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...

4 comments:

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 :)