Friday, September 5, 2014

Jumping for Joy in the ER: When patients have clear advance directives by Monica Williams-Murphy, MD | It's OK to Die

Jumping for Joy in the ER: When patients have clear advance directives by Monica Williams-Murphy, MD | It's OK to Die:

<Q>“What’s going on out there?” the “leaving” doctor asked me in a curious manner.
Before I answered him, I called out, “You guys come listen to this. This is a success story!”
As you might imagine, a small group of curious Emergency Department staff had crowded around me in attempts to understand the commotion.

Speaking in low but excited tones to maintain HIPPA compliance, I gushed the following story:
“So, I just walked into room 48 to see Mr. Bronson. He’s an 85 year old man with COPD who had arrived in respiratory distress and the respiratory therapists had already started BIPAP because the patient arrived on his own machine and it wasn’t doing any good. So, here’s the kicker… he was too short of breath to even speak a word and when I listened to his lungs, I heard no air movement. There was no one in the room family-wise whom I could turn to for a discussion of next steps (meaning no surrogate decision maker). Just as I started to feel a twist developing in the pit of my stomach, assuming that I might have to intubate him without understanding his own personal wishes, the nurse whips out a piece of paper from behind his home med list and starts waving it at me.”
“Voila!” She said smiling, “I know that you would want to see this.”
With two steps in her direction, I was across the room and pulled it from her hand like a young child getting her first mail. <EQ>