May 2, 2011
Compassionate Care at a Challenging Time
A heartfelt story passed on by Katie Van Stedum and Jason Brusky of Home Care/Hospice. Thanks for doing whatever it takes to provide compassionate care during a difficult time.
Jason Brusky, RN, CHPNYesterday, I received a call from Dr. Appenheimer regarding a patient he had in our ICU. The patient had an MI and respiratory failure and was on a ventilator. The family was wanting to honor the patient’s wishes for her to be able to die at home. We discussed the logistics of being able to the patient home. This would involve getting any necessary equipment in place, arranging ambulance transportation who would provide ventilatory support, then extubating the patient at home. Not long after that Julie Ammon from Social Services contacted me stating that the family definitely wanted to proceed with getting the patient home. I went over to ICU to talk to the family. I confirmed their wishes and we proceeded to plan on having the patient go home in the morning. To make everything easier for the family, I went over the hospice information and had them signs the consents in the ICU waiting room.
During this time, Dr. Appenheimer let the family know that the patient’s condition was rapidly deteriating and it was likely the patient would not survive through the night. The family indicated that the patient needed to leave right away to be able to get home. We decided to have the dopamine and fluid support continue through the ambulance transport, I finished up with the hospice consent, Dr. Appenheimer had went over the proper DNR form the ambulance would need with the family, and Julie Ammon contacted Advance Ambulance. I quickly went back to the office with the patient information, and Lucy Torres-Milne quickly registered the patient for hospice and put her in our computer system. I also contacted Chris Fleming in pharmacy who immediately filled the medication for me to take to make sure the patient could remain comfortable. Advance Ambulance was just dropping a patient off in the ER, so they were going right up from there to pick up the patient. I literally was running to my car in mere minutes.
Since the family did not want to wait for equipment to be delivered we were going to use a regular bed in the home. Bonnie O’Connell, the administrator at Heritage Square as well as long time friend of the patient and family, was present during the family discussion. She offered a bed which the patient’s son-in-law picked up in his truck along with a oxygen concentrator the patient owned which was also at Heritage square. I arrived before the ambulance, and assisted the family with setting up the bed and getting the concentrator ready. When the patient arrived, we transferred her to the bed, I stopped the dopamine and fluids as ordered. I continued to provide ventilator support with an Ambu-bag for a few minutes. When the family was ready, extubated the patient and supported the family while she died comfortably in her home with her friends and family at her bedside. From there, I continued to support the family, made the necessary calls to the coroner and MD about the patient’s death, then waiting until they were ready to for the funeral home to be contacted. I then stayed until after the funeral home arrived, picked up the patient, and left. The family was most appreciative of the efforts of Dr. Appenheimer, Julie Ammon, the hospital staff, KSB hospice, and Advance Ambulance for making this happen.
It was an incredible experience to be a part of, and I am so amazed at the concentrated effort everyone took to make this happen in mere moments of the family making the decision to leave as soon as possible.