Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

[colormyquilt]

"Moral distress is characterized by situation where you can't do what you believe you should morally do...
msot common soruce of moral distress is dealing with end-of-life situations, particularly where...disagreement about treatment...
nurses report moral distress adversely effects job satisfaction/ retention/ psychological and physical well-being/ self-image/ spirituality..."

at link:

http://news.nurse.com/article/20090602/CRT01/306020025/-1/frontpage

 

[colormyquilt]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

There is something profoundly unnatural about having our young die.

There is something profoundly unnatural about having to turn away from assisting one individual, knowing that individual may die, so that we can help someone who may need the immediate help more.

How profoundly painful such decisions may prove to be in the days ahead.

Bump this.

 

[ming]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

I think you need a deep spiritual strength to do this job.

 

[mixin]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

You know it’s time to withdraw ventilator support from your unresponsive patient. The physician knows it's time. But the family doesn't.

And herein lies the main problem, imo.

Speaking from my personal experience, I was excected to make life and death decisions for my mother with next to no information on her outcome. They wanted me to tell them to discontinue the life-saving drip while I was still thinking she was going to recover. It wasn't until she was comatose (3 days later) that I was told that 95% of the people who entered the hospital with similar test results never recovered.

The doctor even refused to tell me how she would pass.. peacefully, convulsions.. what?! After he left the room, one of the nurses told me most pass peacefully. Why should that should have been so hard for the doctor to say.

The only thing that got me through that terrible time was my mother's words: "No hospitals! No tubes! When my time comes, just let me go!"

The medical profession should feel a moral obligation to do their best to educate the family so they can make that horrible decision without always wondering if they did the right thing.

Families have an obligation to each other to plan for and discuss end-of-life decisions.

 

[ming]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

I will probably get yelled at for this, but it's what I feel is right.
That doctor should have said "your mother will just sleep away". Whether or not it was true. This modern day obsession for being too factual leaves me unimpressed - if my mother or child was beyond help and had to be switched off then I would far far prefer to spend the rest of my life thinking that she passed gently and peacefully, and not torment myself wondering if she suffered. because after all - what good does knowing that do ? Does it help them passing ? No.

 

[mixin]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

It was important for me to know what to expect because I had planned on being with her at the end and I don't like bad surprises.

I always want the truth so I can prepare myself. If the worst doesn't happen, I usually feel like I was blessed.

 

[tropical]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

#2:
"There is something profoundly unnatural about having to turn away from assisting one individual, knowing that individual may die, so that we can help someone who may need the immediate help more."


And it is even more unnatural when such events are correlated to economic driven cuttings of the health system staff and equipments as a result of too minimized/funded standards per patient (watching worldwide),
acknowledging that every patient will earn, cache or borrow the additional money to got a individual life saving treatment,
if they will be informed in time of an prospected failure of life saving facilities due to pandemic or other reasons.

There was not inserted any additional individualy payed ticket to allow an individualistic private funding (when public was not enaugh) of neccessary facilities/staff enlargements prior this pandemic,
which could partly easy the pandemic stretching hospitals/ER/ICU burden, and got more adjuvanted and non vaccines in time.

 

[mixin]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

As we're learning, just because someone has access to a vent does not guarantee their survival.

How bad would it be to disconnect one to give it to another and then lose both patients?

 

[tropical]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

How bad would it be to disconnect one to give it to another and then lose both patients?

If the hospital have enaugh vents and staff to care all,
(with no additional bad events) trying to help all,
in a moderate pandemic such question could maybe not be actualized
in a lack of efforts sense of speaking.

 

[RNboston]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

Yes when my mom and dad died at home with me on hospice there was this feeling of powerlessness the moment they stopped breathing... Unbelievable to spend your life leaning how to keep a person alive, CPR, medications ect ect. Then to just stop, let them go, accept that there quality of life is unavailable and to further there life would lead to suffering.
To put this into context for pandemic, I had 15 years of treatment for cancer for mom, and three months for my dad, and still struggled to accept the loss. Today to fathum telling a family, that was out with there child running in the park last week or a young adult that was in usual state of health previously to let go, is an reality I don't know how I will deal with when the time comes.

 

[ming]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

It brings us face to face with things previous generations had to face, doesn't it ? How far are we on from 1918 really ...?

 

[tropical]

Re: Life and Death Scenarios Lead to Moral Distress in Nurses-2 June 2009

It brings us face to face with things previous generations had to face, doesn't it ? How far are we on from 1918 really ...?

Yes, who said that hystory can't reply itself again ...

Scientists during the past time create zilions of robots, rockets, genetic modified organisms, megahills of scientific patents,
but when a "moderate" pandemic phase 6, "level 1" came,
we face a possible lack of ICU care and of (non)adjuvanted pandemic vaccines

:yinyang: