Monday, February 2, 2009

Futile Resusitation

My hospital made everyone participate in a Skills Day on Thursday, a day to make sure that everyone knows how to work all the equipment and such.
When my friend and I got to the station on resusitation, our cynicism showed. We were in a group of 2 ER nurses (us), 2 ICU nurses and some OB nurses and others. Only the ER and ICU nurses are used to participating in Code Blues. So when the instructor held up the lidocaine and amiodarone and asked "Which drug leads to more people surviving their hospital stay" and I said "Neither", they were shocked. The instructor just laughed. She admitted that both drugs were usually futile, but said that research showed that amiodarone was better. I wonder who funded the research? I know that amiodarone is much more expensive.
Here's the situation. When Grandpa keels over, Grandma freaks out and calls 911. The paramedics aren't about to tell Grandma that her loved one is gone, so they start CPR and the ALS protocols and bring him to the ER. We certainly aren't going to negate all their efforts by pronouncing him dead on arrival, so we continue the quest. We use shock and drugs and CPR. By the time Grandpa is pronounced dead, he has run up quite a bill!
Sometimes, though, we bring him back. He gets a heartbeat and a blood pressure, although he's on a ventilator and isn't responding to anyone. Then he goes to ICU, probably on multiple drugs, and dies later, with a much bigger bill.
No one wants to be the one to tell the family that it's all futile. They are upset and don't want their loved one to die. They don't want to live without him or her. They want their lives to be the same as always. They want everything done. So we keep the drugs flowing and the ventilator pumping until all systems fail, and Grandpa dies.
You see where I'm going with this?
Here's the USA economy, dead. The whole system of exploiting the Earth and its people in order to provide money for the rich is collapsing. It would have died years ago, but they kept it going with artifical life support - credit, pumping dollars into the invalid to keep it producing.
So now we're in the CPR stage. Interestingly, the rich get the Amiodarone. The bankers are like 300 pound gluttons, with very limited heart function, who have gorged themselves for years, (along with snorting the expensive cocaine), and now are being showered with billions to keep them going.
The automakers get the lidocaine. They are the ones who have been smoking heavily for years, polluting the air for all around them, and getting drunk and trashing the place, sprawling and crashing around with broken lives and barren landscapes to show for their time on Earth.
The rest of us watch. Abused though we are, they're the only family we know, and most Americans are hoping that they can be reususitated, so that our lives can continue without change.
It's time to accept the things we can't change and have the courage to change what we can. (And I'm quoting AA, not Obama, who can't let go either). The drunken abusive system we call "capitalism" has failed us, and we need to move to a sustainable system that provides for the entire human family without destroying the planet we live on.
Let the banking system die. Let the automakers die. Let capitalism die. Quit the resusitative efforts. Move on.


David G said...

Hey, Wagelaborer, this is a fantastic article! It tells it as it is. It should be read by everyone.

I'll make mention of it on my Hot Issues!

Take care!

rose of grace said...

15 years ago, a doctor friend explained how keeping a patient "alive" was more often because of the denial of the family. He felt that responsible medicine was to explain this to the families and let people die whose bodies are trying to die. Your well writen post confirms this common sense and also clearly you explain how "keeping alive" is a big money-maker. There should be no profit in medicine. It is a basic human right. Rather than big bill$$$ at the end of grandpa's -ma's ordeal perhaps some human dignity and wisdom. Peace.

ryk said...

That's an excellent analogy. I'm stealing it.