Today was my first full blown code. Young guy had a suspected PE, went into respiratory failure, and shortly after, cardiac arrest. It was horrible. That is all I can say.
The code went smoothly for the most part. Everyone worked very well together. ACLS prepared me for which meds to push, when to push them, when to shock and when not to shock. ACLS prepared me in how to work together with a team, how fast to perform compressions and how to ventilate a person with an ambu bag.
What ACLS did NOT prepare me for was how I would feel during and after the code. ACLS did not prepare me for how physically tiring and hard it was to do effective compressions on a 250lb muscular man for 40 minutes. ACLS did not prepare me for the look of the patients lifeless eyes staring at me from only 2 feet away as I pumped his chest. ACLS did not prepare me for the surreal experience of fighting to save a man's life as a priest performed the Last Rites over the patient. ACLS did not prepare me for the tangible emotion, disbelief, and pain from the family as they watched a short distance away. ACLS did not prepare me for the sorrow I felt when the physician called the code.
It was horrible. That is all I can say.
Showing posts with label family. Show all posts
Showing posts with label family. Show all posts
January 19, 2012
September 10, 2011
Why I became a nurse
I've been struggling with my desire to share this part of myself versus the difficulty in writing this and the memories it stirs. Ultimately, I think I will share, but I believe I will leave out a few details as it's just a little too painful to talk about.
Growing up, I was my mother's best friend. She had this innocent, child-like soul. Emotionally, I was often more mature and responsible. Not that that was a bad thing. It just was.
She also had many ailments that plagued her. Often “sick”. Now that I know the things that I know, I wonder how much of it was psychiatric in nature. When I was a preteen, my mother suffered an injury that led to her paralysis from the waist down. One that I also now believe was psychiatric in nature. I was her caregiver for many years.
In my late teens, she suffered another injury. A 22 gauge shotgun discharged, with the barrel resting against her chest. Her injuries were extensive. She “died” several times in the first couple of weeks. She spent months in an intensive care unit. I was young, oh so young. I was terrified. I was grieving. I was confused. I was angry. I was a mixed bag of so many emotions I couldn’t even begin to recognize them all.
The nurses in the ICU were absolutely wonderful. Not only did they care for my mother, they cared for me. They were a source of emotional support. They were patient and understanding. I was so thankful for the care they provided us. I was so thankful that there were these wonderful kind souls who were willing to sign on to do all of the undesirable tasks that nursing entails. They were my mother’s lifeline. They were my lifeline.
After many months, my Mother WALKED out of that hospital. It was a miracle in of itself that she survived. How was it even possible that a woman who was paralyzed for 7 years not only survive such horrendous injuries, but regain feeling in her lower extremities and relearn to walk? I never believed in miracles until that day.
Fast forward 5 years. I had made a bit of a mess of my life, but I had finally gotten my shit together. I had some thoughts over the years about what I wanted to do, but finally got to a point in my life where I was able to take action. I enrolled in school to become a nurse. I wanted to do for others what those wonderful nurses did for my mother and me. I wanted to help, I wanted to be a resource for families and patients, I wanted to help people in their time of need.
I became an LPN first. My mother was proud of me, she encouraged me the entire way. She was my motivation. When I started classes part time for my associates degree, she was again proud and my source of motivation. She lived long enough for me to achieve the title “RN”.
That year, her health rapidly declined. Her problems were directly related to complications of her injuries from the gunshot accident. She passed away prior to my making the leap from pediatric homecare to critical care. She was proud of me throughout nursing school, she was proud of me when I worked at the nursing home, she was proud of me when I worked in homecare. I miss her so much it hurts, but I know she is up there smiling down on me, and I know she is proud of me now.
July 31, 2011
Dealing with grief
Today I spent the day shadowing another nurse on the unit. She was absolutely wonderful about taking the time to explain everything to me, and teach me as much as she could. It was hectic and crazy right from the start. We only had one patient, who had come to the emergency room just a few hours earlier. His only complaint was shortness of breath. Within an hour, he declined so quickly he had to have an endotracheal tube placed and was put on a vent. When we received report, we had learned that he had pneumonia, and a suspected pulmonary embolism that was later ruled out. He was on maximum support on the vent and was receiving 100 percent oxygen. Despite this, his O2 sats were only in the 60's and stayed that way all day. He was septic and despite all of our interventions, he was getting worse. I felt sad for this man while helping to provide his care. I wondered if he could hear us despite the sedation, or how aware he could possibly be of what was happening to him. I wondered if he was uncomfortable. He was not expected to survive.
Many family members came to see him. I watched the nurse as she spoke to the family. I observed the reactions and listened to what all the family members had to say. One thing was said frequently by many, "But he was fine yesterday", "But he just said yesterday how well he felt". The wife, the brother, the sister, the niece, the son in law. They all said the same thing. I saw the shock on their faces. Their pain was so intense, you could feel it along with them. It was in the air around you. It was hard to witness this. I had to look away when the teenage granddaughter sobbed. It was so unexpected to all of the family, and in my opinion, that makes it all the harder to deal with.
