new orleans nurses

[dogma]

opinions? thoughts?
what would you do? if you were a nurse there? or a loved one not there?
i have my feelings,, but i 'll just sit back and see how you all feel about it



www.cnn.com/2005/US/10/12/katrina.hospital/index.html

[shmeep]

dogma said:

opinions? thoughts?
what would you do? if you were a nurse there? or a loved one not there?
i have my feelings,, but i 'll just sit back and see how you all feel about it

Talk about a no-win situation! I have no idea what I would have done. Everything about what happened at that hospital was tragic and hard and there was no way to get justice for those poor patients who were suffering under those conditions. Having been close to a friend and an aunt who died after long illnesses, I can relate to the feeling those doctors had of wanting to put someone out of their misery. If they didn't see any way out and felt that the end was inevitable anyway, they may have wanted to make the ending as painless for these people as possible. It's also possible that the medical staff was considering how the supplies were running out and was trying to determine if the mercy killings were the only way to assure that those who were healthy enough could survive until their rescue. But...wow. Tough call. Could I do that? I don't think I could, especially if any of those who were suspected to have been euthanized stood any kind of chance at all. But I do understand the thought processes that went on.

If I had had a terminally ill family member there, I might have felt relieved to know they didn't have to suffer much before their death, but if it was just a sick family member who I thought could pull through, that would have been a different matter.

Dogma, I am really curious about your take on this even though you said you wanted to know ours. You were there rescuing animals and you work in the medical field so your perspective should be very insightful.

[inuvik]

Thanks for posting this Dogma. It's always good to talk about real issues, as well as just having fun on this Board.

If I was a nurse, I would have followed the law and not euthanized anyone. This is just out of self-interest--I wouldn't want to lose my job.

But that just sort of avoids the question. I think you want to know what we really feel.

It's hard to say! It's always dangerous to be paternalistic and assume you know what is best for others. On the other hand, if people are suffering, that is hard for caregivers too.

I think it's like many other things in that the patient's wishes should be followed. That's the benefit of Do Not Resuscitate codes and No Extraordinary Measures, that sort of thing.

If we don't know what the patient wants, that's when the trouble arises. But to assume they wouldn't want to live is always difficult. This reminds me of the Terrie Schiavo case that was in the news about a year ago.

[mlm828]

This is a very tough issue. I think there is a difference between not undertaking, or withdrawing, extraordinary life-sustaining measures -- especially where it's known the person wouldn't want them -- and doing some affirmative act to end someone's life. It's the proverbial "slippery slope" -- who among is us wise enough, and sufficiently free from self-interest, to make that call?

I am troubled, however, by the idea that the medical personnel in New Orleans may face criminal prosecution -- when the people who left those nurses, doctors, and patients in an impossible situation will not also be held accountable.

[Dreamfire]

I find there is not enough detail in the information for me to know what I would do. We have very strict anti-euthenasia laws here too and I would be lying if I said they didn't impose upon actions.

In Australia the media coverage has always been aboout people who asked others to help them die, rather than people choosing for someone who is ill. Did these people ask? Was the decision made for them? Were they conscious? What was the suffering the carers were wittnesing?

However, it is hard from this article to understand why they had no drug supplies? I am suprised a facility like this didn't keep enough supplies to give at least pallative care for many many weeks so there wasn't wide spread suffering?

Also although the autorities quote death numbers before the hurricane, these are not relative as they had electricity, water, food etc. Surely not having the respirators, IV controllers, drugs, surgery possibilties etc would have added to deaths dramatically? And the stress of the hurricane would be enough to push a few more people over the other side I expect.

Bottom line?
If these people did euthanaise dying patients who were conscious and asked for it, I have no beef with them. WOuld I have done it? Depends on if I could think of a way around it so maye they did it to themselves so I could honestly say I didn;t do it if I had to defend myself later, or maybe Iwould have had the courage to help? Not sure.

If they were unconscious, then were they suffering? I would not have euthanised.

( pitty I didn't note how to spell the word before I started tying!)

If they were conscious and asking for help to live? No.

