Making my rounds, I come to Room 603. As I put on my PPE, I see that my patient is desaturating, despite the heated, high-flow oxygen I placed her on yesterday. She isn’t in distress, but the numbers on her monitor tell me where things are headed. When she was admitted two days ago, we talked about the possibility of her needing a breathing tube if she got worse. At that time, she told me that, yes, she wanted everything done to save her life if it came to that.
Knowing we are now at that threshold, I enter her room and crouch beside her bed.
“I’m really worried about you,” I say. “Your oxygen levels are very low, even with the oxygen I’ve been able to give you. I want to talk to you again about the breathing tube and the ventilator. Do you remember what we talked about before?”
“Can I have a blanket?” she responds. “It’s cold in here.”
I retrieve a blanket from the cupboard by the door, and, after placing it over her legs, I try again. “Because your oxygen levels are so low, we need to make a decision about whether you would want to be put on a ventilator to breathe for you.”
She points to her bedside table and asks, “What’s that?”
I push aside the container of baby wipes she’s pointing at and take her hands in mine. “I know this is a hard conversation to have,” I say, “but I need you to talk to me.”
With my shielded face in front of hers, she tells me exactly what she wants. She says that she doesn’t want a breathing tube, that she doesn’t want to die attached to machines. In fact, she doesn’t even want to wear the oxygen mask anymore because it’s burning her nose and she feels worse wearing it. She wants to be allowed to eat and drink. Most of all, she wants her family to come to see her so she can say goodbye.