The need for a pulse-ox device becomes extreme in the hospital when a patient who had been stable suddenly gasps for breath and begins to turn blue. A pulse-ox is a small piece of equipment that clamps onto a patient's finger and registers her oxygen level. Some cost a couple hundred dollars, but the cheapest retail for around $20. When I worked at a teaching hospital in the UPMC system in Pittsburgh, my hospital floor usually had two or three of these devices, and though we nurses begged for more, we were always told the money wasn't "there" in the budget, despite our hospital system's obvious wealth (operating revenues of $14 billion in the first nine months of 2018).
“Knockin’ on Heaven's Door” is a Bob Dylan song, but I prefer the cover by Guns N’ Roses, which adds a rock inflection to what is basically a song about dying: “That cold black cloud is comin’ down / Feels like I'm knockin’ on heaven's door.” It's an apt title for Katy Butler's book, which details her father's slow decline after a stroke, and the relatively quick decline of her mother afterward.
Talking about abortion in terms of ethical decision making may be troubling to abortion foes, but besides being a mother, I'm also a nurse who cares for patients at the end of their lives. For me, looking at arguments about abortion in the context of how best to care for dying patients can clarify the complexity of the ethical issues in abortion.
End-of-life treatment guidelines would help families, physicians and nurses confront the inevitable with care and compassion.
In my mid-twenties, I was twice prescribed the common antihistamine Benadryl for allergies. However, my body’s reaction to the drug was anything but common. Instead of my hives fading, they erupted all over my body and my arms filled with extra fluid until they were almost twice normal size. I subsequently described my experience to a new allergist, who dismissed it as “coincidence.”
As a child, Christie Watson could not decide what kind of career she wanted. Marine biology appealed to her, as she had “visions of wearing a swimsuit all day… and swimming with dolphins.” A teacher proposed law, telling her parents “[s]he can argue all day long.” After quitting school at 16, Watson took a job with an organization called Community Service Volunteers. A nurse there suggested she try nursing: “They give you a grant and somewhere to live.” To the surprise of Watson's family and Watson herself, nursing stuck, and I'm thankful it did.
In The Healing of America, journalist T.R. Reid considers what other countries’ health care systems can teach us.
Sexual assault is excused as normal and forgivable. It’s not. Ask the women who’ve experienced it.
At the start of my shift, at 7 a.m., my patient, newly admitted a few days before for a blood cancer, was talking and acting normally. By the end of my shift, 12 hours later, she had grown confused and her speech was garbled. A CT scan revealed bleeding in her brain. She was sent to intensive care and died the next day.
A few years ago at a meeting of the ad hoc ethics committee at my hospital, we were discussing the issues that arise when treating obese patients. Someone brought up the case of an ICU patient, a young woman who weighed 500 pounds. The ICU nurses complained, sometimes loudly, every time she needed to be moved. Their grousing appalled our chief medical ethicist, but I understood the nurses’ reactions. They likely feared incurring a serious injury from lifting such a heavy patient. This conundrum—how do nurses safely provide high-quality care for people who are obese—will become ever more relevant as the prevalence of obesity in the United States continues to rise.