Bummer of a story

I had a patient I have been dialyzing for almost 2 years now. Super cool guy we would sit and talk music, movies, always have a trivia question or a funny joke to tell to each other. Anyway Thursday he called me to the back of the clinic and told me how much he appriciated my kindness and for not only being his nurse, but his friend as well, he started crying, kissed me on the forehead and said I love you for all of this. Told me bye and he wouldnt be back. Dude has been doing dialysis for 28 years and recently found out he was going to have his legs amputated.
What is one to do in the situation? I knew his health was rapidly deterating.
I started crying and hugged him. I knew what was in store,and I knew he was determined to do it. So I did the only thing I felt was right at the time, I told him I loved him and would see him again one day.
Got word he went to his field Friday night and cut thru his fistula and bled to death.
Now I'am beating myself up with what if's. I dont usually get upset over pt's deaths but his death has really got me fucked up in the head.
Did I do the right thing by letting him make his own choice knowing he was tired and things were only soon to get worse, or should I of intervened. :frown:

 

there is nothing you could have said or done to stop it.

My grandfather was doing home hospice care, had his mind all in tact but his body and quality of life had gone to hell. He begged me for weeks to kill him, or to give him his gun. He had grown a huge tolerance to the pain meds ... was having 60+ crushed and put in his feeding tube... plus was on a morphine pump.

He looked at me with hate in his eyes for me not giving him his gun. Instead , he went a nicer/cleaner way of ODing

When someone of sound mind wants to die, I think they should have the right to do what they want.

Dont beat yourself up, there was nothing you could have done, and he is not suffering anymore.

I have to give him kudos for being considerate to others ,by going into a field .
He had it all planed out, and was of very sound mind.

 

I agree with BIGMAMA,there was nothing you could have done to change his mind.I had an uncle die of Aids 13 yrs ago and I know he thought about suicide,and if he had ended his life that way I wouldn't have blamed him at all.He was in such pain at the end,constant morphine.I don't know what I would do faced with the decision he had but I would like to think if I was of sound mind no one would stop me.

 

I agree. People always talk of the "sanctity of life" - but they always disregard the fact that sentient beings have a choice to end it in a in a manner of their own choosing.

For whatever reason, this person knowingly chose a less painful path, and spared himself (and his loved ones) from the agony of his exaggerated death.

Don't beat yourself up over this - instead, rejoice in the knowledge that he is no longer suffering, and was able to carry out his own will until the very end.

I can imagine no worse a nightmare than being in a "living dead" position as he was faced with. You were of sound mind, and completely humane, when it came to handling his wishes - and he knew that - otherwise, he would've never confided in you.

 

You did the right thing. He would not have intended you to be sad. In respect to his wishes you should heed Big and Lomo's advice.

 

I realize he wouldnt want me to be sad, I suppose the main thing that really bums me out is knowing he wont be there anymore to shoot the shit with. Normally I do not allow myself to get too close to my patients emotionally because I know most of them already have 1 foot in the grave. But this cat was one I connected with almost immediately. We just had a lot in common, from our love of music,we both play guitar,both movie buffs, etc.etc.
I'am not really beating myself up anymore, I just miss him. And I now realize even if I would of intervened, it would of only prolonged what he was dead set to do. With the way he committed suicide I just hope he didnt suffer too long.
Thanks for the comments guys, made me feel a little better.

 

I'm sorry about your friend. :frown:

 

Im sorry to have to ask this. What is a fistula?

 

A fistula is constructed by connecting an artery to a vein,which increases blood flow thru vein. Over time the vein stretches and becomes stronger which allows a greater amount of blood to be passed thru the vein to allow dialysis to proceed more effeciently.

 

Fistulas can also be created on your own. Having Crohn's I am always worried about them. Especially after I read about the ones in the vag. Basically you #2 out your vag.

A fistula is a tiny channel or tract that develops in the presence of inflammation and infection. It may or may not be associated with an abscess, but like abscesses, certain illnesses such as Crohn's disease can cause fistulas to develop. The channel usually runs from the rectum to an opening in the skin around the anus. However, sometimes the fistula opening develops elsewhere. For example, in women with Crohn's disease or obstetric injuries, the fistula could open into the vagina or bladder.

 

Leave it to Pukey to gross us out.

Sorry about your friend Methead.

 

It's always about you, isn't it? That's disgusting.

 

I wasn't trying to steer the subject towards me. It was my knowledge of what a fistula was. I didn't know that they were made on purpose.

 

that might have been my weak attempt at a joke. I do that sometimes.

Anyways, moremetalformepls, I agree with most of the people here too, for what it's worth. I'm very sorry about your friend but I hope you don't blame yourself in some way. It sounds like he trusted you and just wanted to give you the courtesy of a goodbye.

I know that doesn't make the situation or the circumstances any better. I just hope you don't beat yourself up over it.

 

Even though I am still bummed out over the whole deal, Iam not beating myself up over it anymore. At first, in my weird little mind I kinda felt like Jack Kevorkian(minus assisting him in the suicide) by not saying or doing anything when I knew what he was going to do. But he would of eventually done it anyway. Anyway, whats done is done and he is no longer suffering.

 

Do you not like Jack?

I think he's a wonderful human being, personally.

 

I don't think she said one way or another... Sounds like she added the "without the assisted suicide" part to remove herself from any possible implication...

 

I feel that if someone is suffering from something like a terminal illness and they chose to end their suffering, then more power to them. And by me stating that in my own weird mind I felt like Jack Kevorkian, I meant I felt like I was contributing to his wishes to commit suicide by not saying anything.
If that made any sense.

 

It does... and without going into any legal precedents.

The Kevorkian dilemma is that he was directly involved in their deaths, as the patients were incapable, or unable, to perform it themselves in a relatively painless and dignified manner.

In your case, you "looked the other way" with both a respect for your patient, and a respect for his wishes, which is exactly what Jack set out to do. Trouble was, he cared too much, got himself directly involved, and was somehow found guilty by a panel of people suffering from CRD (Cranio-Rectal Disorder... Heads shoved up their asses.)

 

Good onne, lomo. In case she was worried about getting sued or arrested. Can you recommend a good firearm for her to use against the cops?