Amanda was the primary nurse for an unfortunate 79-year-old male patient, dying of rapidly progressive lymphoma. He had been transferred to 8SW from the medical intensive care unit, awaiting the arrival of his daughter and grandson from Australia before deciding about ongoing mechanical ventilation.
After his daughter arrived, the patient and his family decided to proceed with a terminal ventilator wean. Amanda was instrumental in coordinating the extensive preparations necessary to ensure this patient's absolute comfort during the ventilator weaning process. In addition to a continuous opioid infusion, he required every 10-minute boluses of opioids and benzodiazepines after the ventilator was weaned off. Contrary to expectations, he did not expire immediately and required continuous nursing attention for almost 3 hours.
Amanda was excellent in her coordination with pharmacy, respiratory therapy, and the charge nurse during the prolonged and difficult process. Despite my recommendations against, she obtained permission from her charge nurse to stay after her scheduled shift to maintain continuity of care for her patient. In Amanda's own words, "I need to see this thing through." And she did - ensuring that her patient received the best care until his final breath.
We should all recognize the wonderful example of dedication and compassionate patient-centered care shown by Amanda. Her selfless attention to the needs of her dying patient and his family are to be commended.