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4th December 2008

engage with grace

Being a resident and supervising interns is hard work. I don’t think I’ve ever worked with such a clingy intern before. Intern paged me every 15-20 minutes until around 1 in the morning and it was all that I could do not to get snippy on the phone. Because if I had done that, and something serious were to happen to one of her patients, then she would have hesitated calling me. It’s a difficult balance between too much autonomy and too much supervision. She was completely resistant to my efforts to give her more autonomy (and talking with my friend who is her resident every day, it wasn’t just last night), but it’s something that I need to work on.

I’m tired and have to be up early tomorrow. My snowblower is missing a bolt and the little spout that directs the snow now flops and I end upblow the same bit of snow over and over again. We’re interviewing candidates for next year and we take them out to dinner so I didn’t get a chance to go by home depot before so I’ll have to go bright and early so I can come back and clear the sidewalk before I go to work. Ugh.

In the meantime, I’m sharing this:

Since I’m in the critical care unit, I see many patients who are coming in with devastating injuries. These families, already dealing with the tragedy and pain of an injured loved one, are now having to make difficult medical decisions and so often, they are making these decisions without knowing what the wishes of their loved one are. Those with the most peace have had the discussion, they are comfortable in knowing that they are doing what their loved one who do if they could speak.

Engage with grace is a website that is trying to help with this problem. Here’s some of the statistics they provided:

  • 73% of Americans would prefer to die at home1, but anywhere between 20-50% of Americans die in hospital settings.2
  • More than 80% of Californians say their loved ones know exactly or have a good idea of what their wishes would be if they were in a persistent coma, but only 50% say they’ve talked to them about their preferences.3
  • Eight out of ten people say it is very or somewhat important to write down EOL wishes, but only 36% actually have written instructions.4

After my first months on the NICU, I completed the paperwork for a durable power of attorney (which actually needs to be redone, since I didn’t have it witnessed properly) and sat down with my parents to have the talk about my wishes. My friends who are also residents have said that they have “the talk” every couple of years, so that wishes are understood.

I encourage everybody, regardless of age, regardless of health to have a conversation with the person that you would want to make your medical decisions if you couldn’t.

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