Sunday, June 20, 2010

Everyday should be a good day to die

I've been missing in action the last few days.  Mostly just working and being lazy.

I am happy to report that I finished Week  7 of the Couch to 5k program today. Two more weeks to go!
 I have resorted to allowing myself walking breaks. Sorry, but it is not feasible to run for 25 minutes straight in this weather. They are only 30 second breaks at a time, but totally help. And I finally bought a hat (had to buy child size. Apparently, I have a tiny head?), which has helped more than I thought with the heat/sun.

I took an unscheduled rest day yesterday. After I work two twelve hour shifts, I feel dead the next day. I never understand how people do three 12's in a row! I am weak. Nursing is physical.

(source: duke nursing)

Friday was a bit of an emotionally and physically draining day. My older something patient with a DNR was septic, maxed out on levophed (with her BP still in 70/30 with MAP of 40-50's), received numerous liters of fluid, and deteriorating pretty quickly.

 I spoke with the family member who was quite realistic about the situation and after retrieving a blood gas and relaying that the patient needed to be intubated or he/she would die, the family member made the right decision to go CMO. I was so glad. I absolutely hate to watch people suffer through death.
This was still a difficult decision for the family member, of course. I had to call another family member and explain the situation while everyone cried.
At first, we were going to wait for 2 other family members to arrive that night before we stopped everything besides morphine/ativan, but then the 1st family member just said he/she did not want his/her mom/dad/sister/brother to suffer any longer, and the rest of the family on the phone agreed.

Finally, I shut off the levophed, all fluids, and turned the monitor around. I stayed in the room with the lone family member behind the monitor and we talked about his/her mom/dad/brother/sister, the kind of life he/she led, how strong he/she was, etc. He/She passed in about 15 minutes. And then I let the family member stay with him/her for as long as he/she wanted.

I felt good about the job I did because the family member kept saying thank you and how grateful he/she was to have such a wonderful nurse.

Is it weird that I still talk to the patient after they die? For instance, as I was removing tape, etc., I continued to explain to the patient, "ok, i'm just going to pull off some tape here..." I suppose I am just used to talking to people who don't respond (sedation/vented,etc).

Everyone dies. EVERYONE.

And to make this post a little less serious...something light for your viewing pleasure. The comic genius of Mr. Carlin...


Iris said...

It's great that you were there for your patient and the family.

No, it's not weird that you talk to your patients after they die.

Kelli said...

I think its wonderful that you talk to your patients after they die. I think, if it was my relative, that I would be glad to hear that you did. And I sure do hope that if we ever have to go through anything like that in my family, that we are fortunate enough to have a nurse like you.

BurniatricRN said...

Thank you for your post on my blog. I havent written for a long time. Perhaps I should start again. There certainly is a lot to learn about life and death in ICU nursing. Good luck with your path. Thanks again -AE, RN (seattle)

Rachael said...

I went through this with my grandmother- it's great to know there are great nurses, like you :)