During my first shift of this week, I discovered a new appreciation for hospice nurses. I started my shift with 2 patients- the first was a 79-year-old female who was chronically ill with CHF and related respiratory issues; she had been back and forth between the ICU and the telemetry unit over the past month. She had been planning for discharge when she coded on telemetry; she was transferred back to the ICU on a ventilator and multiple drips.
Through that evening, the nurse kept having to increase the amount of vasoactive medications she was on and shortly after the start of my shift that next morning, she was maxed out on multiple medications (vasopressin, epinephrine, levophed, neosynephrine, and dopamine). Her daughter arrived at 0800 and we discussed the fact that her mom probably would not make it through the day no matter what else we tried to do (there’s already so much damage being done to the body on that amount of medication).