A friend of mine was admitted to the CIU floor. She was 88-years old at the time of admission. She was very malnourished at her admission (around 90 lbs), very dehydrated, displaying three pressure sores, and had atrial Fibrillation. She "gave up" back in July 2018 when her great-grandson died. She had full custody and care for this special needs great-grandson for 20 years!!! All that to say that she was worn out, approaching, and welcoming death when she entered Vidant. Her remaining two adult children did not understand that unless directed otherwise, the medical system must treat for the "cure". The patient did not have a DNR nor an Advance Directive.
I visited my friend when I learned of her admission to Vidant. Being a nurse myself I quickly saw that "going for the cure" was counterproductive. I spoke to my dear friend in her room and asked her the hard questions related to how she wanted to spend her last days. She clearly said she wanted to go home and did not want measures taken to save her life. Enter the nurse on CIU floor, Shirley... I introduced myself to Shirley RN and told her that I had talked with my friend about end-of-life issues and that she wanted a DNR and comfort care. Shirley quickly summoned the chaplain and the palliative care folks. While waiting for the DNR to be processed Shirley was very sensitive to the patient's need to control her own environment. She offered drink and food and meds and was more than willing to assist but did not force her to take drink or food. There was one practitioner treating her that did not "get" that she was on a fast decline and made comments that she must take her meds and that they must be crushed. Shirley spoke up for the patient and tried to explain that a DNR had been signed and was being processed and that she simply did not want to eat or drink.
It is very difficult to explain the full details of the entire situation but the way Shirley spoke for the patient's wishes was heartwarming and compassionate. Shirley displayed professionalism and competence in initiating the patient's DNR and comfort care. Because Shirley helped to get the ball rolling toward comfort care my friend got home that day under the care of hospice and subsequently died this past Saturday, a week later. My friend got her wish of going home because of the prompt assistance of Shirley and the team. The two remaining sons have a strained relationship. Both adult children came to understand the need to support their mother's decision during the palliative care conference lead by Shirley's team. Please extend to Shirley recognition for a job very well done.