I know, I know, 2 posts in 3 days, what is wrong with me? Just super reflective, I guess! I'm headed off to Camp Eagle for the weekend, but didn't want to wait until I was back to blog on this.
So this week was rough. I pulled a 12 hour shift on Wednesday and since my supervisor has taken a leave of absence, I've felt a lot more pressure to complete tasks that normally we work together on and now I have no idea what's going on. (See previous post: I Have No Idea What I'm Doing). For instance, normally she coordinates who is speaking at our next support group lunch, and so it was my job to figure that out. I still am super nervous about talking to most doctors - so her idea of having one of the hospitalists speak was not my cup of tea. But you know what? I grew up and made the call. And sometimes you just have to DO it, even if you don't want to.
Thursday, yesterday, was the worst. I was in the ICU, caring for one of my heart surgery patients. While I was typing up a note about him, my other surgery patient stopped breathing and coded. In that situation, everyone in the area rushes to the room to help, and although I'm trained in ACLS, I officially am not assigned a role, especially when there's nurses who do this a lot more often. So I took an observational position outside the room, looking through the small window. While they're trying to establish her airway, the surgeon makes it up and starts doing compressions, shouting out orders I can't hear. He then decides to "go in," and they prepare a surgical tray. I don't think I'll ever forget what happened next. Ever. Since she had just had surgery the day before, her sternum was already broken, so he just cut right through, reached his hand in, and started to literally pump her heart for her!
I was standing next to the chaplain, observing from a mere curious point of view, interested to see how a code was run, who does what, and what decisions are made. The chaplain sighed once and I immediately was brought out of my objective view into the fact that there was a grandmother, mother, and wife in there, fighting for her life, who I had just spoken to the day before when I did her pre-op teaching and assessment. I started to recall our conversation, her anxiety about the surgery, and meeting her daughter. It all kind of hit me and suddenly I realized I was praying for her.
The team left the floor, headed to the OR, and I was left standing there, dumfounded. The other nurses were hanging around, cleaning up the mess and asking who had given what drug and when. There was no pow-wow or debriefing, life went on as normal. I wasn't quite sure what to make of it. I returned after lunch to find an empty room. They ended up taking her to the OR to try and fix her bypasses, then to the cath lab to stent her failing vessels, and finally she expired.
If I had not known this patient, I wouldn't have thought much of it. But I DID know her. I spoke to her, helped her understand the specifics of her surgery. And that day, the team didn't just lose another patient, they lost the life of someone who was loved and treasured by her family and friends. To them, the world had stopped. But to the hospital staff, it has to keep going.
I've been wrestling with the battle between my emotions as a person and my emotions as a caregiver. The only way to survive in the ICU and working at a hospital, I believe, is by repressing or not even acknowledging these feelings. If you do, you will end up having a crummy day and not be able to focus, haunted by the thoughts and actions you did or did not take. You instead have to take an objective view and not get personally involved. But how do you remain compassionate and caring in your position?
I know I'm new to working in a hospital, so after time I will learn to cope, but gosh, this stuff is hard.
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