Thursday, January 24, 2008

Because we are Human

I still wonder how I ended up where I am in life. Never as a child did I want to be a nurse. I wanted to be a teacher. For some reason path in life led me into nursing. I'm still trying to figure that out.

I will write more about my last 6 straight nights of working later on. I'm tired & need to get some sleep, but I wanted to post about what happened Tuesday night. Or should I say early Wednesday morning. There was a patient on my floor - he wasn't my patient, but I got to know who he was, what happened to him and ultimately - I was the one to watch him die. I didn't plan on the last part happening, but sometimes things don't go as planned.

The patient was a man in his 70' active man. In fact, he had been doing yardwork as recently as this past Saturday. On Sunday he began feeling some left-sided weakness. Like any of us, he thought it would go away. It didn't. He ended up falling at home because of the weakness. So his wife brought him to the hospital to get him checked out. He was admitted to my floor Sunday night.

He still had left sided weakness, but he was responding to questions and able to move. By the time I got back to work Monday night - things had changed drastically. I overheard the day nurse telling his night nurse that he wasn't expected to make it through the night. Huh??? What??? Why not???

Turns out when he came in, he had what I believe they called an evolving stroke. They had started Mannitol on Sunday night to reduce intracranial swelling. It wasn't helping. The patient's wishes (before this happened) was not to do anything drastic to save his life. He was in his 70's, felt he lived a good life and if/when the time came - let him go peacefully. Hospice had been contacted and they came in Monday night. His nurse and I spent some time with his wife.

She was so full of stories inbetween the tears. I can only imagine how she was feeling - to see the love of your life slowly fading away. We got a private room so she could spend the night, but around 2 am she came out & told me that she simply couldn't sleep in there. The noises were keeping her awake & she needed her rest to provide her with strength for the coming days. I assured her she was doing the right thing - that she did need to get some rest and get something to eat. I told her to call if she needed anything at all and that we would be in touch should something happen while she was not there.

I checked on him a few times that night - he was doing ok. His breathing sounded wet - like he had fluid in his lungs, but his 02 sat was fine. He developed a high fever that morning...I believe it was over 103. His nurse gave him a tylenol suppository, but it wasn't working. His temp wasn't going down. I went home that morning thinking his temperature was going to lead to his death sooner than later.

I went back Tuesday night and his temp ended up being ok. Although at this point his family had withdrawn all medications. He was in hospice care now - but they did not have a bed available at their facility - so he was still in the hospital. He had a different nurse that night - someone that wasn't familiar with him or his family. They had left before I arrived. Regardless, I didn't have a good feeling about the night.

They only did vital signs on him once that evening. We still had him hooked up to the heart monitor and the 02 sat. Amazingly his heart rate & rhythm were ok as well as his 02 sat. It was around 3:25 am that his 02 sat monitor was alarming. Well, it had been alarming on & off all night...but it was at that time that I went in to check on him. I looked at him & immediately questioned whether he was even breathing. I didn't see his chest rising - but I also couldn't understand why his 02 sat was as high as it was = (85% - low, but not bad for someone who didn't look like they were breathing). I touched his hand - he was still warm. The 02 sat monitor was still recording a decent pulse around 100 beats per minute. I stood there for a few minutes watching him - assessing his respiration rate. It wasn't good - maybe 3 respirations a minute. Or more like loud gasps. I could sense the end was near.

I went to inform his nurse - she was sitting at the nurses station. She was a med/surg nurse that had been floated to our unit. I told her "I don't think he's going to make it through the night." She replied "Don't say that." It was then on the monitor his heart rate jumped up to 149 instantly. The rhythm was chaotic. I said to her "Look." Of course she had no idea what she was looking at because she wasn't used to having to deal with heart monitors or rhythm strips. So we went to go look at him & by that time he was already gone. :(

The family was informed and showed up shortly afterwards. This is definitely the hardest part of nursing - having to see the sadness in their eyes as they say goodbye to someone that was so very special. As they were leaving, his wife came over to me to hug me.

I silently wished that she didn't have to go through something this painful. No one should...but yet we do...because we are human.


tendernoggle said...

Yes...unfortunately death is as much a part of life as birth is....but It hank God for nurses who you do.

nemokat05 said...

I'm probably going to get ANOTHER staph infection..... for the second time!!!!