what I was going to write. and reality.

I had this post all planned out in my head last night. want to hear it?
Last night, I:
was not done with meds by 9 like I usually am. Or 930. or for that matter 10. I wasn't done with my chart checks by midnight, not to mention my charting. I had a bed alarm go off 3 (maybe 4?) times. A patient refuse to take her meds. I showed up with 2 patients without IVs. a guy who was laying stark naked on the bed and refused to wear any clothes. This night had the basic definition of a bad night.

But now the rest of the story.
Last night I spent 10 minutes with naked guys wife talking about the nursing homes she had visited that day, after realizing that her husband who was driving a month ago was so confused and weak she could never take care of him at home. A hard thing to realize. I also spent almost 30 minutes with the son of bed alarm lady explaining everything going on with her medically, and reinforcing what he had been told all day about why she couldn't go home alone. "she is so independant" he said. She can't tell me where she is, and she is obviously not tracking this conversation at all, I replied. I think I made headway. I moved a pt to a bed by the window so she could see the sunset. I talked on the phone to the significant other of the guy in 1*, who she had signed hte papers to make a DNR that day.
It was a good night. I love talking to pts and families. Doing basic education. That is the one thing I miss about working days.

That was going to be my post today. Until 205 this morning when I got a page that 41*s heart rate had just dropped in half, and ran into the room to find an O2 sat of 41%. I had been checking on him all night long, halfway expecting him to die, but still, not easy to find the man who the night before was talkking to me laying unresponsive and gray. My first patient died this morning. While I was on the phone once again with the significant other explaining, that no, we didn't expect him to get better two other nurses were listening for 2 minutes verifying no heart beat. Even after I got off I stiill wasn't sure she understood.

He was a DNR. A very sick man. who had been struggling to breathe, and in pain. Now he isn't. And that is good. Someday I will expound on why I am such a firm believer in DNRs and Advanced Directives. He didn't die alone, which was something I promised myself the day I saw a nurse sitting at the desk while her pt died and the family members didn't bother coming in. Unless there is just no way to avoid it, my pts won't die alone. There will be family present, and if that is not possible, I will be present. Everyone deserves to have someone with them at the end of life. It always made me feel better that my dad had made it to the hospital before Grandma Ross died. That she was with someone who could tell her how loved she was.

Okay. Just started crying for the first time all day. I expected I would start bawling when I walked in my front door, but I felt horrid so I just climbed into bed and slept for 8 hours.

Some nights, this job is harder than others. Yet sometimes I think it is the hard nights that makes it all worth while. that make me feel like the nurse I want to be.