Icu regrets (upsetting)(16 Posts)
(Sorry poorly written essay) My dm died over a year ago now she was a palliative care specialist nurse, when in hospital in ICU I basically exaggerated something she said to me about her fears/ opinions regarding shortness of breath in end of life care. Due to what I said they increased her fentanyl prior to extubating her. After the tube was removed she didn't try to breath at all. On one level I feel this was a good outcome she was able to be an organ donor, with the organs removed in as good nick as they could be from a non beating heart donor however I also feel completely consumed by guilt that my lie may have changed the treatment she was given. Is this the sort of thing people should discuss with therapists. I really want to talk about this in real life but I'm worried anyone would judge me.
What makes you feel that you exaggerated?
It sounds as though the treatment offered gave her a peaceful end, which is what we all wish for. It is very common to have feelings of guilt after the death of a loved one and when we are feeling that way we tend to focus on small things that then grow in our minds.
Whatever you said, the desired outcome was achieved and your Mum had a peaceful death. Do not beat yourself up about this - you did what felt right at the time. Soon I am sure you will feel able to concentrate on the happy memories.
Thank you for your kind reply, what I meant by exaggerate was to tell an anecdote that didn't really happen. At this stage we had been through about 72 hours without going to sleep and I'm not sure I was thinking straight. I do have lots of happy memories but I was so anxious at the time about a slower more challenging death that when it was all over quite quickly I felt almost happy
It sounds as though she was at the end of her life and whatever you said didn't change the outcome. Besides the medical team in the icu will have also used their own clinical judgement and not relied solely on your information when deciding the treatment.
When my DM died last year, she had been ill for a long time. When the doctor asked to speak to me I was so anxious about them trying to treat her that I'm sure I said things I shouldn't have done. Thankfully, they agreed with me and we let her go peacefully, but I ask myself every day if we did the right thing.
I think 'guilt' ( it's not really that, but I can't think of another way to put it) is a normal part of grief, especially when you have been asked to make decisions regarding another person. It's very hard, I know, but be kind to yourself. Your DM was peaceful at the end, and I think that is all anyone really wants.
My Dad died this year. Before he became very poorly he was in a care home anyway and we had to have a discussion with his doctor about end of life care. The doctor said that whilst they take into account the wishes and opinions of the family, ultimately they still make the final medical decision with regards treatment. We had said that my Dad would not have wanted to be kept alive at any cost, so when he became very poorly he wasn't taken into hospital as it wouldn't have changed the final outcome merely prolonged it.
It sounds like your DM went peacefully without distress or pain, that is a gift to your Mum.
The staff were fantastic, The event that preceded her death was impossible to anticipate so it was all very sudden. At the point at which life support was removed there was no chance of a recovery. To be honest we had known that from about 12 hours in. I ended up having many conversations that I would have expected my father (her husband in 50s) to have but he just shut down near the start. It has been very cathartic just to talk over these things so thank you.
I have been through this too. I worry that our desperation to make sure Dad didn't suffer means we missed some chance for recovery. Even though I know it's not really the case. Big hug.
Forgive yourself - immediately !
When my dad died they basically said that they the medics make the decision - not the families . The reason being that families carry too much guilt - this thread is a classic example . Please - forgive yourself op
Big hugs from you.
I think your mum's had a very peaceful and dignified death. I assume her brain stem was affected. "Brainstem death" it means they are unable to breathe on their own once the ventilator is turned off.
Her being an organ donor is such an amazing gift and she continues to live through your memories.
The medics talk to, and consult families but they make decisions on clinical grounds, please don't blame yourself for wanting a peaceful end for her.
I watched my DM die in pain and I'd have done anything to ease her suffering.
Thank you and your family so much for the generous act of donating your DM's organs. My DH had a transplant, without which he probably wouldn't still be around and the DCs wouldn't exist.
May your DM rest in peace and I hope you are able to put these feeling behind you.
OP, you have nothing to feel guilty for. My own DM died last summer from cancer and I myself stopped giving her drinks as she wasn't swallowing properly. I know she wouldn't have wanted me to carry on trying to get her to drink.
She was v dehydrated when she died, which probably sped up her death by a day or two......but the outcome would have been the same.
Sometimes I feel guilty for not trying harder to give her fluids but i know she would have been saying "just make this happen'.
You have nothing to feel guilty for. Your mum was a palliative care nurse, she has seen a lot of death and she wouldn't have thought what you did was wrong
the increased fentanyl won't have changed her treatment at all. Spontaneous breathing is only one of a battery of tests carried out to ensure brain death.
Also, i am fairly sure that for the brain stem tests the level of drug in the system has to be at a certain level to be absolutely sure medication doesnt have them so deep they cant respond. The lab i worked in often did bloods on patients about to be brain stem tested to make sure the levels were correct.
While I'm sure they listened to what you said, they will have done a multitude of tests to confirm the situation and decide what to do next.
As she was a palliative care specialist I'm sure she would have a very strong opinion on what treatment she wanted, based on what she had seen others go through, and it sounds like she was pain free when she passed away (my dad worked in cancer research and died of cancer). Dad was determined to be an organ donor (he was able to donate some things although not organs due to the cancer), I'm sure your mum would be equally happy and proud to have been able to be a donor.
Honestly, you're a good daughter. The febtanyl would have still been a prescribed dose - it's not nice to see involuntary gasping movements and I'm glad you didn't. Your mum doesn't sound like she would have wanted you to see that either.
How amazing that she was an organ donor - you must be so proud of her. Xx
It sounds like you're beating yourself up - please don't! I can understand though - I imagine that if I had any sort of involvement in a loved one's final moments I'd subsequently find a way to criticise my own behaviour, being a self flaggelating type! But you should give yourself a break; it sounds like she had a peaceful death, and her wish to be an organ donor was met. That's as much as we can all hope for
Join the discussion
Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.Register now
Already registered with Mumsnet? Log in to leave your comment or alternatively, sign in with Facebook or Google.
Please login first.