How can I know what the situation was in which these nurses and doctors found themselves? I do not have a moral problem with euthansasia itslef when it is requested by the patient. I suspect detah is worse for the loving ones left behind than the dying one.

If the medical staff did not euthaniase anyone, how awful to be accused of it. How scary they may have to face trial and really prove they did not. I know the system says you have to prove guilt not innocence but we know how when a society makes up it's mind someone is guilty all the evidence somehow materialises. It's just how you look at it isn't it?

Natascha

[dogma]

ok,, well this isn't going to be easy,, or in any type of order, but these are my thoughts, personal feelings,, and what i have observed in 17 yrs as a respiratory therapist in a larger hosp ( over 500 bed ) and after being a veterinary technician since 1975 ( they both tend to blend together at times )

i personally would be an assistant to dr kevorkian. those patients suffering from disease or terminal illness sought him out personally. he did not immediately whip out his little machine with the button that pushed the syringe,, he took time and evaluated test results, psychiatric evaluations, etc. there were people that looked to him for help that he turned away. He wasn’t kill happy.
these people were suffering, knowing a much worse fate was ahead of them, months, yrs of suffering, financial ruin for the family, etc,, it was not done for glory or personal gain, it was done because he had the courage to take a stand and do something that we sit around and discuss in our dept but never do more than that
again, this is not rambling, but it is not a condensed version

my father committed suicide on oct 15, 2004,, he had been in severe pain since he was 32,, that was 42 yrs of spinal degeneration, escalating and debilitating pain ( he was not a candidate for numerous new experimental surgeries for pain control,etc ) this was a man that would go to the ends of the earth to keep his pain from controlling his life, and the consequences he felt was a burdon to his family,, i honor him, ,respect his decision, and had he failed in his attempt, he knows my mother, sister ( critical care nurse) and i would've helped him do what ever he asked of us,, that is my true definition of honor and devotion ,, mine,, i don't expect any one else to understand it or feel that way themselves

compare that to my d/h’s brother, who blew his head off, because he didn’t want to face his parole officer again, ,he beat his girlfriend terribly,, never held a job longer than a few months, never was accountable for his actions. For him, suicide was an easy way out. Not one of love.

Now,, over the yrs that I started working for veterinarians, I personally euthanized many many animals. I didn’t “kill” them,, in my mind , those are two different words. If an animal was injured beyond repair, I would go get chicken or beef, and let the poor animal enjoy one last meal. When I had to euthanize my personal pets, I was the one to hold them for the vet, so they would know it was my voice, and touch they felt before they crossed over the rainbow bridge.

i am working on the rest of this,, didnt' want it to be too long to read all at once,this will be continued w/ in the next hr or two

[Dreamfire]

i appreciate your sharing. i'm still listening.

[dogma]

PART TWO: dogma's opinions and personal feelings continue

There are progressive diseases that I would not want anyone to endure. Huntington’s chorea, for example. I just recently took care of a woman that some would consider to be in a state consciousness. Her eyes were the only part of her body she could control. She couldn’t speak beyond one word, and that was a slur, her exhausted body never ever had 10 seconds of rest. She had convulsions or tremors that would throw her legs over the bedrails. It was torture for me to see her. There are end stage diseases, cancers that have metasticized to organs, etc, that the only thing is pain control, no more treatment. And wait and wait and wait.
Then there are the ventilator patients. I don’t know what even the capability of our back up generators are in a situation that would last days.
And our oxygen is in a huge tank that is outside. I have no idea how many days/weeks of O 2 that it holds. When that runs out, pts will die, sometimes air starved, and slowly.
Let’s look at the dialysis patients. There are pts on continual dialysis. There are pts on dialysis three or more times a week ,, for up to 5 hrs at a time. If there is no power to run the dialysis machines, they also die. They get toxic poisoning, and it can also go into multisystem organ failure, and it is extremely painful, and can last longer than several days.
Face it,, death is not the beautiful gentle closing of the eyes and letting out that one last sigh that is so often depicted in movies or on tv.
And for the pts the were dead before Katrina, I can only speculate, maybe the morgues could not pick them up due to the impending hurricane. If we had no power, I can imagine that our hosp could lose at least 5 – 10 pts a day after the generators quit, and only increasing to a higher number as each day goes on.
If I was placed in a situation where I didn’t know if even I would get out alive, the last thing I would worry about was my own job. i would know I wouldn’t want a member of my family to lay there and languish .Playing God? I feel so often it’s playing God when certain patients' lives are on artificial life support for the rest of their lives.They are not aware of the existence around them. They are placed in facilities that give them care. these are patients that are hooked up to a ventilator by a trach hole in their throat, get fed thru a g tube in their stomach, poop thru a hole in their stomach into a bag, and pee into a catheter that goes into their bladder. I worked for 4 days in a nursing home last year, the hours were better, it was closer to home, and I would’ve made $4.00 / hr more. But I turned it down. I couldn’t do care like that day after day.
I have dear friends, and even relatives that believe that where there is life, there is hope. But artificial life isn’t really life, if someone can’t make their own decisions.
to be continued,,

