

Originally Posted by il Padrino Ute

As tough as it must have been for you to see her go, I'm guessing she was very happy to have her son by her side when it was time to go.

Thanks, I think so as well. As hard as it was and still is on me, I am thankful that I was able to be there to tell her goodbye as she passed on.

[Zulu451]

ER - I have seen many codes at my facility and I have never seen a family be allowed to witness the code.

Now when a family decides to withdraw care, we will always allow the family to be there when they die.

Mike - I can't think of a single reason why you would crack a chest for a medical code and unless it is penetrating thoracic and sometimes penetrating abdominal trauma, I won't even do it for blunt trauma.

Though cracking a chest is pretty cool.

[Zulu451]

Originally Posted by ERCougar

Wow...fortunately, our painful situations are short-lived. I see plenty of tragedy, but I don't have to watch it draw out over weeks. I can't imagine having to bury one of my children, even if they were an adult--I can understand the denial.

Can you get her into hospice?

Family didn't want hospice. Gratefully, she died last night. I guess that is what happens when your CVP matches your MAP.

[ERCougar]

Originally Posted by Zulu451

Family didn't want hospice. Gratefully, she died last night. I guess that is what happens when your CVP matches your MAP.

Yeah...not a good sign. I don't think I've ever seen that. (Well, except in a dead person, I suppose...)

[ERCougar]

Originally Posted by Zulu451

ER - I have seen many codes at my facility and I have never seen a family be allowed to witness the code.

Now when a family decides to withdraw care, we will always allow the family to be there when they die.

Mike - I can't think of a single reason why you would crack a chest for a medical code and unless it is penetrating thoracic and sometimes penetrating abdominal trauma, I won't even do it for blunt trauma.

Though cracking a chest is pretty cool.

That's because surgeons are a-holes and don't care about the family... Honestly, this trend is changing. I changed my practice about three years ago on this and have never had a bad experience. The only exception I can think of is cracking a chest and if I have a new resident doing any procedures.

I've cracked a chest once on a blunt trauma (it was a cop), lots on penetrating traumas. There really wouldn't ever be an indication in a medical code. Family has never been there in time for it so it's never been an issue.

[Clark Addison]

This is an interesting thread, but for us non-doctors who have never spent any time in a hospital, can you explain a couple of things?

What is this "Code" you keep referencing?

"Cracking the chest" - I'm assuming this is an emergency open heart surgery? Going in to massage the heart or something. Am I right?

[ERCougar]

Originally Posted by Clark Addison

This is an interesting thread, but for us non-doctors who have never spent any time in a hospital, can you explain a couple of things?

What is this "Code" you keep referencing?

"Cracking the chest" - I'm assuming this is an emergency open heart surgery? Going in to massage the heart or something. Am I right?

A "code" is the treatment protocol for resuscitating a patient, i.e. they have no pulse or are not breathing. "Code blue" is the origin of the word--hospitals used to announce this overhead to alert doctors in the hospital but not panic patients. Doesn't really work anymore as most people know what "code blue" means.

Cracking the chest is exactly that--emergency open heart surgery. The reason you would want to do this is in a case where CPR won't work, i.e. you suspect that blood has accumulated in the pericardial sac (the sac enclosing the heart) and is preventing the heart from filling, or there is a whole in the heart or one of its major outgoing arteries (stab wound, gunshot wound). This is one that you as a family member wouldn't want to watch--it's extremely bloody. Most of the time (every time, in my experience), it happens immediately as the patient gets into the ER, and before the family's arrival anyway.