Being on the other side.

Well it has finally happened!  I am on the other side of nursing as the “family member who is a nurse”.  How many times have I said that over the years and known that that could be a good thing or a bad?  Now my father has to have triple bypass surgery this week and now I will be facing those same feelings from the nursing staff that will be caring for my dad.  Certainly, my experience will benefit my dad.  Nurses are better equipped in dealing with chronic illnesses, we “know too much” and are better at questioning (Weiss, 2005).  But I don’t want to be the overbearing family member that becomes more of a problem then the solution.  As a nurse I know that families can be the best allies in caring for a patient, but they can also be a hindrance.  Now being on the other side, I don’t want to be a hindrance!  Healthcare has changed over the years and now with allowing families to stay with the patients in the ICU, it has become a partnership in providing care (Weiss, 2005). Some nurses are really good and partnering with families but others are reluctant to share, or relinquish control over the situation to a family member. I want his stay to be a positive one, though he will be in pain, I don't want him to feel any stress over how he is cared for. 

Has anyone else felt this dilemma or had an experience positive or negative with having a family member in the hospital?

Weiss, B. (2005). Balancing act. When a family member requires your care. Rn, 68(4), 63-65.

End of Life Decisions

Recently in our ICU we have had an increase in the number of patient deaths.  Many of these patients had multiple co-morbidities and quickly succumbed despite efforts to revive them.  We have all types of gadgets to keep people alive that require extensive training but less attention is given to dealing with the difficult ethical questions of allowing natural death (Sviri & Heerden, 2014).  Barriers to these important discussions are due to lack of advanced directives, insufficient training, lack of time, and lack of palliative care services (Sviri & Heerde, 2014).  This results in patients dying in the ICU when they could have had options presented such as dying at home on hospice.  As and ICU nurse, I have coded patients only to find out later from family members that advanced measures was not what they wanted. Addressing the end-of-life issues should occur prior to an untoward event occurring.  Communicating with patient and family is key in successful transition to end-of-life care. They need to be provided the risks and long-term outcomes of a catastrophic event prior to an event occurring.  These conversations are difficult but will provide address their needs long before the event occurs.  Please share any tips that you have come across in dealing with end-of-life issues.

Sviri, S. & van Heerden, P. (2014) Discussing End-of-Life Decisions in the ICU-Are We

       Doing Our Best. Critical Care Medicine. 42(6), pp. 1560-1561. doi:

       10.1097/CCM.0000000000000284

Flu death despite vaccination

5-year-old Las Vegas girl dies from flu despite receiving vaccination. 
Foxnews.com January 26, 2015

"A 5-year-old Las Vegas girl died Tuesday after coming down with a strain of the flu that she had been vaccinated against earlier this year, FOX5 Vegas reported.

The Clark County Coroner’s Official determined Kiera Driscoll died from cardiac arrest due to influenza A. Her father, Patrick, told FOX5 Vegas that she had developed a cough and fever Sunday before being prescribed steroids and a nebulizer on Monday. Kiera later collapsed, and paramedics were unable to revive her.

Patrick told the station that his daughter had received a flu shot, with her doctors confirming that she had contracted the same strain that she had been vaccinated against.

“She was healthy Friday. Sunday in the evening, her mother noticed that she was getting ill,” Laurel Beckstead, Kiera’s aunt told FOX5 Vegas.

Southern Nevada Health District spokeswoman told the news station that there have been six flu-related deaths in Clark County this season. Four of the deaths were children.

According to the Centers for Disease Control and Prevention (CDC), at least 56 children in 23 states have died from the flu since Sept. 28. The CDC warned in December that the current flu vaccine available may not be a good match for the most common strain circulating in the U.S.

The CDC issued an advisory to doctors noting that flu virus samples the agency took from Oct. 1 through Nov. 22 showed that just under half were a good match for the current influenza A component contained in flu shots for the 2014-2015 season, suggesting the virus had drifted.

In past seasons when the influenza A strain had mutated from the vaccine strain, flu shots were less effective. Flu seasons dominated by influenza A strains tend to have higher overall hospitalization rates and more flu-related deaths, especially among older people and very young children, according to Reuters.

The CDC said the flu shots may still offer some protection against drifted viruses, which could help reduce the risk of the most severe complications of the flu."

FoxNews(2014) 5-year-old Las Vegas girl dies from flu despite receiving vaccination.

       Foxnews.com. Retrieved from:  http://www.foxnews.com/health/2015/01/26/5-year-old-las-vegas-girl-dies-from-flu-despite-receiving-vaccination/

I posted this story because of the debate on whether or not to get the flu vaccine. We see flu patients in the CVICU when they become so ill that they are placed on ECMO. Last year we saw several patients in their 30-40 years of age suffering from the flu that required ECMO. This year we haven't seen as many, yet! Please add your thoughts on how you view mandatory vaccinations for health care workers.

Sue Matson