(warning for long post, a heavy topic and some graphic descriptions)
One of my patients coded the other day. For those of you fortunate enough to not know what that means, "code" is short for Code 44, which is what they announce over the intercom in the hospital when someone stops breathing/heart stops beating. It's the signal for people to come help try to resuscitate.
After over 2 years as a nurse this was the first time one of my personal patients has coded. I'm usually able to see them getting sicker and move them to a higher level of care, but the population we work with is so chronically ill at their baseline that they can turn pretty quick.
We were able to bring them back, but they never regained consciousness and passed away the next day. I don't like to be in on codes. Normally when one happens on my unit I go gather the spouse or family and take them to our break room, give them a box of tissues and pass them off to the chaplain. Then I stay at the station to direct traffic and answer the phones. Being in there is too jarring for me. The whole thing just left me feeling
off for the rest of the weekend.
Since the patient passed on a Saturday the chaplains' offices were locked and I didn't have any
Covered in Love quilts. Fortunately, the amazing Nancy (
of the rail fence quilts) just donated me two finished quilts and I was able to mail one off the next week.
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| Nancy just got a long arm and we are the lucky, lucky recipients of some of her "practice" quilts |
As we all know, when I feel
off, when I'm stressed, I quilt. But more than that, I quilt as a direct response to situations like that one. I know that as a nurse, Codes are part of what we do. We're supposed to keep people alive. And if they attempt to die, then we try to resuscitate them and keep keeping them alive.
(Soapbox rant, if you want to skip it go down to the picture with the quilts)
But personally, I won't ever feel good about what we do in situations like that one. The vast majority of Codes run in a hospital are on patients who are so old, and so sick. The dying process is the elephant in the room and no one, not the family and definitely not the doctors, wants to address it. Dying is a natural part of life, it happens to everyone eventually. And no, we don't want to hasten it. We're never ready to lose the ones we love. But if you ask most people what they fear for death, they'll say pain, suffering, and being alone. We're terrified not so much of dying as of the part right before. Yet despite that, most people die in hospitals, surrounded by caring strangers rather than family, being poked for blood draws and IVs, restrained, with hard plastic tubes down their throats during the last few weeks of their lives, with aching chests and punctured lungs from CPR that only buys them a few more days of hazy consciousness and pain in the ICU and finally, when their body has absolutely had it, they die in a code
(pardon me, graphic) naked in a room packed full of strangers with a nurse pumping on their chest, breaking their sternum and ribs, beating the literal crap out of them.
CPR works reasonably well for relatively young, relatively healthy people who have sudden cardiac events. That is what it was invented for. It was never supposed to be applied across the board. The success rates for CPR in any other demographics is abysmal.
No one who has ever seen a code wants to die that way, yet so so many people do. Why? I guess because we don't want to talk about dying, and everyone assumes it won't happen to them. Every patient that codes never thought it would be them either. We tend to assume that when the time comes our family members will just know what we would want, but trust me, they don't. Please, please have the conversation with your family members about what care you would or wouldn't want at the end of life. There are tons of resources online to help you get started.
The Conversation Project can help you talk to your family. And while you're at it, read
this article. And remember, it's always too early, until it's too late.
Ok, end of rant. Thanks for anyone who hung with me though that. I'm not trying to traumatize you, but here's the thing
if what happens in hospitals at the end of life is too graphic to talk about, how can we let people send themselves and their relatives to it blindly, having no idea what they're going into? That's like saying 18 year olds are too young to watch a graphic shoot 'em up war movie, but then handing them a gun and sending them off to
actual war.
We are working in my hospital to create a palliative care program that would help head off situations like these and improve end-of-life care, but it will be years before the program is up and running and the resources are barely a drop in the bucket next to the need. We are working to create a better future, but what about the patients dying today? This is why I created
Covered in Love, to do something, even a small something, for the patients and families that are suffering now.
I had a basting party last Sunday so today I am working on quilting and binding the stack above, look for more of these quilts in future Friday Finish posts. Thank you, as always, to anyone who has contributed blocks, tops, or quilts to
Covered in Love. If you would like to get involved please check out the
main page.
Linking to WIP Wednesday at
Freshly Pieced.