I was on that side of hospital bed 15 years ago. My mother had a horrible accident that put her in the intensive care unit for approximately 5 months. She was not expected to survive either. Driving home after my shift, I cried. I cried for that man, I cried for his family, and I cried for my mom. I briefly questioned whether or not I was strong enough to do this. But I know I am. This is why I became a nurse, so I could help others in their time of need. I need to recognise that I'm human, that I have emotions, and that it is ok to feel these things, and cry if I need to. I called my grandma, and told her about my day. She cried a little with me, as we both remembered what my mother went through. She told me she was proud of me, and that my mom is watching over me and that she is proud of me too. I felt better after talking to grandma, it was just what I needed.
The man was transferred to another hospital. I will probably never know if he pulled through.
Many family members came to see him. I watched the nurse as she spoke to the family. I observed the reactions and listened to what all the family members had to say. One thing was said frequently by many, "But he was fine yesterday", "But he just said yesterday how well he felt". The wife, the brother, the sister, the niece, the son in law. They all said the same thing. I saw the shock on their faces. Their pain was so intense, you could feel it along with them. It was in the air around you. It was hard to witness this. I had to look away when the teenage granddaughter sobbed. It was so unexpected to all of the family, and in my opinion, that makes it all the harder to deal with.
I was on that side of hospital bed 15 years ago. My mother had a horrible accident that put her in the intensive care unit for approximately 5 months. She was not expected to survive either. Driving home after my shift, I cried. I cried for that man, I cried for his family, and I cried for my mom. I briefly questioned whether or not I was strong enough to do this. But I know I am. This is why I became a nurse, so I could help others in their time of need. I need to recognise that I'm human, that I have emotions, and that it is ok to feel these things, and cry if I need to. I called my grandma, and told her about my day. She cried a little with me, as we both remembered what my mother went through. She told me she was proud of me, and that my mom is watching over me and that she is proud of me too. I felt better after talking to grandma, it was just what I needed.
The man was transferred to another hospital. I will probably never know if he pulled through.
June 09, 2011
Erin
I was fond of all of my clients. But there were a few that really tugged at my heart strings, even more than the rest. Erin was one of those. She was a beautiful baby girl that I had cared for since she was 2 months old. I remember very clearly the day I met her. It was just before she was discharged from the hospital. I went to visit her so I could meet her mom and dad, and learn some of her care. Mom was holding Erin, and she was smiling at her mother. I didn’t know this at the time, but that would not only be the first, but also the last time I’d ever see Erin smile.
Her condition quickly got worse after she came home. She was trached, and on the vent 24 hours per day. They did all kinds of genetic testing, but were never able to figure out what was wrong with her. All we knew was that it was a metabolic disorder.
She developed seizures, went into heart failure and got to the point that she no longer responded to anyone. She couldn’t track you with her eyes, she never looked at anyone. It appeared as though she were looking through you, not at you. She didn’t laugh or smile. She only cried or lay in her crib with a blank look on her face. She started having these sympathetic responses that were very sudden. Her little heart would race well over 200 beats per minute, I was scared she’d have a heart attack, and her oxygen sats would drop to less than 50-60 percent in less than 10 seconds. She would turn blue and we’d have to bag her with 100% oxygen while trying to calm her. It was scary. I loved that little girl like she was my own.
Now keep in mind, I am a firm believer in not treating special needs kids any differently than other children. Even though they have a nurse at their disposal all night long, other kids do not, and are expected to sleep through the night (once they are old enough to do so). So I really try not to intervene unless medically necessary. I provide the care they need, keep them comfortable, but try to let them be otherwise. I care for them, show them love, but I certainly do not coddle them. To treat these kids differently from other kids really does a huge disservice to the kids and their parents.
But Erin was different. She was never going to recover and I knew she would not survive. She was getting worse every day. So for months I just held and rocked her all night long and gave her as much love as I possibly could. She never responded to me and I often wondered if she knew she was loved and knew that we were all there for her.
Eventually the parents made the decision to make her a DNR and made the agonizing decision to remove her from the vent. They decided to wait until just after her birthday so that she would at least live to see her first birthday. Erin kept getting worse and fell into a coma. We didn’t think she’d make it much longer. It was heart-breaking, but unlike with Gary, I was determined to stay and help that family. I was NOT bailing.
I had the night off and I was at home relaxing with my family. I got a phone call from the regular day shift nurse. Erin had just passed away. We knew it was going to happen but I was still stunned. I cried and cried with the other nurse on the phone. She was only a week away from her first birthday.
I was still crying, but got it under control as best as I could as I drove to their house. I was very unsure of myself, if I should really go to see them, and wasn’t sure if the family would want me there or not. I was scared of imposing on them since I technically wasn’t working, and I certainly wasn't family But I couldn’t stay away. I cared for the family just as much as I did for their daughter.
