like this, on the right.
Also there was some mucous and supraventricular tachycardia and even a ham, but otherwise, just like that picture.
I had the same patient all three nights, also had her a lot a few weeks ago. I think she's done, as we say, she's "declared herself." She went from being awake and somewhat alert one night, so far as I actually interacted with her, could ask her about her pain levels, etc, and she would respond with nodding or shaking her head and squeezing my hands, to...nothing. No response, not to verbal stimuli, pain, sternal rub, nothing. No pain meds or sedation on board either. So last night she stopped making urine and her blood pressure started falling, and she was running a high temp. She has cancer, and slowly her organ systems are failing. One of her family members wants us to go ahead with dialysis and give her a tracheostomy. This makes us nurses sad because just because you can do something, doesn't mean you should. Just as we help people to stay alive, and live the best way that they can, we should be able to help them at the end of their lives, to die with peace and dignity. And to respect that when they say they're done, they're done. I wiped off her sweaty forehead with a cool cloth, while I told her that it was okay, that we understood, and it was okay. Sometimes it seems like they just wait for permission to go, and I hope someone she loves tells her that it's okay too. Interestingly, the family member who wants all of these "heroic" measures taken also happens to not have had a good relationship with or been close to her. Maybe he's trying to compensate for something. So...if you love someone, be good to them, and tell them. Because life is short, and the ICU is not the time to make up for not living and loving when you should have. *steps off soapbox.*
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