November 2002, Volume 32 Number 11 , p 50 - 52
Awake but confused
Quite a character
Beaches of Normandy
Winning the war
At the end of his life, this World War II veteran had one more battle to fight.
SOMETIMES AS NURSES we focus too much energy on events and decisions that are beyond our control. Roy and his friend Buster helped me learn to accept matters that are truly out of my hands.
A World War II veteran, Roy, 88, came to my critical care unit from the orthopedic unit after he began experiencing respiratory distress 3 days after surgery to repair a fractured hip. He had a cardiac ejection fraction of only 10% and impaired respiratory function from pulmonary fibrosis.
Although dyspneic, Roy was able to tell me how worried he was about his wife, Mary, who had Alzheimer's disease. He and Mary had no children to rely on, but their neighbor, Katherine, helped them at home. Because Mary wasn't competent to participate in decision making, Roy gave permission to share any information about his condition with Katherine, but she had no authority to make health care decisions.
Then he told me about his army buddy, Buster, who was overseeing his finances while he was hospitalized. Buster had power of attorney for Roy's estate, but when I asked Roy if he had a health care representative, he said no.
On the first day that I cared for Roy, he was alert, oriented, and able to give informed consent for a bronchoscopy. He also confirmed his desire for full-code status.
Roy's respiratory condition deteriorated during the procedure, and he required intubation and respiratory support. Later that evening, he began to experience short runs of ventricular tachycardia (VT). By early morning, he was suffering sustained episodes of VT with hypotension. Although he maintained ...