I begin my shift at 8am. Before I can even head to my allocated bay, a nurse is already asking for a doctor to help her. One of the patients won’t put on his mask and his oxygen levels are dropping. It takes me a few moments to get on my PPE before I can get to him. I try to talk to the man, but it’s difficult for him to hear me through my mask and the noise of all of the CPAP oxygen machines. He tells me that he’s tired of fighting, and that he wants to be left alone.
Through my mask I try to explain that he has been getting better, and that we wouldn’t have a place for him on the high dependency unit (HDU) unless we thought he had a good chance of survival. He tells me that I don’t understand what it’s like, desperately struggling to breathe, which is true. This goes on for around 10 minutes. Eventually, I have to take his request seriously. Perhaps it isn’t illogical for him to want to die peacefully.
In order for me to allow him to make this decision, I have to be sure that he understands the risks, so I ask him to explain to me what he expects will happen if he takes off his mask and doesn’t put it back on. He says he doesn’t know. I tell him that he has to understand that he will die and that he needs to say those words to me if that is what he really wants. Eventually we compromise; he will put his mask on for another hour, then phone his wife and tell me his decision. This man is 61.
I am allocated B Bay, in which there are five patients. My patients are mostly men, ranging from their early 30s to their 60s. This is younger than normal on HDU because — as I explained to the man — we only have beds for people with a fighting chance. I read their charts to update myself on what happened overnight.
Who dropped their oxygen saturations? Who needed their CPAP (Continuous Positive Airway Pressure) settings increasing? This comes via a tight mask that goes over your face to help you breathe by forcing air into the lungs at high pressures, keeping the airways open. I am told that it feels like you are suffocating.
Who crashed overnight and is now on the ICU (intensive care unit)? Who has died?
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