This guest blog was sent into us by a follower. Whilst it is not an easy read, we are sharing it because the experience of this colleague might help anyone who is ever put in a similar situation:
‘There’s no doubt about it, some conversations are easier to have than others.
And there’s one in particular, that has to be one of the hardest, yet it can make such a difference to what happens next. Dignity. Peace. Memories that will stay with you forever.
If I could show people the reality of a full resuscitation, maybe they would have that oh so difficult conversation if a loved one were in the end stages of terminal illness.
Maybe they would be able to bring themselves to arrange the relevant documents.
Not keep putting it off, unable to shake the feeling of “giving up”.
I can’t show you. I wouldn’t want to. But maybe my words can help give people the strength and realisation that they are not giving up on anyone. They are giving their loved one a final gift. That dignity I spoke of.
This particular call came in, as so many do, as unconscious, abnormal breathing.
In other words, a likely cardiac arrest.
We were the second crew to arrive on
As we came in, the two crew members there were lifting the patient from the bed to the floor. Cardiac arrest, no DNAR in place.
No sooner had he touched the floor, a colleague had already pulled his shirt open, leaving the area clear for me to start compressions immediately, while another inserted an airway into his throat. And therein started a prolonged resuscitation effort.
While one colleague started breathing for him via a bag mask, another was attaching all the leads, the third drawing up the necessary drugs, eventually having to gain access via IO directly into his bone, while I continued with the chest compressions.
We were told of a recent infection but nothing else.
Where previously there had been calm, now there was a scene straight from your worst nightmares. There is nothing gentle about CPR and you never forget the feeling of someone’s ribs snapping under your hands.
15 minutes in, his wife cried out that he’d never have wanted this.
But for us, it was too late to stop.
I think you get the general idea without me going into more detail but it was a full 50 minutes due to short bouts of rhythm change and three shocks before we eventually agreed to stop.
We rocked back on our knees, wiping the sweat from our foreheads, as we surveyed the chaos around us. Discarded equipment. Lines everywhere. And in the middle of it all, our poor patient.
Ribs now crushed and a large sore over his chest from the compressions.
Thankfully, his wife had left the room so never saw this most of this.
One of the crew went to break the news to her as gently as she could, in another room.
While she did so, we were able to disconnect everything, remove the airway, lines and leads, tidy up the detriment of equipment and get it outside before, between us, lifting her husband back into his bed and covering him up.
Returning his dignity to him as best as we could.
His wife told us that they had been in the process of arranging a DNAR but she hadn’t been able to bring herself to complete the process. Her husband was, in fact, terminally ill.
Once back at base, we started the task of restocking everything. Sorting out the equipment from both ambulances. And took a moment to reflect. It’s not just the family that are affected.
Yes, it’s our job but we’re still human too.
CPR in the right circumstances is an incredible life saving procedure. But it is also brutal and, dare I say it, in the wrong circumstances, unintentionally cruel.
I don’t blame the families at all.
I know how difficult that decision is from personal experience.
But please, I beg of you.
No matter how hard it is, please consider a DNAR if the circumstances warrant it.
You are giving the ultimate loving gift you can. A dignified and peaceful end.’
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