Remember in the last post how I mentioned I was waiting for my lung transplant patient to return from the OR. Well... She got back up to the unit following her surgery in the early evening. She was on the older end of transplant recipients and I wasn't quite sure how she would do. I recovered her from surgery but then my shift ended before we could take her off the ventilator to see if she would fly.
The next morning when I returned not much had changed, she was still ventilated. Fortunately by mid morning she was ready to come off the vent. As I woke her up and put her on the spontaneous breathing trial, she became very anxious and had a death grip on my hand. Once we took the ET tube out, she began to cry. These were not tears of pain but tears of joy, she finally realized what it was that had just happened and her hope for life was renewed. She kept repeating, "I can't believe I can breathe! Thank you all so much, this is amazing."
She continued to recover very quickly following her extubation, getting out of bed only only an hour later. It wasn't long before we had her walking circles around the unit with her IV pole, 4 chest tubes, portable suction, monitor and drains in tow but remarkably no oxygen! (Of course I had packed it with us "just in case...") I can't say that she made for the most exciting patient but she was the one who truly "got it" and did her best to take great care of her new lungs. It's moments like these that give nurses the energy to keep on doing what they do.
Tuesday, March 17, 2009
Tuesday, March 3, 2009
Not Again...
At work this weekend I found myself "CRN" (the nurse who runs around and puts out fires) while I was awaiting my patient's return form surgery. About mid morning I got a call from another hospital saying that they were sending a critical patient our way. We prepared as much as we could for his arrival, setting up 12 different IV drips, ordering ventilators, etc...
The patient arrived in terrible shape and went into cardiac arrest only minutes after he rolled in the door. Once again I found myself doing chest compressions on the middle bed of our only 3 bed room, which of course was full... Again with the sequence of CPR, shock, pulse comes back, lose it again, lather rinse and repeat. In midst of all of this, his family walks in (or rather runs in). "Daddy, daddy, come back," they screamed slapping his face. We continued to try but all of us knew it was futile. The attending physician, a small Asian woman, calmingly spoke to the family at the bedside explaining what was being done and that we were running out of options. Finally we stopped, but as soon as we did the man's daughter ran up and tried to do compressions. The son then started to beat on his father's chest and the entire family began to wail. The family was middle eastern and I'm sure that some this reaction was related to thier culture and I'm sure the suddenness of it all didn't help... The little Asian doctor bear hugged the son from behind while another nurse did the same with the daughter. Just like that, it was over.
The patient arrived in terrible shape and went into cardiac arrest only minutes after he rolled in the door. Once again I found myself doing chest compressions on the middle bed of our only 3 bed room, which of course was full... Again with the sequence of CPR, shock, pulse comes back, lose it again, lather rinse and repeat. In midst of all of this, his family walks in (or rather runs in). "Daddy, daddy, come back," they screamed slapping his face. We continued to try but all of us knew it was futile. The attending physician, a small Asian woman, calmingly spoke to the family at the bedside explaining what was being done and that we were running out of options. Finally we stopped, but as soon as we did the man's daughter ran up and tried to do compressions. The son then started to beat on his father's chest and the entire family began to wail. The family was middle eastern and I'm sure that some this reaction was related to thier culture and I'm sure the suddenness of it all didn't help... The little Asian doctor bear hugged the son from behind while another nurse did the same with the daughter. Just like that, it was over.
He was Right, Life is Precious...
I worked my first official day shift in 10 years yesterday. As I went into the report room to grab a cup of coffee I was met by the hospital chaplain. Within a few minutes they had managed to herd a handful of us into the room. Then, the breaking news... One of our fellow nurses had very unexpectedly had a stroke that morning. At first she had only paralysis on one site, but as the bleed in her brain got worse she gradually lost consciousness; she was dying. As ICU nurses there was a thousand things we could have done to prolong her life, but nothing we do to save it. We all knew what she would want and so did her family, she died peacefuly only a few hours later.
Of course the entire unit was in a state of shock. Deanna had been a nurse who repeatedly took on the most chronic hopeless patients; the ones who stuck around for months and usually died a very slow and drawn out death. She treated each one of these patients like family, she treated them like they still had hope. I remember one occassion when she arranged for one last flight for a dying Air Force officer. She treated life as it were precious and now in her death has shown us all that it most certainly is. You would think that as nurses we would know that, but somehow it's a little different in the context of our job as opposed to the rest of our lives. I suppose we just learn to compartmentalize?
Of course the entire unit was in a state of shock. Deanna had been a nurse who repeatedly took on the most chronic hopeless patients; the ones who stuck around for months and usually died a very slow and drawn out death. She treated each one of these patients like family, she treated them like they still had hope. I remember one occassion when she arranged for one last flight for a dying Air Force officer. She treated life as it were precious and now in her death has shown us all that it most certainly is. You would think that as nurses we would know that, but somehow it's a little different in the context of our job as opposed to the rest of our lives. I suppose we just learn to compartmentalize?
Speechless (again)
Last Wednesday I was called in early for some overtime on top of my last night shift. It was a busy day and all of our beds were full and patient acuity was very high. Throughout the course of my 17 hours my patient assignment changed 4 times as patients and nurses came and went from my part of the unit. I found myself assigned to the units only triple room. At one point I had managed to transfer one my patients to another unit opening the only ICU bed in the hospital. It didn't stay open for long...
Within minutes I heard a code being called overhead on the telemetry. Of course I knew it would be coming to my room. Within a few minutes of his arrival the new patient went into cardiac arrest again. We worked on him for several hours: CPR, shock, IV meds, regaining a pulse, losing the pulse, lather, rinse and repeat...
The family came in said their goodbyes and time of death was called.
The part I neglected to mention until now, my two other patients sharing the room were fully awake and aware of the events of the night. They heard every word.
"You must really look at life as a precious thing," said one of my patients as I checked on him after it was all over. I could tell he was a little shaken by it as he himself had just returned from surgery for a potentially fatal aortic anneurysm. I mist admit that I felt a little guilty for being releaved that time didn't allow for much more than a short chat. But what do you say to that?
Within minutes I heard a code being called overhead on the telemetry. Of course I knew it would be coming to my room. Within a few minutes of his arrival the new patient went into cardiac arrest again. We worked on him for several hours: CPR, shock, IV meds, regaining a pulse, losing the pulse, lather, rinse and repeat...
The family came in said their goodbyes and time of death was called.
The part I neglected to mention until now, my two other patients sharing the room were fully awake and aware of the events of the night. They heard every word.
"You must really look at life as a precious thing," said one of my patients as I checked on him after it was all over. I could tell he was a little shaken by it as he himself had just returned from surgery for a potentially fatal aortic anneurysm. I mist admit that I felt a little guilty for being releaved that time didn't allow for much more than a short chat. But what do you say to that?
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