Tuesday, May 31, 2005

Prisoner in Palliative Care

About two days after I posted the reference to Prison Hospices, we admitted a forensic patient to our palliative care unit. This patient, unlike the one I described in that post, had not received a compassionate release. Instead, there were two guards sitting at the bedside at all times.

This man was not my patient, but I checked in on him while his nurse was at lunch.

There is no way this man could harm anyone, as he was essentially comatose. He was given a prognosis of one to two days to live. Having the guards at the bedside, however, definitely affected my experience with this patient. They altered the entire energy in the room. Instead of focusing my energy on bringing a calm, compassionate presence to the patient, their presence triggered my mind to wander off, wondering what this man had done that prevented him from being able to receive a compassionate release, minimally for these last 24 hours or so of his life.

There were no other visitors in the room. Unlike the family members whom I normally encounter in the rooms, these two adult men in uniform sat nearby, waiting for their shift to whittle away so they could go home. Professionally waiting, neither anxious for nor dreading when death would come. It seemed neither their responsibility nor of interest to them to inform me of changes with the patient.

I interacted with the sleeping patient, as I do with all others who are dying. I spoke to him, despite his unresponsiveness, explaining that I was bringing him pain medicine (his respirations had increased, suggesting discomfort).

As I turned to leave the room, I faced the guards once again. Their expressions were almost as lifeless as the patient's.

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