[bjobsessed]

Thank you for sharing all that and for whatever is to come. Some of it is very personal and can't be easy to talk about. You've given us--or me anyway--something to think about with some of the points you've made

[dogma]

this is the finale of my opinions and personal beliefs
hope you can understand where i am coming from, even though it is not the beliefs you have,, just like politics and religion, there are always differant viewpoints:::and i am not trying to change anyones mind

part 3:
As far as living wills, they are so misunderstood. A person needs to keep a copy of it on them. To have it in a dr’s office, a lawyer’s office, in a drawer with special papers at home doesn’t do it.
It needs to be available at that exact moment. If someone is a resident in a nursing home, and they call 911 , and don’t transport the living will , that patient is treated as a full code. If someone is dying at home, and calls 911,, that overrides the living will. They are also “put on hold” when a person goes into the OR. If I am a no code ( having a living will ) and I am traveling from home, it might as well be put in the space shuttle. If it is in the dr’s office, and it is fri evening of a holiday weekend,, guess what,, same thing.

These are the countries in Europe that do have legal euthanasia: Belgium, Holland, Austria, denmark, france, germany, hungary, Norway, slovenia, spain, Sweden, and Switzerland.
I am not intending to offend anyones beliefs. That was not why I made this long post. These are my own beliefs. Many of them I felt before I ever stepped foot inside a hospital as an employee.
I hope and pray that the nurses and dr in new Orleans had the compassion to make the right decision if indeed they did help euthanize some patients. I know if a family member of mine were in a condition that was only being pain controlled, and there was no cure, that someone did help them die with compassin before they lingered for days or longer without proper medical care/ equipment.
The family members that weren’t there shouldn’t be so quick to make them guilty. There were family members that did come stay at that hospital. But like most individuals, they were involved with saving their own lives. These medical personnel had no choice. They were there for the duration, and suffered the heat and lack of power as well. They did not leave and abandon the patients. They could predict the outcome of some of the patients, if some of them did have conditions similar to what I previously mentioned.

if anyone did read back on the post I made in april, I went into painfully long detail about the circumstances involving my father’s death.
And by the way, in a way, some of you might think I aided in his death. We convinced the surgeon that this was not the way my father intended to go, and pulled his breathing tube. He died with in 5 minutes.
Tomorrow, my family will gather at the property he loved, hunted, and had a Christmas tree farm on. He sold it to my younger brother. We are having our own private memorial, and spreading his ashes on the land he loved so much. I am not the same person I was on oct 14, 2004. my life changed the moment my dad died. I will look at things with a different perspective, have a different attitude, personality, etc. this is the new dogma, can’t say it is improved, but this is who I am now. I will never be the person I was before that day.

[Duchess of Lashes]

This is a follow-up article to what Dogma has already posted - it details a little further the situation in that hospital. Click on the link below and look for the headline, Chaos Reigned in Dark New Orleans Hospital. It's a long article but well worth the time to read.

www.latimes.com/news/nationworld/nation/

I never really understood suicide, my first exposure to it came when five young men in my high school signed a death pact and within a few days, they had all met that goal. I wondered then what would cause anyone to feel desperate enough to do that? Moreso, how could anyone feel desperate enough to want to do that?

