Is this really how you want to die?

Is this really how you want to die?

Those of us in the healthcare have all seen horrible, awful things that scar us and we have difficulty talking about these things. My first code was a 97 year old woman who was massively bleeding out of her head. She was fully conscious when this happened and she was absolutely wailing in pain as I held a wash cloth to her head and tried to calm her down. The facility where this happened was so understaffed it was just me and one (yes one) nurse running this code. I had just turned 20 when this happened and she fortunately survived. I had nightmares about that night for months that were so bad, I went to a therapist. I don't have nightmares anymore but I think about that night all the time. Everyone who works in healthcare has had moments like these and they quickly mature you.

Is this really how you want to die?

Now its quite morbid to think about but not a lot of people talk about their wishes when they begin to die. So imagine this. You are in a horrific car accident. Paramedics respond and begin chest compressions. Mind you, chest compressions must 2 inches deep into the chest. For a lot of people, that will break their ribs. Broken ribs is painful and awful. Its difficult to even breath but suffering from a serious case of the deadness is worse.

Is this really how you want to die?

By the time you get to the hospital, there's no pulse and very little signs of life. Because of modern science, we can mechanically pump your heart and lungs. But you've never talked about your wishes. Too many people would rather avoid the subject because it's morbid. You're family is truly in shock and doesn't know to think. But there is no time to sit down and think about this. At least not now there isn't.

At this time, the medical staff takes matter in their own hands. A nurse or someone the nurse designates, calls a "code blue." And all hell breaks loose. Every nurse, doctor, anesthesiologist, nursing student, the code blue team, respiratory therapist, and med students are now at your bedside. At this time, we confirm you have no pulse and ask if anyone objects to beginning the code blue. Every code blue has a leader usually an experienced doctor or nurse, they grab a terrified student and tell them to begin compressions. Because that's how you learn by being thrown into the dark end as they critique your compressions. And they tell just about everyone else to get in line for compressions when they can't go on.

Is this really how you want to die?

All the while, you still aren't breathing so you are intubated with basically, a metal crowbar. Now, people who aren't forcing your airway to open or doing chest compressions, still have a task and you need drugs in you ASAP. If we can't get an IV access in the arm, we don't time to find another vein in the arm. We'll try the groin instead. A resident or intern will be poking around with a needle several inches big in your groin. Blood will be going everywhere because they may miss and hit your artery in their rush to find access. Now of course, the cracking ribs is still going on, air is still being squeezed in your chest, and you're being pumped full of drugs. Hopefully you have been given something to sedate you because people have been awake while they have received CPR. That's not guaranteed because the little amount of blood rushing back to your brain may be making you peripherally aware.

Unfortunately the statistics for CPR survival are not great. Every year, approximately 400,000 people in the United States suffer an out of hospital cardiac arrest. Of these, typically less than 10% survive. And in the hospital, only 18% of those who receive CPR are well enough to leave the hospital. And almost 1 in every 3 people admitted to the hospital will die there. If you wake up, you will wake up in a clinical setting with a person you've never met staring back at you. You don't know what happened and you can't speak because of the steel crowbar in your throat.

Is this really how you want to die?After CPR, people can't go back to what they were like before. Ventilator may be breathing for you. A tube in your rectum and another tube in your urethra will be taking care of your bodily fluids. And another tube in your stomach will be giving your food, nutrients, and meds. In addition to being on an IV, or even several IVs. It doesn't have to be like this though. Just talk to someone you trust and who also respects your values. If you're a 35 year old male who is healthy with the exception of being in cardiac arrest, make sure your family and loved ones know to "try everything." But what if you're 80 with fourth stage kidney failure would you want to go down this route?

And working in healthcare, this is something that infuriates me. CPR doesn't work a majority of the time and yet people would rather that the ribs of their 97 year old grandmother, with paragraphs of medical problems, be cracked and broken in a vein attempt to save her. Its always a subject to avoid until the time is too late. Pick someone who won't be blinded by emotion when your time comes. Personally, I'd rather the medical professionals fight for me until my older sister, (who is a care flight paramedic and med student) says no more. She works in healthcare like me and is the only person I know won't be blinded by emotion because sees things like this all the time and she knows when the odds are no longer in our favor.


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Most Helpful Guy

  • I believe that everyone should have the right to choose their manner of death so long as their of sound mind. That's why I think it's important to get your affairs in order when you're young and I tell my friends and family to do so as well as ask if it's pertinent to the conversation. Quite a few people find this morbid, but I want it to be explicit so that should the situation arise where I'm making the decision I don't either end their life early or keep them alive despite being tortured.

    I don't have the same experiences as you, but I find it ludicrous that y'all were so short staffed. I remember when my ex told me about his first paramedic call where the parameds made him do compressions on an elderly heart-attack victim. He said he could feel the bones breaking as he pressed and was informed that the fellow had already died but they thought it good experience for him. That seems rather morbid to me.

