Ethics

A few months ago, I saved someone’s life. And I’ve regretted it every day since.

91 years old. Oriented to nothing. Alzheimers, dementia, delirium. Broken neck from a fall. Constant aspiration. Unsafe towards self and others. Calling security or utilizing restraints daily. FULL. CODE.

What could have been a peaceful passing in their sleep ended up being the first of multiple codes. The beginning of a journey that would include vasopressers, ventilator support, a tracheostomy, a feeding tube, and breaking every rib…twice.

This patient is no longer living. Are they alive? Yes. But are they living? Not by my standards. No control of bowel, bladder, secretions. No freedom of movement due to restraints for their safety. But they’re alive. They’re still here. And for the family, that’s apparently enough.

“It’s just part of the job.” Yes, death is part of our job. Codes are part of our job. Seeing difficult patient situations every single day is part of our jobs. However, it doesn’t mean it’s easy. It doesn’t mean we agree. It doesn’t mean we don’t take it all home with us. It doesn’t mean we don’t perform actions/interventions against our own personal beliefs.

“You’re fulfilling the patient’s/family’s wishes.” This is the only statement that prevents me from being completely distraught in this situation. Regardless of if I agree with their wishes, they’re exactly that: their wishes. They want everything done. They don’t want to “give up”. They don’t want to “play God”. So here we are.

“It’d be different if it was your loved one.” You’re right. Because I wouldn’t have let it get to this point. For my loved ones I wish nothing but a passing free of struggle and pain upon my loved one. I hope they never reach a point necessary of restraints and security presence because they are violent towards hospital staff. I want their last meal to be a food or drink they enjoy, and not a cocktail pumped through their stomache. I’d love for their last breath to be one of ease, not one controlled by a ventilator button. So yes, you got me. It’d be much different if it were my loved one.

I check obituaries for this patient more than I’d like to admit. More than I probably should. But until the day they have finally found peace and freedom from every medical intervention keeping their heart beating and their lungs expanding, a part of me will remain unsettled. A part of me will feel guilty for saving them. For prolonging the already complicated situation. For instilling false hope in the family that the patient will return to their baseline mentality–or whatever is left of it after multiple anoxic episodes.

That all being said, I cannot change what is done. I cannot intervene. I cannot undo my actions.

It will happen again. And when it does, I’ll continue to be thankful for my coworkers, employee support, and strong sense of self for providing me the tools to handle it.