A week later, Mr. 'Reed’ came into our ICU at 5 am. The sun was already up and was shining softly into the room. Earlier that night, Mr. Reed was hospitalised in the emergency room. They couldn't get an infusion in because his veins were destroyed by chemotherapy. He was in the palliative state of cancer and now suffering with a variceal bleed.
The ER physicians asked our doctor to assist—to provide some guidance on what to do. Mr. Reed had no one, only a neighbour that hadn’t stayed at the hospital with him. There was not a clear vision about Mr. Reed’s thoughts about the end of his life. It was not clear if he would be transferred to the ICU and hooked up to the machines—did he have a choice? At this moment, he was vomiting, anxious, covered with blood and exhausted. Did we have to make these choices? What should the doctor do at this very moment? How did I feel as a nurse? My immediate feeling was that we should give this man palliative sedation and let him go —thereby ending his suffering.
In the end, the doctor decided to intubate him. He explained to Mr. Reed that this was a very risky situation; that it might result in his death. He told Mr. Reed that he could give him a central infusion when he was asleep, so he wouldn't feel it anymore. There was also the possibility of using an endoscopic treatment to try to get the bleeding to stop. The only thing Mr. Reed said was: "I want to sleep".
afterwards was swift; the doctor acted like a "white tornado", intubating
him at a record speed, and the endoscopist was there and set to work within
half an hour.
result? There was blood everywhere; it was a mess. Mr. Reed was gone long
before his blood pressure dropped, all the packed cells went in, they couldn't
find the source of the bleeding. At half past eight he passed away. As the
early morning sun poured through the window with a harsh light, the nurses
cleaned up and Mr. Reed's name was wiped off of the board. My nightshift was
over when I saw the last glimpse of his small face and his massive stomach;
naked on the bed, a Sengtaken-Blakemore tube still in his mouth. I realised
that no one had thought to hold his hand, and suddenly wondered... Why hadn’t
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