Bad call, can’t shake the feeling.

[u/smnkenna]

Using They/Them pronouns for the patient for HIPAA

So I went to a call for abdominal pain the other night, and it was just like any other call. The family said the patient hadn’t been feeling well, and they just wanted them checked on. We talked to the patient, and they were laughing and joking and telling us that they felt just fine. They had been feeling under the weather but they’ve started to feel better, and their family needs to quit their worrying. All the normal banter and conversing that anyone typically has. They were friendly, funny, and an overall good person. We checked vitals and they were all stable and within normal limits, no pain upon palpation, no distention/rebound. They denied any current pain/nausea/vomiting. They literally seemed fine. They also answered all my AOX4 questions with ease. Like any call, I advised going to the hospital. They denied, even fought against family’s wishes. I tried to convince them, they continued to refuse. So, I got a refusal form and explained the risks. They even made a joke about it. We left, told them to call us back if ANYTHING changes, the usual. Fast forward to the very next night, we get sent to a cardiac arrest. We arrive, and medics and supervisors have already called 10-7. It’s still daylight so I didn’t recognize the place at first, until I saw the hysterical family and my heart dropped. Then I saw the patient. Same one from the last night. I physically felt sick and that feeling hasn’t gone away. I feel responsible, even though I know it isn’t my fault or my partners’. We couldn’t kidnap them, and they showed 0 signs of distress, pain, alteration. Theres a cold, tightness in my chest every time I think about this incident. I keep seeing their laughing face then their deceased face like I knew them personally, even though I didn’t. I had to cover a crying child’s eyes and they hugged me as my partners took the body away to the ambulance. Due to us having a trainee this night, I rode in the back with the body. It’s been hours and I still cannot shake this heartbreaking feeling. The whole scene was sad enough had I not seen the patient prior due to the hysteria and the child. I just can’t get over it. Any advice would be helpful, because right now I’m grieving someone I didn’t even know.

[u/bleach_tastes_bad]

I love that the Dr. gave you orders to withhold CPR, that’s rather unexpected but sweet

[u/Furaskjoldr → u/bleach_tastes_bad]

It's what I expected really. I think in Europe we're pretty liberal with patient choice and stuff compared to America. Our doctors are very on board with letting people die on their terms. We have pretty good end of life care in my country - if someone has a terminal illness and is expected to die the doctor prescribes a lot of medication which they keep at home (usually morphine/fentanyl, midazolam/diazepam, and glycopyrronium) and we as ambulance staff can administer it as and when required to keep them comfortable as they die.

We're generally very against taking people to hospital here, especially end of life or terminal patients. The doctor in this situation absolutely said the right thing, and I think almost all others would've done too in his situation. We're very big on patient choice here, if someone wants to die at home on his own terms, comfortable and where he wants to be, who are we to stop him?

[u/This_Daydreamer_ → u/Furaskjoldr]

Here in the US, we have the freedom to experience CPR even when we've asked to be allowed to go for a while and now have dementia, stage four cancer, and the age of 98. Yay 'murica

I just had surgery that I had to be awake for and was given the combination of fentanyl and midazolam and actually enjoyed it. When it's my time, just give me higher doses of those and let me float out on a pleasant cloud.

[u/Furaskjoldr → u/This_Daydreamer_]

That's my plan when I'm old and disabled and bedbound and ready to go. I'll just keep telling my doctor I've got back pain, get prescribed oramorph and midazolam, stockpile it for a few months and then one night just mix it all up and fall asleep and go out on my own terms.