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So, yeah, Mom's currently on a ventilator 
They should have her off tomorrow, though.
Here's what happened. They were all set to move her to the nursing home for a couple more weeks of rehab. Wednesday late afternoon, my oldest sister JA went to be there when they moved her. She'd been complaining of difficulty with her breathing all day. While my sister was there she suddenly went into A fib (atrial fibrillation). Her chest was also very crackly, so they put her in ICU instead of sending her to the nursing home. They figured she had pneumonia, so they'd stabilize her overnight and maybe another day before moving her.
11:15 pm that same night, I get a phone call from the hospital. This guy, who turned out to be my Mom's night nurse, first asked for my Dad, who's at the nursing home (feeling much better btw, but having clear signs of dementia). When I said he wasn't here but I was her daughter, may I ask why you're calling? He hemmed and hawed and asked "Well do you know what happened with her earlier today?" I said yes, I did, she's in ICU, what's going on??
More rambling and confusion ensued, with him telling a long circuitous story about how her blood gasses started falling and she was getting really sleepy, and they were concerned about that etc, etc.
Meanwhile my heart is starting to pound out of my chest, but I just kept saying yeah, ok, mm-hmm. FINALLY he gets to the part about having to intubate her because they didn't want her blood oxygen to fall any further.
I stopped him and asked "Did you get her consent? Did you ask if that was ok??" Both my parents have living wills; they don't want extraordinary measures to be taken to preserve their lives. He said "well, no, she was getting very sleepy and unresponsive, and we didn't have anything in her file about a DNR order."
So I said ok, whatever, what now? He wanted me to give consent for a chest CT to look for a possible pulmonary embolism, and a head CT to look for stroke. I consented to both. Then called all my siblings, and then tried to talk myself down so I could go to sleep, which I eventually did.
That whole exchange is my bedside manner tip of the day: GET TO THE F***ING POINT!!!! Especially when you call the family at almost midnight! Sheesh!! (cue The More You Know jingle)
So, long story short (too late!
), there was no stroke or pulmonary embolism. She just picked up a bacterial pneumonia, which with her COPD, is always a mess. They were able to turn down the oxygen flow the next morning already, and today when they started weaning her, she woke up enough to pull out her NG tube.
I did take a copy of her living will over to go in her file. Nurse Rambles never said she coded, so I suspect that if they hadn't intubated, she may still have been ok, it just would take her longer to fight off the pneumonia.
She'll be off the vent tomorrow and I'm sure she'll be cranky. But she'll likely have laryngitis too
They should have her off tomorrow, though. Here's what happened. They were all set to move her to the nursing home for a couple more weeks of rehab. Wednesday late afternoon, my oldest sister JA went to be there when they moved her. She'd been complaining of difficulty with her breathing all day. While my sister was there she suddenly went into A fib (atrial fibrillation). Her chest was also very crackly, so they put her in ICU instead of sending her to the nursing home. They figured she had pneumonia, so they'd stabilize her overnight and maybe another day before moving her.
11:15 pm that same night, I get a phone call from the hospital. This guy, who turned out to be my Mom's night nurse, first asked for my Dad, who's at the nursing home (feeling much better btw, but having clear signs of dementia). When I said he wasn't here but I was her daughter, may I ask why you're calling? He hemmed and hawed and asked "Well do you know what happened with her earlier today?" I said yes, I did, she's in ICU, what's going on??
More rambling and confusion ensued, with him telling a long circuitous story about how her blood gasses started falling and she was getting really sleepy, and they were concerned about that etc, etc.
Meanwhile my heart is starting to pound out of my chest, but I just kept saying yeah, ok, mm-hmm. FINALLY he gets to the part about having to intubate her because they didn't want her blood oxygen to fall any further.
I stopped him and asked "Did you get her consent? Did you ask if that was ok??" Both my parents have living wills; they don't want extraordinary measures to be taken to preserve their lives. He said "well, no, she was getting very sleepy and unresponsive, and we didn't have anything in her file about a DNR order."
So I said ok, whatever, what now? He wanted me to give consent for a chest CT to look for a possible pulmonary embolism, and a head CT to look for stroke. I consented to both. Then called all my siblings, and then tried to talk myself down so I could go to sleep, which I eventually did.
That whole exchange is my bedside manner tip of the day: GET TO THE F***ING POINT!!!! Especially when you call the family at almost midnight! Sheesh!! (cue The More You Know jingle)
So, long story short (too late!
), there was no stroke or pulmonary embolism. She just picked up a bacterial pneumonia, which with her COPD, is always a mess. They were able to turn down the oxygen flow the next morning already, and today when they started weaning her, she woke up enough to pull out her NG tube. I did take a copy of her living will over to go in her file. Nurse Rambles never said she coded, so I suspect that if they hadn't intubated, she may still have been ok, it just would take her longer to fight off the pneumonia.
She'll be off the vent tomorrow and I'm sure she'll be cranky. But she'll likely have laryngitis too
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