But I did rally support behind the courage of Dr. Jack Kevorkian and the service he offered, a dignity and grace to dying that those who sought him out so desperately wanted; people who lived in never ending pain, or those whose quality of life had so diminished that they weren't really living. I firmly believe that should be a very personal decision.

The Doctors and Nurses who now stand accused of murder in this case valiantly stayed behind and watched the conditions around them slowly erode while trying to administer the best medical care to those who were too sick to move; there was no air conditioning, excessive heat, no electricity, no light, the generators were failing and they were, at that point, well aware that no help would be forthcoming in a timely manner. Bless them for their courage to stay in the first place!

What happened in this hospital, in the days after the levee breach, remains to be proven. I would never want to have to make the same determination they did, to stand in their shoes for just one minute of what they faced, nor would I want to be asked to stand in judgment of them. That's not up to me.

Dogma, bless you and your family and thank you for sharing your thoughts. You obviously have a very personal view based on very difficult experiences. You have given us much to think about.

[mlm828]

Thank you, dogma, for sharing your family's story. It is a difficult story to tell, I am sure, but one that needs to be told. You and your family have my sympathy and support for your decision.

But I have to sound a cautionary note. While I generally agree with what dogma has said, the devil, as they say, is in the details. Not all families can agree on the right and compassionate thing to do under difficult circumstances. And, sadly, not all human beings act from higher motives. How, then, to make sure that undue influence isn't exerted on Grandma by those who want to speed up their receipt of her estate? And disabled people have pointed out the danger that people who would not want to live with a disability might attempt to persuade disabled persons their lives aren't worth living. Surely none of us would want to share the condition of Stephen Hawking or Christopher Reeve, but who would say their lives aren't or weren't worth continuing?

Someone far wiser than me will have to answer these questions. I can only ask them.

[Deleted]

The only thing that I can really say on this topic is that I believe in the "right of peace" so to speak. My beloved uncle, who really was my father when my own father wasn't, passed at 59 years old of an inoperable brain tumor. I remember witnessing this vibrant man (who loved sports, horses, his seven kids - I being one of them) dwindle to a shell of a man. I laid on the hospital floor holding his hand and never leaving his side. God was kind and he ended up passing very quietly with all of us around; but to end any further suffering? Yea, assisted suicide would have been done.

Decisions like this are, quite obviously, never easy to make but to keep someone alive on machines, etc. is just beyond cruel - to both the patient and the family.

Dogma, you have my support; your father is now "whole" again in a place where he can be with you until the end of time - and he is, trust me on this one.

[dogma]

divinemrse said:

Dogma, you have my support; your father is now "whole" again in a place where he can be with you until the end of time - and he is, trust me on this one.

thank you for your caring words,, sunday was a bitter sweet day,, sprinkling his ashes, it was like he died for the third time,, the first when he shot himself,, the second when we terminated life support, and the third saying goodbye to his ashes

he was a wonderful man,, and there isn't a nite when i dont' go out into the field adjacent to the boarding kennel and seek out mars, ,and talk to him in the heavens

on a lighter note,, we will be seeing you shortly,, am really looking forward to it,, alittle more than a week away,, ;D

[awlrite4now]

At the nursing home where my mother resides, in her room, above her bed, is a small bulletin board that has a simple Stop sign tacked to it. That is for any personnel who attend her to know that there is a Do Not Resuscitate order on file for her.

I made that decision as I have power of attorney. I stand to gain nothing; she has nothing but her Social Security and her VA pension from her second husband (not my father, who died many years before). I struggled with making that decision, but after seeing the terror in her eyes once when she was in the hospital with a blood clot in her lung, and hearing how she feels about other residents who are just lying there unresponsive in the care facility, that is the conclusion I came to make.

I don't want to see my mother go. I also do not want to see her vegetating while her family waits for the end. There is no good choice. I also have a DNR on myself. It's what I want, and pray everyone will respect that.

Thank you for sharing what I know is a soul-baring story with us, Judy.