When I got there, the family embraced me, hugged and kissed me, and thanked me for coming. I had made the right decision. We were all crying and it was so so sad. The physician was just leaving when I got there, he had pronounced her, and she was already removed from the vent. It was so eerily quiet without the sound of all the equipment running. All you heard were people crying and hushed voices. The family had decided to wait to call the funeral home so that they could have those last moments with their daughter before they came to take her to the funeral home.
At one point I sat down in the rocking chair where I had spent so much time rocking her each night. Mom brought Erin to me and placed her in my arms. I got to hold, kiss, and rock her one last time. I know this sounds so sad, and maybe even morbid to people who don’t understand, but I will forever cherish that memory. That family gave me their daughter during their precious last moments with her, so that I may hold her and say my good-bye’s. I will always be grateful to them for allowing me to have those final moments and for allowing me to be part of their lives.
In a way it was a blessing that she passed on when she did. It spared the family from having to face removing her from the vent and letting her go. This awful decision was taken out of their hands. I'm glad they won't ever have to live with the grief or possible self doubt over the decision to take her off the vent. This family endured something so tragic and fiercely loved a child they will never see grow up. I can't even begin to imagine what that is like. I'm just glad I could be there, and help in whatever small way I could.
Before I finally left for the night, Erin's mother gave me my Christmas present since I wouldn’t be back. It was a beautiful ornament with Erin’s picture in it. I hang it on my tree every year.
Her condition quickly got worse after she came home. She was trached, and on the vent 24 hours per day. They did all kinds of genetic testing, but were never able to figure out what was wrong with her. All we knew was that it was a metabolic disorder.
She developed seizures, went into heart failure and got to the point that she no longer responded to anyone. She couldn’t track you with her eyes, she never looked at anyone. It appeared as though she were looking through you, not at you. She didn’t laugh or smile. She only cried or lay in her crib with a blank look on her face. She started having these sympathetic responses that were very sudden. Her little heart would race well over 200 beats per minute, I was scared she’d have a heart attack, and her oxygen sats would drop to less than 50-60 percent in less than 10 seconds. She would turn blue and we’d have to bag her with 100% oxygen while trying to calm her. It was scary. I loved that little girl like she was my own.
Now keep in mind, I am a firm believer in not treating special needs kids any differently than other children. Even though they have a nurse at their disposal all night long, other kids do not, and are expected to sleep through the night (once they are old enough to do so). So I really try not to intervene unless medically necessary. I provide the care they need, keep them comfortable, but try to let them be otherwise. I care for them, show them love, but I certainly do not coddle them. To treat these kids differently from other kids really does a huge disservice to the kids and their parents.
But Erin was different. She was never going to recover and I knew she would not survive. She was getting worse every day. So for months I just held and rocked her all night long and gave her as much love as I possibly could. She never responded to me and I often wondered if she knew she was loved and knew that we were all there for her.
Eventually the parents made the decision to make her a DNR and made the agonizing decision to remove her from the vent. They decided to wait until just after her birthday so that she would at least live to see her first birthday. Erin kept getting worse and fell into a coma. We didn’t think she’d make it much longer. It was heart-breaking, but unlike with Gary, I was determined to stay and help that family. I was NOT bailing.
I had the night off and I was at home relaxing with my family. I got a phone call from the regular day shift nurse. Erin had just passed away. We knew it was going to happen but I was still stunned. I cried and cried with the other nurse on the phone. She was only a week away from her first birthday.
I was still crying, but got it under control as best as I could as I drove to their house. I was very unsure of myself, if I should really go to see them, and wasn’t sure if the family would want me there or not. I was scared of imposing on them since I technically wasn’t working, and I certainly wasn't family But I couldn’t stay away. I cared for the family just as much as I did for their daughter.
When I got there, the family embraced me, hugged and kissed me, and thanked me for coming. I had made the right decision. We were all crying and it was so so sad. The physician was just leaving when I got there, he had pronounced her, and she was already removed from the vent. It was so eerily quiet without the sound of all the equipment running. All you heard were people crying and hushed voices. The family had decided to wait to call the funeral home so that they could have those last moments with their daughter before they came to take her to the funeral home.
At one point I sat down in the rocking chair where I had spent so much time rocking her each night. Mom brought Erin to me and placed her in my arms. I got to hold, kiss, and rock her one last time. I know this sounds so sad, and maybe even morbid to people who don’t understand, but I will forever cherish that memory. That family gave me their daughter during their precious last moments with her, so that I may hold her and say my good-bye’s. I will always be grateful to them for allowing me to have those final moments and for allowing me to be part of their lives.
In a way it was a blessing that she passed on when she did. It spared the family from having to face removing her from the vent and letting her go. This awful decision was taken out of their hands. I'm glad they won't ever have to live with the grief or possible self doubt over the decision to take her off the vent. This family endured something so tragic and fiercely loved a child they will never see grow up. I can't even begin to imagine what that is like. I'm just glad I could be there, and help in whatever small way I could.
Before I finally left for the night, Erin's mother gave me my Christmas present since I wouldn’t be back. It was a beautiful ornament with Erin’s picture in it. I hang it on my tree every year.
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