It’s an intense environment when caring for someone who’s dying. The family, caregivers, pets, neighbors and at times people who want to impose their life’s horror stories are usually weary, grieving and not used to simply waiting. As the clock ticks the precious time away, I need to draw all my reserves to remain patient, tactful and be part of the solution to any problem that may show up.
But last week it was too ridiculous. I was shocked, disappointed and super angry. I had a private hospice patient in a world-renowned cancer facility. The Palliative Care team was assigned to assess his pain; of course that’s what they do, right?
But…they had no idea what to do. (No, I’m not going to soften this)
They addressed his pain control with paranoia and a fluffiness that made me furious. At home, my patient was in perfect pain control on Methadone and as soon as he was admitted for vomiting, they changed his pain medication. Then, three days later when he was out of his mind with pain and disorientation, they assumed he was perforating and cranked up everything, As soon as I entered his room I knew he wasn’t as they said in front of he and his family- “Perfing.” There was lots of old blood on his sheets from his disconnecting his IV from the hub; the bright overhead lights were on, and he was sweaty and uncovered. He was quiet– no…he was zonked. There’s a big difference between someone who is comfortably sleeping and someone who is drugged to practical coma.
I asked the nurse if his appearance was acceptable to them. She said yes. I asked for new bedding and told them that I was going to change his sheets, then asked the very kind cleaning person to get me a table lamp. I turned off the overhead lights, and gently, calmly changed the sheets. His four children were there so I couldn’t go on a rant, but they could see that I was disturbed by the ignorance of the medical team.
We went out in the hallway and I tactfully asked them questions that they would not answer. I asked them why they took him off Methadone. They looked at the floor. I asked them why he wasn’t on Hospice care after he requested it as soon as he was admitted. They looked at the floor.
I knew it was about money because the family gave me full permission to have access to his medical records, so their silence was not about breaching confidentiality.
MEDICAL CARE IS ABOUT MONEY AND AVOIDING LAWSUITS.
The public must begin speaking up. I’m furious and disappointed.
My patient died in the hospital with an intravenous pump in his chest, beeping alarms, hospital gown, and rushed nurses and paranoid doctors. I had many compassionate discussions with my patient. Perhaps the student nurses learned about serving the dying as they helped me with his care. (BTW, he wasn’t perforating.)
Why are we so numb and dead? Why? Why? Why do we allow them to make us feel powerless? How dare they! Without patients there would be no job for them.