Critical care nurse blog: Giving up the ghost

Cassandra Leese

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Critical care nurse blogger Cassandra Leese on coping with patients who have simply given up

Far too frequently in intensive care, you are privy to the kind of sad stories that Dickens himself would struggle to come to terms with.

In a type of nursing where patients are frequently admitted following overdose, violent altercations and road accidents, there are often sad stories tucked into the medical notes or written between the lines. But none hit me as hard as patients who have quite simply had enough.

Often they are smiling, appreciative souls who have close family and friends and are evidently a popular member of society. They will work with the nursing and medical team and rarely complain, instead being very grateful for all the care they are receiving.

Despite this, for a multitude of reasons, they plainly and repeatedly state that they want to die; for the medical and nursing interventions to come to a halt and to be left alone. Often they have had a long and challenging few years battling myriad medical problems. Sometimes they have lost their spouse and their life, as they knew it, is over. Sometimes they are just very old, and very tired. And yet on we go.

Whilst I am aware of the moral, legal, and ethical arguments surrounding the modern day preoccupation with the prolongation of human life; I can't help feeling on a more basic, human level, that sometimes it is just wrong. And sometimes we just refuse to listen.

Sometimes there is no place in an intensive care unit for an 89-year-old man, wanting to spend the rest of his days in peace, without invasive lines, machinery, drugs and the endless persistence of the caring professions. And yet we go on.