Saturday, May 3, 2008

Job Notes

Things have been fairly slow at HealthSouth lately, so I have been going over to Kindred Hospital (where I used to work before Michael was born) on some days to get my hours in. Kindred is a long term acute care hospital. I won't go into all the details of why they are necessary, but it has to do with insurances and reimbursement and money. So people who need antibiotics for several weeks, have wounds that need special treatment or require long term ventilator use are sent there from the big hospitals. About 2 or so months ago I evaluated a fella in the ICU who was ventilator dependent, but he was pretty cognizant (he wasn't all drugged up and out of it as they often are). He was a biochemist by trade that had done quite a bit of research and had many papers published, a smart man. At the time I evaluated him, his ventilator settings were too high for me to do much with him, but every time I go over I check on his progress to see if there is any recommendations that I can make (this particular building doesn't have a speech language pathologist right now, so they only get seen when I get a chance to go over, thankfully one will be starting next month so I can be rid of the guilt feeling that I have that these people aren't getting speech therapy). Anyhow, so the last time I was over at Kindred, I was checking his chart and saw that he had made the decision to withdraw life support and they had just shut everything down. In reading the social services notes, I saw how he had reached this decision, but what killed me was that he had no family and apparently his sister wasn't able to fly out. I nearly started crying there at the nurses station. How difficult it must have been for this man to make the decision, how he was truly facing his own mortality and beliefs about what was soon to follow. I always think it's easier for me to put it in perspective, but what about someone who doesn't understand the plan of salvation? Anyhow, this leads me onto a soapbox of sorts, I am a proponent of livings wills and advance directives, follow this link to find out more:
I think it is very important to discuss with your spouse or family what you would want and what limits you have on medical intervention, time frames and such. I have also told Mark more specifics, like he has to have my sisters come and pluck my unsightly facials hairs and eyebrows if I'm in a coma.


Sarah said...

How heartbreaking for this man. I can't imagine having to make that decision alone. How brave of him.

Jossie said...

I seriously love how much passion you have for your job and your patients! And you crack me up that you will have your sisters groom you in case of a coma :-) I know it's kind of morbid to think about being in a coma but it's funny at the same time.