This is the third patient in two days from █████ [local nursing home], deathly ill of COVID-19, that I’ve seen. Yesterday the paramedic said the same: “This is the second patient today I’ve taken from █████ [same skilled nursing facility] dying of COVID-19.” He described this time: “They carried out no intervention measures. Just nine of them [staff] all huddled in one corner, all scared, and there’s no IV, no drip, no oxygen, no anything.”
“Yeah. This is just… She’s already dying,” said Dr R. (And it really didn’t take any medical training to see that the ambulance has practically brought in a 97-year-old’s corpse. A crossed out DNR [do not revive] document, that looks exactly like all the other crossed out DNRs from that facility—somebody’s just been copying them: “Full care…! And of course this looks like all the other ones. This is just cruel, just cruel. Dr K. [who is co-owner of the facility and one of the primary physicians there—“Great, no conflict of interest at all.”] doesn’t dictate how I practice medicine. I can’t intubate this woman.”
“I picked up the prescription list for one of the patients there—it’s two pages long! And every patient is like that! A med list two pages long—”
“One of everything. He just strings them along.”
The respiratory tech: “Some guys just want all the money. And that guy isn’t even hurting for money. He makes too much money. If he had half a heart…”
“You could have half a heart and K. would say, ‘Oh, you’ll live.’ Totally unethical.”
Dr R. called the patient’s son and tried, initially, gently, to nudge him towards hospice care. “So, what I’m trying to say is, does your mother have a high quality of life? Is she very active, have lots of social contact, does she do a lot of things and maintain a lot of strong connections—or when you see her, is she barely there? If she’d want us to do everything in our power to save her life, we can do that—I just want to make sure we’re not prolonging her suffering or making her bear any unnecessary pain.”
“Can you call us tomorrow morning? We’ll make a decision then.”
“Sir, you don’t understand. Your mother’s dying now. Her family has to make a decision now. If I may be very frank, she could die at any moment, and as a 97-year-old woman in her state of health, she has an almost zero percent chance of surviving an intubation. You need to decide her end-of-life care now.”
So yet another woman like that from that place has arrived. And these are just the three I’ve seen… The paramedic today (a different one from yesterday):
“I think they’re just dumping them all in one ward to die.”
They have short-staffed us here shamefully. Many nurses from the floors floating down here… I’ve embarrassed myself more than a few times asking them, “Oh, are you new here?” “No, I’m from Tele 2.” None of them have badges that work in the ED… What is HR doing? Though, it’s been outsourced to some far-off centre out of state.
[Ansel]: So what are they doing?!
Trifling note:
Yesterday an irate woman called multiple times, incensed that security would not allow her into the building without a mask…