Florida: Heaven's Waiting Room

The last few weeks I have been struggling through dealing with death. Particularly elderly patients being brought to my room in full cardiac arrest and me and my co-workers do everything we can and despite all efforts, it's not enough and my patients die. In 3 weeks I have had four patients just like that and it's rough. For two of the patients, I had to go with the physician and tell their spouses that we couldn't save their beloved family member. It caused me nightmares and it put many questions in my mind about how I am supposed to react to this situation because I know I am going to have to deal with this my entire nursing career.

I received very wise counsel from several nurses that I work with and also Nurse Corrie, and my hero daddy who is also a nurse (not sure if I have mentioned this fact before). Life and death are not in my hands nor in the hands of my co-workers or the physician's. It is solely in the Master's hands. My responsibility is to use the gifts and skills that He gave me to carry out His plan.

Even though I understand this, it's still hard to prepare a body for the morgue. This is something I don't think I will ever get used to doing and I don't like it one bit. I've done it twice and I can't even express how hard it is for me. But, it's part of my job.

Last night I had a different sort of patient. He came to us as a possible overdose and he was only in his 30's. EMS brought him to us and he was barely breathing but they hadn't intubated him. He was completely unresponsive and Narcan did nothing to bring him around. The doctor prepared to intubate him and since he was my patient, I had to grab the drugs. I was nervous and my hands were shaking because the physician working the patient has a reputation for being harsh during code situations which this wasn't but it ended up turning that direction.

Almost everything went wrong with this guy, he was tough to intubate and even after the doc and respiratory got it he still wasn't ventilating well. It turns out that the cuff on the intubation tube that keeps it in place was blown so they had to switch the tube out. After he was intubated his blood pressure dropped to almost nothing and nothing we did could get it up. Bag after bag of fluids were hung, two types of pressors were started and still his pressure was only like 70/50. I felt such despair and hopelessness because I felt like all my efforts were for naught and he wasn't going to make it.

I juggled with the pressure issue for like 45 mins and finally got it stabilized but then it was another issue and then another. This young man was sick and I was virtually taking care of him by myself because five patients from a car accident were brought in who required the attention of the doc and the rest of the nurses.

I really can't even properly express how tough this patient was to care for and how badly I wanted him to pull through and how defeated I felt. He ended up being in rhabdomyolysis and metobolic acidosis, secondary to whatever he overdosed on. He never woke up despite not being on any type of depressive medicine to keep him asleep while intubated. I never did get him stabilized enough to take him to get his head scanned in CT. Night shift came and even though I would have liked to have gotten the patient up to the ICU, they weren't ready for him yet so I had to pass report to night shift. Luckily the night nurse is a man whom I respect very much and he has taught me a lot through this first year of me being a nurse and he didn't criticize what had or hadn't done and he didn't complain about getting dumped this drain-circling patient.

I didn't leave work til 8pm which NEVER happens because I had to catch up on charting for the past 4 hours. I was mentally and physically exhausted when I got home. I called my dad to talk about everything and see if I did right by this patient. I work again Sunday so it will be interesting to see if I can figure out what happened to this patient after I left and how he's doing now. I am pretty sure I did the best I could and I hope it was enough. I learned a whole lot through all of this and I hope it makes me a better nurse.

A nurse once quoted M*A*S*H to me, actually the very same nurse who took over for me last night. He said, "The first rule of medicine is people die. The second rule is doctors (and nurses) can't change the first rule."

I must press on and keep doing my best and leave the outcome in God's hands. So much easier said than done.