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Sunday, November 16, 2008

This is the hour.

So one of my patients recently gave my preceptor and I a scare just a couple hours short of the change of shift after being stable the whole day. That is not fun--and not pretty. The day in the life of a critical care unit, never a dull moment and rarely a predictable day.

You know it's going downhill when you see the BP reading at the monitor, think "Okay, that's not good", tell your preceptor who is nearby, immediately adjust the cuff on patient, hit the Go button again while silently willing the new number to be higher, therefore rendering the previous number a false reading, only to see that the new number is lower, and when you look at your preceptor, she has the same look that you have on your face--which is the "Oh sh**" face. Oh and then the patient is yelping out in pain. I'll say this again: not pretty.

I'll spare you the details of the "Oh sh**" hour that followed, but we thought the patient was bleeding internally and was crashing on us, which turned out to be not the case, but we didn't know that for a good 30 minutes or so trying to figure out what the heck was going and how to manage it while waiting for the stat H&H result to come back. Luckily, the patient was stabilized within an hour and everything went back to being peachy again, like nothing happened.

When I finally got out of my shift, obviously later than I usually do, I rounded up the corner to the waiting area, where a family member who was in the room when it all started had to be escorted out because the shift was ending, therefore visiting hour was too before it resumes 2 hours later. I had told the family member that I'd give an update if I could before the shift ended, but if that wasn't the case, I'd drop by on my way out. So I did.

She immediately stood up when she saw me, I smiled at her and told her that her family has been stabilized, her BP back to the normal range and the pain controlled, and was currently sleeping. I could see the worry in her eyes subsided as I delivered the news. Now, that is pretty. As I made my way home, I was once again reminded of why I'm still here doing this. For a moment like those, when you see your patient sleeping comfortably after what could lead to otherwise, and when you see the family take that deep breath of relief after the gripping worries.

I know that the "Oh sh**" moment does not always lead to this, but it's always nice and appreciated when it does.

Feel free to share any "Oh sh**" moment you have had.

1 comment:

katalina said...

I had a huge Oh shit moment today--however it ended up quite the opposite. my patient coded after surgery, in the PACU, and after assisting the medication nurse (my nurse and i ran down from ICU to answer the code, which was our pt anyway)...the patient died. it wasn't really expected either because she seemed to be doing fine in PACU... times like those just make you step back and appreciate life in a weird way..