On my cardiopulmonary placement on a ward, I had several opportunities to go down to ICU to treat patients (organised by our supervisor to give us an exposure to a wide range of cardio patitients). On our first encounter in ICU, the other student and I, with our Curtin tutor, treated a patient who had been in ICU for many weeks with renal, liver (etc) trouble, and had been intubated several times. The previous day, the patient was able to sit over the edge of the bed and cooperated with treatment, however his nurse reported to us that he was not as well today but to go ahead with physio treatment. As we bagan to speak to the patient it became aparrent that treatment would be limited to "chest physio" in modifications of supine.
During our treatment the patient desaturated on rolling onto his left, but recovered quickly on repositioning. At the end of our treatment the medical team was using the patient's notes so we said that we would come back after lunch to write in them. We came back after lunch to be informed by one of the physios that the patient had passed away, as the patient and their family decided against re-intubation. Our initial response was 'oh gosh wht did we do?' We were reassured by the physio that our treatment was fine, but in hindsight if they knew that he that close to slipping away physio treatment would have been witheld.
I do not think we were to know how close the end was for this patient, and although we felt terrible, we did not do anything wrong. If I ecountered this situation again, I feel I have a better understanding of how quickly patients can change, and would ask the medical team directly what they feel the best course of action to be.
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