Monthly Archives: June 2012

Do LTACs Benefit ICU Patients?

So, this interesting study explores the efficacy of LTACs in the post-hospitalization survival rates of ICU patients. Essentially, the gist of the matter is that older patients with lots of comorbids don’t have a very high survival rate a year after hospital discharge, despite LTAC utilization. Probably not too surprising, given the acuity level of the patients studied. The study did not include patients coming from non-ICU care, although such patients are cared for in LTACs.

However, the question of whether LTACs serve as a more cost-effective method of delivering care to patients and families not ready to give up and die is asked, but not well explored. It would be interesting to see a study delineating survival rates only for non-DNR/DNI patients utilizing LTACs.

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Endings. . .

Some say life is a series of beginnings, others a progression of endings.  Perhaps it’s a matter of perspective.

So, far, 2012 feels somewhat like a year of final things, like the end of my first year as a CNA, the end of the first year of nursing school, and other endings far too personal and painful to discuss here, dear readers. 

I have seen others’ end times. . .watched patients slip away (into what?), seen their families grieve for them.  Hospital work provides many opportunities, sometimes too many, to spend time with Death.  He sits in every corner, patiently waiting for brave patients, families and healthcare warriors to exhaust the possibilities so that He can have a turn. 

There are some sights and smells I will never be able to forget. . .the plastic-y scent of a new body bag, just removed from its wrapper. . .the wreck of a hospital room, post-code, the sight of a widow numbly trying to come to grips with the loss of the man she’d been with since her teens, the harried, red-eyed relatives rushing up to the front desk.  Numb-eyed nurses, feet aching, charting still to be done, absorbing the impact of their task, once the adrenaline rush has subsided.  And the patients. . .the dying woman gripping my hand, fear in her eyes.  I had just helped her walk in the corridor the day before – how could this be?  Another patient, asking me “Am I alive?” 

So, I have no answers. . .except that despite all this, I know I’m in the right spot.  As a nurse, I will become close to patients, yet without knowing them in the fullness of their lives.  I will care for their bodies, and their spirits, lacking full understanding of who they are.  And, that will be OK, because perhaps these things are the privacy that remains, even after the indignities involved in being a hospital patient.  I can be at peace with that.