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Oral Suctioning, what do patients experience

Eric F
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Does anyone have experience with Oral Suctioning - that is, during a lung infection with mucous constantly landing in the throat, the patient "gargling" and in danger of asphyxiation, and oral suctioning is used to clear the throat so that the patient can breathe again. I often see comments that this procedure is very uncomfortable, but is it possible that a patient get's to the stage of screaming, louder and louder in total panic to the point of becoming unconscious ?

I witnessed such an event while my Mother was in hospital a few weeks ago, it was a very disturbing experience and re-visits me as nightmare quite often. I was standing in the ward behind a curtain when the nurses performed this procedure, the screaming started and just got louder and louder, .. till there was silence that is. The suctioning complete and curtains withdrawn, I found my Mother lying with eyes wide open staring at the ceiling. She was breathing but her eyes were motionless and she did not blink, her eyelids slowly closing over a 5-10 minute period. 4 hours after that my Mother died and while I can't change that sad fact I am constantly wondering whether I witnessed a normal suctioning reaction or a somewhat abnormal one that should not have happened at all. On a previous occasion a different Nurse performed a suctioning and it went relatively harmless. 

Directly after this disturbing event I asked the Nurse if my Mother should be going through such an ordeal because she was being given non-stop morphine in order to have a peaceful exit in her last days. I was told suctioning is necessary else the patient suffers instead from a choking feeling, which is also unpleasant. Also, after my Mother had passed away I re-visited one of the doctors who prescribed the end stage morphine that should have prevented anxiety and suffering in her last hours. He informed me that the level of morphine is difficult to judge - too much and the patient remains unconscious, too less and they experience pain. He was very sorry that I had to witness such an event.

Nevertheless, none of those answers really satisfies me and I'm looking to hopefully tap in to other peoples / expert experiences in order to understand what has happened. I need to know if this oral suctioning is just an uncomfortable experience, or if it is common that the patient screams to the level of unconsciousness. When yes then it's just an unfortunate reality that I have to live with, when not then I need to follow up so that other people don't have to go through this same agonizing ordeal.

If you do have information to share then it's probably a hard topic to talk about and I'm sorry for bringing up such unpleasant memories, but you might be able to help me. I guess I'm still very traumatized by all that has happened and still seeking clarity for peace of mind.

Please help me understand this procedure.

Ellen M-Macmillan
Posted by

Hi Eric F

Thanks for getting in touch with us and welcome to our online community.

We’re sorry that your mum has recently died. It can’t have been easy for you to write all this down and to share it with us. It’s never easy watching someone you love die. But, witnessing something that was distressing has naturally left you with lots of unanswered questions.

After going through such a traumatic time, nightmares can occur and it can be hard to get the image of what is happening out of your head. Although grief can affect us in different ways it might help to talk to your own GP about what happened and for you to get support.

Oral suction should not have caused your mother to be screaming to the extent that you’re describing. It can be unpleasant if someone is conscious and some people do describe that feeling of thinking they are going to choke. When someone is having difficulty understanding what was happening then they can react by screaming. It doesn’t necessary mean that it was pain that was causing this reaction. Nevertheless, from what you’re saying your mother was distressed and in these situations, you would have expected that the procedure was stopped.

We would have suggested that you talk to the doctors that were responsible for her care. But, as you’ve already done that and you don’t feel any of the answers that were given have been satisfactory, then some people find that the only way to help you to get an answer is to make a formal complaint. We have this information that might be helpful for you to look at before deciding what you would want to do.

We have a bereaved family and friend’s online community you could join if you wanted to talk to others and share how your feeling.

We also have Wendy our Bereavement Support Practitioner who could offer extra support if you think it would help.

Alternatively, if you think it would be helpful to talk things through with us on our support line, we are open Monday to Friday 9am till 8pm. Our contact number is 0808-808-0000

Best wishes and take care

Ellen-Macmillan Online Digital Nurse Specialist 

Eric F
Posted by

Hello Ellen,

thank you so much for your reply. You are right, it was indeed hard to write it all down but I discovered that by doing so and having someone independent to share this with has already made a big difference, so thanks.

I've been reading the information in the links you shared and especially the talk to your own GP part was very helpful. Somehow I also ended up at the loss foundation: https://www.thelossfoundation.org/nightmares-and-flashbacks/, and this particular article has probably explained to some extent what I am currently experiencing.

It's true, I did witness a very distressing event and I know my Mother was very distressed too, else she would not have be screaming in a way that I don't want to detail here. I also believe she was conscious about it because as time went by the screams got more and more frantic and louder, doesn't it sound just terrible, it really was. For me the procedure seemed to last a really long time, my girlfriend who was with me at the time however doesn't think it lasted that long, so I seem to have been very receptive, sensitive and alert to what was going on, picking up all the details.

I think the biggest problem I have is the expectation I had when we made the choice to stop life supporting treatment and go on to 24H morphine instead. I honestly believed that my mother, not being able to eat or drink the last days, would at least be able to have a peaceful, non stressful departure, and of course without pain. After that there were a few occasions when we had to give extra morphine to stop chest pains, and then finally this very traumatic event which I believe was the last thing my Mother ever consciously  experienced: what a total mismatch to that original expectation! I'm not happy about the fact that I had explained the situation to my Mother a few hours earlier and informed her that she would be receiving drugs to ease the pain, reassuring her not to worry, and the events that then occurred just don't match up to that promise.

Please don't get me wrong though, I'm not looking for someone to blame here. I have a high respect for the nurses and doctors at the NHS who did a fantastic job under the very difficult circumstances the NHS is having right now, and who made great efforts to treat my Mother and to keep her alive for the many weeks previous. The last day, the end-of-life part didn't go so well. It's for this reason that I don't think a complaint is appropriate. Instead, I'll be asking my GP what might have happened and if it could have been avoided. Probably not and I can't change it anyway. As you mentioned, it might not have been pain but rather some difficulty in understanding what was going on, and maybe the morphine has something to do with that.

I might give Wendy a call in a week or so if I'm still having problems coming to terms with all of this, and as mentioned I'll be talking to my GP in the meantime. One comfort that I do have is that my dear Mother is now peacefully at rest. She had a nice ceremony at the crematorium and everyone I know has fond memories of her.

Best Regards,
Eric

Ellen M-Macmillan
Posted by

Hello Eric

Thanks for getting back in touch with us and letting us know how you’re getting on. I’m glad you have found some of the links helpful as well as sharing a good link that I have found helpful too. So, thank you for that.

Hopefully talking to your GP will help you to get a clearer understanding of what happened. Wendy will also be able to support you if you need it. But it’s okay to read her other answers and links she’s used to reply to others.

Once again thank you so much for sharing your very emotional story with us. But, you’re right to take comfort that your lovely dear mother is at peace. Looking back on her ceremony can be comforting to do too. Sharing fond memories with people who knew your mother will also help. It’s because of the love that you had for her that makes everything so painful.

Best wishes and take care

Ellen-Macmillan Online Digital Nurse Specialist