Death is a part of life

Hi

“Death is not the opposite of life, but a part of it.” 

Television shows are a lot different than the reality faced by millions of healthcare workers across the country everyday. Do we have moments that are so surreal you do a double take and think what the fuck?  Absolutely.  Do we see miracles occur? You bet we do.  Are we honored to stand next to people and assist them during their hours of need?  Yes, we do.   We love to share the moments that make us laugh.  We love to share the moments that are super gross.   We love to share the moments that are absolute chaos.   However, many of us shut down when it comes to speaking about the moments that leave us emotionally drained.  We try to forget about the moments that leave us breathless, heartbroken, devastated, and/or questioning why we do what we do.

My specialty is critical care.   Critical care has allowed me the opportunity to see people at their most vulnerable not only recover, but prove miracles happen everyday.  Sadly,  I have also witnessed my fair share of people cross over from this life to the next.  Preventing, witnessing, and fighting with death is what we do.   Sorry the RN doesn’t stand for refreshment and narcotics.  Nor are we waitresses.  We work to save lives.  And death is that annoying family member that shows up at 2 am causing all sorts of drama and commotion.    Death doesn’t care about your economic status, ethnicity, sexuality, gender, age, height, weight, or looks.  Death is an equal opportunity taker.

The process of watching an individual die, whether quickly or slowly, is something few people ever witness.  Sometimes the process can be etched into your mind so strongly you can recall the events, names, and people who were there like it was yesterday.   You see the look of utter shock and grief flash across their face.  You know they are going to ask you the same questions again and it is okay.  You try to block out the cries.  You try to encourage them to share memories of this person and encourage them to lean on each other for support.   You feel terrible to have to ask them – what funeral home would you like to send their body?   You give them time and then sometimes you have to wrap their bodies and send them down to the morgue, if a funeral home isn’t selected as of yet.   And even after years of doing this job, the process is difficult.  The process hits you at the core & all you can do is emotionally let go.

The past few weeks has been emotionally overwhelming for me.   I rarely have had to call an medical emergency/cardiac arrest (code), yet in the past couple of weeks – I have had to call two and in the end neither patient survived their injuries.  And I watched one lady slip away as her brain swelling couldn’t be stopped.   All three cases stick with me.  However I will share two out of the three stories because I think sometimes people need a look at the harsh parts of what we do.

The lady who slipped away from life due to brain swelling was hard.  It is hard to watch someone neurologically decline.  It is even harder to look at the person who has loved her for 56 years, watch her die.  He told me wonderful stories about the woman he loved.  He called her the boss and respected how she raised their family and supported him while he provided financially for the family.   He wanted her to recover.  He said he would be lost without her.  He said how much he loved that woman.  He gently stroked her hair and kissed her forehead while reminding her constantly.  “Baby, I am right here.  I haven’t left your side.”  He looked at me and asked would she be returning home to him.  I gave my PC answer – “the next 24-72 hours are the most critical.  We will have to wait and see.”  I didn’t have the heart to look him in the eyes and say you won’t be bringing home your wife, lover, best friend and mother of your children.   You won’t be holding her hand or kissing her again.    I am grateful I didn’t have to see her die with him by her side.  My heart would have broken for him.  And the days ahead that no words would be able to soothe or heal.   The pain that no one would understand because his life partner was no longer standing by his side.

Death doesn’t discriminate & it took a woman in her 20’s like a thief in the night.  I can remember wanting the physician to see her as soon as possible because I didn’t like anything I heard.   The physician was busy and said when they got a moment they would be around.  Pt wasn’t breathing the best and we had some conversations about comfort and not wanting to remain this way if nothing could be done.   Got her breathing treatments going and he O2 sats started picking up and she was sleeping soundly.  The physician peaked in and saw everything improving and basically said if you need something call but she will be fine.  I didn’t feel comfortable but I started to think maybe I am just paranoid.  I kept calling doing labs, listening to her breath sounds, monitoring everything looking for signs, and some things were improving.  She was comfortable and still resting in no distress.    An hour before shift change, I was outside her door and heard her let out a yell.  I went inside.  She looked at me and said “I can’t breath.” Told respiratory to get an ABG stat while I called the physician.   Within the two minutes it took to call and get a response.  I saw her go from having a rhythm to asystole.  We tried to save her life while her family member stood by the entire time just watching in shock.   We never saw life return to her body.  Finally I hear a crying out from the other side of the room “no more”.   After 27 minutes, we declared this young woman dead.   I couldn’t catch my breath.   I heard her family member say remember our conversation from earlier & I did.  And I couldn’t hold back the tears. I had to walk away because heartbreaking doesn’t come close to describing how I felt.  I came back and held this lady and told her take all the time you need.  And we talked about her not being in pain any longer.  I was assured there was nothing I could have done.  I did everything possible, yet I felt like a failure.   I carried that home with me that day.  And still do in some ways.

I love what I do for a living.   I can’t imagine doing anything else at times.   However, we forget that health care providers are people as well.  We also leave part of our hearts with you.  We hurt and grieve the loss of our patients.  We are impacted by the losses and victories of medicine.

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