Sometimes the simplest phrases can really stick with you. This isn't a happy story, but it's the life that I live.
A few weeks ago I came into work and looked at the assignment list, like I always do. I picked up a report sheet and started the typical search for the day shift nurse that had been taking care of my patients. I got report and started my night.
I could tell when entering the room that if I was going to have a problematic patient, this was going to be it. By problematic I don't mean being demanding, whining, or anything like that. Sometimes you can just tell when a patient is teetering on the border of bad and worse. He was on the cusp of going into full on respiratory failure and I think he knew it. Just by looking at his status you could see it. He was on a lot of oxygen, breathing too fast, and his heart rate was way too fast.
After checking him out I headed back out to the desk to formulate my plan for the night. The one thing that really stuck out to me was that it was very easy to see that he was legitimately scared. So, needless to say, my goal for the night was to keep him calm so we could keep the rest under control. Thankfully, this is something i've gotten pretty good at.
I spent a lot of time during that night sitting in the room and talking to him. He would get worked up and start to panic. When he would panic, his respiratory status would decline in a hurry. We would make some changes and press on. I was on and off the phone with doctors throughout the night. They would give orders and I would make changes. Honestly, it was a stressful night. His status wasn't improving. My fellow nurses and I knew what was coming, but we just kept on working because that is what we do.
We had made it through the night. It wasn't an easy feet up on the desk kind of night, but we made it. As I was tying up all the loose ends at the end of the shift, I was sitting in the room talking to this gentleman before I headed home. He was telling me that he was feeling a lot better this morning and was just ready to go home. I told him that I would be back in a few days and would come find him wherever he was in the hospital to come say hey. As I was walking out the door he stopped me and said, "Kyle, you did good."
I headed home for a few days off. That phrase would pop into my head several times in those days and I would wonder how he was doing. I considered calling up there a few times to ask about him, but kept telling myself I would be there in just a day or two.
My first night back I got some bad news. Somewhere around a day after I had gotten off, his status had declined to the point where he had to be placed on the ventilator. That is typically no big deal to myself because we place people on the ventilator all the time and manage to get a lot of them off. Sometime after he was placed on the vent something else happened. This incident left him completely unresponsive. I went in to see him that night and he didn't even look like the same person.
I took care of him the next night. I was told in report that the family was waiting on one other son to get into town and then they were planning on withdrawing care. Soon into the shift the family came out to the desk and told me that they were ready. I made all the proper calls and we did what we had to do. The family told me that they didn't want to be in the room while he passed. The family said their final goodbyes and headed out into the waiting room. I stayed in the room with him. I just didn't feel right letting him pass in that room alone. A few of us, that had taken care of him, stayed by his side and watched his heart rate creep down until if finally reached zero.
All I could think of were those words. "Kyle, you did good." You'd never believe how a couple of words can stick with you until it actually happens. In the field we work in, we experience them more often than most. We have our moments and we press on. I'll tell you one thing, you really learn to not take life for granted working in the ICU. Take it from me, life is a precious thing, so don't waste it!
Until Next Time,