Stat Triage to the parking lot!
Headed out the door with a gurney at a half run, half walk, an SUV with the rear door is open and a man and a woman are frantically waving us to them. The woman’s shirt has mud and blood stains on it from picking up her dog after he was hit by a car when her dog chased his ball into the street. Minutes before all of this happened this dog was in his prime, enjoying the sunshine, chasing his ball, his most favorite activity, with the person he loved the most, his Mom. The man at the car is a kind neighbor who saw the event happen and graciously offered to drive them to the emergency hospital.
In the backseat of the car is an approximately 45lb. mixed breed male dog who is 8 years old. His name is Waffles. He is lying on his side, with numerous lacerations and degloved areas on his hind legs. His mucous membranes are pale, his respiratory rate is shallow, labored and approximately 50 breaths a minute and he is struggling to sit up. The owner gives us a brief history of what happened and wants us to do everything we can to save her boy. She runs along-side the gurney as we head into the door, very upset and saying “please don’t die” to him. She pleads with us to let her stay with him and to head back to treatment with him. As per hospital policy, we let her know we will take care of him while she talks briefly with the customer service representative up front to take of admission paperwork and someone will get back with her as soon as possible once we stabilize her boy. This client fills out all necessary paperwork and again pleads with the receptionist to let her go in the back with her boy. As this client is in the lobby of the hospital her boy in back who is being stabilized and treated for shock, decompensates and develops an arrhythmia called pulses ventricular tachycardia, a life-threatening electrical rhythm of the heart. The staff trained in RECOVER CPR initiates the CPR algorithm and the patient receives several shocks from the defibrillator and medications to help bring his heart rhythm back to a perfusing rhythm. As the team continues to work on bringing this patient back, the owner is pleading to be with her dog. What say you?
So now I am going to pose a controversial question. Do you think pet parents who want to be present during treatment and resuscitation efforts should be allowed to be present? Is it better for the staff not to have pet parents in the room so they can focus on life saving treatments and not worry about what the owner may see or do? Is there concern for a pet owner not understanding what is happening and later decide that they want to sue the hospital or be angry that their pet died? Is it a situation where the decision to allow pet owners to be with their pets is a case by case basis instead of a hospital policy? Can pet owners handle what they may witness in a resuscitation effort? Will it be traumatizing for them? Will an owner being present allow them to see the room, the technology of the equipment being used, the high energy being channeled to save a life? Does bearing witness to the urgency and frantic nature of the moment reflect well or poorly on the team? Does watching a group of people pull out all the stops to save a life and move in sync with the vivacity of what makes them love what they do help or hurt the owner who might be present? Does allowing an owner to see the sadness that the team members deal with and feel during a resuscitation make it better or worse for the staff or the owner? Is it possible that allowing an owner to be present and witness the heroic efforts make it somehow easier for them to be the one to say “I want to stop”? What if there was a staff member assigned to stay with the owner through a witnessed resuscitation to answer questions and remove the owner from the situation if they were struggling to deal with what they were witnessing, then would it be okay? Is typical hospital staffing enough to make this a reality? Is it really a bad thing for an owner to witness that your team has tried every possible thing they know to bring your boy back, and even with heroic efforts, the heart just won’t beat? Might this help to make it easier for an owner to say goodbye to a pet they loved so much, because they got to see the effort put forth to try to save him?
These are all powerful moments that most people do not witness. Should they? Will owners being present cause the team to be distracted? Will bearing witness in the final moments to these powerful moments empower a pet owner to make the final decision after watching the full out effort made to save the life on the table?
I don’t know the right answers to all of my questions but I do know that for me personally, being a certified veterinary technician with a background as a Registered Nurse that I would want to be present with my pet until the end. It would help me accept what was happening and put my mind to rest that all those people who are scrambling around my beloved dog or cat are pulling out all of the stops to keep him/her on this earth. My needs are born out of my background in medicine, my spiritual make-up and having been one of those people on that resuscitation team. But I also understand, being present in these situations isn’t for everyone. I pray that no one has to ever make this decision.
I understand this from all the perspectives, pet parent, certified veterinary technician and from the veterinarian’s point of view, even hospital management’s concerns.
Lean in, share your viewpoint. There are no right or wrong answers. When we all share our viewpoints, everyone gets to see another perspective and person’s experience. When you share your opinion, it helps everyone reading understand where you are coming from, how you feel, your beliefs and desires, your passion, determination, and knowledge. Can’t wait to read what you think!
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