February 2024
Michael
Belcher
,
BSN
Intensive Care Unit
UPMC Western Maryland
Cumberland
,
MD
United States
Mike then held his phone to the patient’s ear while his son painstakingly said his goodbyes to his father from a distance.
A patient was admitted to the Intensive Care Unit with the diagnosis of septic shock. He remained in ICU for a few days before he was able to be transferred to a step-down unit. A couple days after being on the step-down unit the patient became severely bradycardic and the medical evaluation team was called. Mike was one of the MET Call responders from the ICU where they had to quickly act to preserve the patient’s life. During the response to the MET Call the team had to start transcutaneous pacing the patient, administer lifesaving medications and the patient required intubation. The patient was then transferred back to the Intensive Care Unit where his demand for lifesaving vasopressors increased. Mike called the patient’s son and talked to him in great detail about the severity of his father’s condition. Mike explained that the patient’s heart was failing to beat at an acceptable rate to sustain life and that the patient was continuously being shocked to keep his heart beating. Mike also explained that the patient had a breathing tube in and has since required medications to keep his blood pressure up. Mike explained to the patient’s son that with the patient’s condition like it is it is possible he would need cardiopulmonary resuscitation in the near future. The patient’s son spoke to Mike and explained that the patient would not want to be connect to the ventilator or for anyone to have to perform chest compressions on him. Mike verified with the patient’s son and with the Intensive Care CRNP that the patient would want to be a ‘do not resuscitate’ palliative care. Mike explained to the son what it meant to stop the transcutaneous pacing and the medications they were administering as well as removing the breathing tube. The patient’s son stated he understood but he also knew what his father would want. The patient’s son stated that unfortunately he nor any other family member would be able to make it to his fathers’ bedside. Mike offered to allow the son to speak to his father over the phone. Mike then held his ASCOM phone to the patient’s ear while his son painstakingly said his goodbyes to his father from a distance. When the son was done Mike again reiterated what the process was to make the patient comfortable and to let nature take its course. Mike attempted to comfort the son by telling him that the staff would make every effort to make sure the patient was comfortable during his passing. Mike told the son he would call him back after his father passed away. Morphine was administered to the patient for comfort purposes, the lifepak was shut off and the transcutaneous pacing was stopped as well as the vasopressor medication. The patient was extubated to comfort and passed away comfortably. Mike gave the son a return phone call to notify him of his father’s passing.