Friday, May 09, 2008

Friday Night In "The Big City"

Yeah - right.....

Today I spent the day on ALS-5, working with one of the guys that works for me at the track during the summer. Not a bad day, but we did have some interesting calls. One of them was for a 92 year-old female released from the hospital - status post left hip fracture with surgical repair. That in itself isn't terribly remarkable. What was remarkable, though, was her mental status. She was extremely confused. Because of this problem, I was really concerned about her - I'm not certain that she was appropriate for leaving to go to rehab. Her son was with her, and he told me that she had been given a considerable amount of pain medication prior to our arrival (I'm not sure how much prior), and she was really pretty gorked out. She was acting really paranoid - again, likely as a result of the medication, and it was as though she was looking through me. Really weird.

We also took a patient from her home to hospice. I'm not sure how old this patient was, but I'm guessing she was in her mid 60's. She'd been discharged from the hospital at around mid-day today after being diagnosed with a recurrence of cancer - lung, I believe, plus she had a history of pulmonary disease. She was pretty sick, and the major problem was that her caretakers had been overwhelmed and it was getting worse. On top of that, the patient's condition was terminal. Her husband was upset because he didn't want her going, but she and her family thought it was appropriate. So when we arrived, we were met by the nurse from the hospice agency, and she filled us in on the dynamics of this situation. The patient's two sisters and a niece were also present, and they wanted us to wait for her husband to return so that he could be there when we left. Personally, I had no problem with this, so I made arrangements with out dispatch center for us to wait. The dispatcher who was working was actually really cool with this whole situation, so we waited. Once he arrived, we packaged and transported her. All things considered, it went reasonably well, but it is still a sad situation. Any time I've dealt with hospice patients it's been sad although it has never really been "bad", in a manner of speaking.

I think it is always difficult when you have to deal with the families of those who are terminally ill. The patient is usually not the one who needs to have the psychological first aid rendered to them. It's always the families as they are the ones who are left behind. From personal experience, I can say that this is true. When my father passed away, it was no different; my mother was his primary caregiver, and when he died, she was left alone and had an empty space in her heart. But healing does happen. She is much better and while she misses him, she's comfortable being with herself.

Tonight I'm on my normal shift on ALS-2. So far we've been to an 89 year-old male who had an AV fistula put in today and it ruptured, and we've had a 33 year-old female in labor with her third child. He water broke early this evening and her contractions followed with a vengeance. That said, she was dilated at 3cm when we got her to Labor and Delivery. Still contracting, but not near ready to push.

It is now 9:45PM. The night is still young.

1 comment:

Pete said...

From personal experience with my Dad a few years back, I'd suggest that Hospice care is a wonderful example of what is "right" in the healthcare world. Compassion, caring, non-rushed, attentive, etc. Out of all the decisions we had to make on his behalf in his waning days, Hospice care was the best and easiest decision we made. Good for you for waiting for the husband to get home...