Every day my job is to assist patient to heal, and definitely hope patient to recover. Yet things never go to the way you wish all the time. And if it’s hopeless to see their recovery, please just fulfill their needs.
He was an old man with activity of daily living (ADL) mostly dependent, yet he could still speak quite clearly comparing with those bed-ridden. He was admitted with repeated intestinal obstruction, anaemia, and with poor prognosis he was declared to be DNR (Do not resuscitate).
For those DNR the only thing we can do for them is to let their comfort be the top priority. Blood was transfused, the nasogastric tube once put on was removed. Gradually he was seen better and better.
Though there are signs of hope they just don’t guarantee miracle. With organs inside being too weak to maintain metabolism even one problem resolve another will eventually pop up and kill him, and yes, at one night when I was on duty he was breathing so fast and shallow; The saturation of oxygen (SaO2) inside the body was not reaching 90% with 100% oxygen given via mask.
I was standing in front of him, after 30 mins of high flow oxygen delivered and still there is no rise of SaO2; I tried to suction to see if sputum had blocked the airway, but it seemed not. All of a second when I put out the suction tube he attempted to speak to me, no longer in clear voice. ‘Are you saying you want to see your relatives??’ he nodded deliberately, with weak voice ‘yes, yes’.
When someone who was simply busy breathing for oxygen and still able to deliver their wish of seeing his/her relatives, undoubtedly he/she love them.
I called his family, urged them to come asap.
Respect their wishes and empower their dignity. That's all we can do for them at the end of their life journey.
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