    My experience in psychiatric care has informed my beliefs about what I would like to live through. On our senior care floor I had to take care of people that, were I in their shoes, I'd rather be dead. It was such a demeaning position to be in that I wouldn't want it. Thus I would rather be euthanized (should their be no feasible chance of getting better) than live through it whether or not I'm cognizant. I don't think that anyone would acquiesce to this, but I can at least make sure that I'd have a DNR or something set up in that scenario.

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    • Oh yeah your first traumatic experience, you'll be thrown in the thick of it because that's how you learn. On one hand you learn what you're capable of but it's terrifying. Unfortunately, after my first code I had nightmares for months. I agree that it's demeaning. When I first started as a CNA, I had a patient who was a fighter pilot. He had severe dementia but he tell me war stories for days. I know it's inevitable to happen to all of, but I thought it was so demeaning for him to be in that position. He's a former fighter pilot and now he needs help from a skinny 100 pound, 21 year old college student to go to the bathroom. So it's no wonder that depression is so common for the elderly. I'm incredibly independent so I would hate my life if I needed help to brush my teeth or go to the bathroom.

    • Mm. Yeah psych rounds I hear tend to be pretty... interesting for RNs that go on to do work another unit. I have two friends who actually just got ER nurse which is pretty awesome albeit I'm sure intense.

      I had too many alzheimers/ severely demented people thinking looking at me in absolute terror as they though I was some home invader who was assaulting them to want to be in that situation. Much less the other problems associated. I had one fella think that I was his son raping him and he started swinging (every night). As a result we had to hold him down and force-feed him medication to calm down. I can't imagine the terror that he was going through, and this wasn't an isolated event. It was daily or almost daily. I wouldn't want to live like that.

Most Helpful Girl

  • I've been close to dead before and all I remember is being in an out of consciousness and thinking, I don't think i'll survive this pain, Just let me go. I'm not suicidal but it was one of those times.

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  • We don't exactly pick and choose our deaths and all the deatils that go with it, just like we never got to pick and choose our very births and point of origin of coming into existence into this kind of a world. There are never any guarantees that we're gonna be "saved" or "rescued", one must recognize that this is the harshness of reality, once your time is up in this world and your luck runs out, then it is what it is, unexpected things CAN and WILL HAPPEN to anybody.

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    • Well yes no one knows what will bring about their demise. But when terrible things happen, a lot of people are blinded by emotion and make their family member remain a vegetable because this wasn't discussed in advance and they can't let go.

    • If I'm like dying and not going to make it, i would rather go sooner than later, if the emts can give me morphine fine but if I'm going to die from an accident I would rather not delay it

    • All the more reason that somebody should always have a "will" legal document planned ahead of time should the worst case scenarios like that ever were to happen. Think of the financial burden it would be for their own family to keep them alive if they are completely beyond any hope of recovering from a coma, or even if they did they'd become completely crippled for life. I'm certain that with a legal document such as a will would override and overrule any and all decisions coming from their family members. And if one had a family to support and all, all the more reason they need to have life insurance to help cover all the financial problems and issues that come after, such as debts, mortgage payments, etc.

  • Where I live (Netherlands) there are these papers you can sign that basically say that if certain condition is reached i. e. no pulse that the hospital they'll let you die in a normal way without treatment, and medical personnel are legally obliged to uphold it.

    Of course I don't know how it works in the USA, but what one wants to go through regarding medical practices is something everyone should think about. Like do you want to be in coma for the rest of your life?

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    • Some people just never talk about it and that leaves the family who is blinded by emotion to decide. It's totally normal for families to make their family member remain as a vegetable because they can't let go.

    • Yeah I get why families do that and since the victim probably never thinks about it beforehand the family only has emotion to base their decision on

    • We call them a DNR (do not resuscitate)

  • Yeah, if I'm in a serious car accident and dying just let me die

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    • Only with lots of morphine or anesthetics right?

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    • @JudgmentDay yeah you can only hope and write legal documents detailing what you want. Still no guarantee though. For lots of people with terminal illnesses, it's a fight for them just to be a DNR. A lot of it is government involvement but working in a hospital, I've seen it from patients family members a lot.

    • If I get a terminal illness I do not care if it's legal I'm punching my own ticket

  • I think this is an important topic more people should be talking about. We should have the right to die with dignity. The government shouldn't decide that for us.

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  • We are going to die anyway and we can't exactly choose how we die anyway (the choice being called suicide). So what's your point or what is it, that you are suggesting? Death is inevitable.

    Just like how my friend @judgmentday said.

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    • Try to make it as painless as possible? I thought that was obvious but I've explained it numerous times. I hope you don't work in healthcare. If you see a dying person and you just say oh well, they're dying anyways you don't deserve this job.

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    • We call security if we have a violent patient. And security is under no obligation to be nice to patients so they put them in line. Security also carry mace and handcuffs with them. I would research companies and see who offer good benefits.

    • Well, at least you have that. Hopefully they're tough "dogs"

  • l dont want to think about it l am not even ready to die yet

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