It would seem that this week I have experienced a bit of ineffective individual coping, I don't know how else to explain it... I spent all day Monday at Overlake Hospital trying to jump through all the necessary hoops to get my students in to start their clinicals today. Apparently the instructors are supposed to orient their own students to the hospital and to the floor they will be working on. This is a little difficult to do if you've never worked at said hospital on said floor.
So Monday was my crash course in hospital and medical oncology orientation, agonizing to say the least.
After spending all day working out the clinical situation, I went work at the good old UW. My patient was especially unstable and the family was very needy. The entire night I kept hearing things like "He's starting to look better," and "I just know he'll come around." Of course I knew that these statements were not true, but how do you say that to hopeful family? I did my best not to feed their false hope and prayed hard under my breath.
Somehow I finished the night and made it home. By the time I was getting ready for work on Tuesday night, it didn't seem like I had slept at all. I took back my assignment from the night previous, my unstable patient with the needy family. It seems as though that night they were beginning to understand that he wasn't going to get any better. When I went into the room, his three teenage kids were at the bedside and very tearful. I tried to stay out of the room as much as I could that night to allow the family some private moments to say goodbye, but I tried to stay close enough so that they knew I was there if needed. It's a hard balance to find.
The kids finally left for the night to go to the hotel to try and get some sleep while the wife stayed.
As I was outside the room charting I noticed his heart rate start to drop, 110 to 90 to 80... I knew we must be getting close so I headed into the room. As soon as I entered, his wife (who was a nurse) asked me what was going on. I told her that his heart rate was dropping and that she should call the kids. I just stood there with her helplessly as we watched him slip away. A few minutes later she said, "He's gone isn't he." I tried one lost time to feel for a pulse and listen with my stethoscope; nothing but the rhythmic sound of the ventilator which was still giving him breaths. I recorded time of death at 0122 and waited until the rest of the family arrived and then left them in the room with him to say goodbye.
Of course the "death packet" must filled out as soon as possible. There I sat pushing papers and calling the medical examiner, the attending physician, and the organ donation agency. I turns out he was eligible for cornea donation which his wife graciously consented to. Now it was time to give his family the bereavement packet and start post mortem care preparing the eyes for "harvest."
More family drama, more co-worker drama, the medical examiner changing his mind about autopsy after I had extubated and delined the patient... Seven thirty finally came. I got home just in time for a nap before teaching my lab. It was the first time my students were doing injections on real people, each other... Shaky hands with needles can be a very entertaining thing. During office hours I helped some students learn how to administer an enema to a plastic doll. I have such a weird job sometimes.
Then it was off to plan a Bible study and the students orientation. By the time I got to church and found my Bible study being video taped, I just wanted to cry. Ineffective individual coping? Yes!!! I guess maybe I just can't change gears that fast. I've just to remember to pray.
No comments:
Post a Comment