I started Clinical Week 4 by finding out that one of my assigned patients was on comfort care, which is when your interventions with a dying patient focus on just that…comfort.  Do not resuscitate (DNR) status, no invasive procedures, no blood draws, not even blood pressure.  Just turn for comfort and to avoid skin breakdown, monitor for pain and anxiety and make the patient as comfortable as possible.  I spent a lot of time just chatting with the family and making sure their needs were met; the good news is that they had accepted their mother’s situation and were at peace with keeping vigil by her side until she passed anyway. But as I know well, that doesn’t make it hurt any less.  As of this afternoon when I left, however, she was still hanging on.

My other patient was a younger man with a history of chronic kidney disease who for some reason started experiencing congestive heart failure AND renal failure about two weeks ago.  The docs are stumped as to the reason at this point, but he has a long journey ahead of him. He has handled these rather significant life changes very gracefully, but I can tell he and his family are pretty shaken up.

Then there was the general atmosphere on the floor today.  One patient coded in the morning, and although he also had a DNR, the family asked for the code team anyway.  When the team arrived, they explained the interventions they would need to try and bring him back, and the family ultimately decided to let him go.

A few hours later, another patient’s life support was withdrawn.

There are some days that just feel heavy…

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