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Thursday, March 5, 2009

What is this feeling?

As much as I'm at peace with my granmpa's death last summer, today I realized that I don't know if I'll ever be "okay" when I have patients in the similar situation my family and I went through that fateful July.

The first one happened last semester, and I wrote about it. At the time, I thought it was just a one time thing. It was my first and of course I was bound to feel...something. I thought it'd go away and but it didn't. Yesterday, I started to realize that one of my patients is dying and the family was finally able to made that difficult decision to let go of treatment and do palliative care instead. Today, everything is more...official, I guess. All PO meds are on hold, and the Morphine Sulfate surfaced in the order. Again, I got that uneasy feeling I did last semester.

I think what did it for me is seeing the Morphine PRN dose on the MAR first thing in the morning, just because that is the staple drug for end of life patients to keep them comfortable. It's become some kind of a sign for me that, yes, the time is near for that person. We were given doses of that, too, from the hospice care for Grampa when he went home from the hospital. I had to give him that, and so did my cousins.

Then my chest got thighter as I walked in the room. The patient is much like my Grampa was before he died. Eyes opened but no one is there. They can't talk and you wonder if they knew who you were, and you wish they remember who you were. They're just lying there, waiting for their time to come, and it's an excruciating wait for the family members.

It's a weird weird thing to experience, I can't say enough how uncanny it is to watch a dying person, especially when you've watched a family member went through it. I wasn't exactly sad or upset, I didn't feel like crying or breaking down. There is just...an uneasiness to it. There is a voice screaming in my head that this is the same thing as Grampa: the Morphine, the inability to talk, the waiting, the what happens when we bring him home, the ever present wondering of when he'd actually die. It keeps screaming I have been here before and I should never be reminded of it again.

But it's life. People die everyday, and unfortunately, you will witness that more times than you'd like. Heck, I'm only a student nurse and it already happened twice. My career awaits many a future experience of taking care and witnessing dying patients. After the first time, I thought I had to find a way to be okay with this, to erase that feeling out of me. But after today, I realized I can never make that feeling go away, and I'm accepting that I will forever be taken back to Grampa when that happens again. I will always take a sharp breath, my chest will always feel thight, and I'll always get this inexplicable feeling when I have a dying patient.

As if one dying patient isn't enough, the universe, of course, just has to mess around with me some more. Another patient on the floor, although wasn't mine, vomitted, had a seizure, and went into a code. (This was also a second code, the first one I saw was also last semester) Oh, the brouhaha of a code, there's nothing like it. It seems like, in a code, no matter how fast you're moving to get things, you are never fast enough. How many times did I hear that doctor yelled out "I NEED PROPOFOL 10 cc FAST!!! WHERE IS THE PROPOFOL?! GIMME THE PROPOFOL!!!" in the 10-15 seconds it took the other doctor to get the Propofol and have it drawn up in syringe? You're trying to bring someone back to life, get that heart beating again, breathe air into the lungs. It's a person's life literally in the hands of the many medical staff who rush into that room, and I don't think you'll ever be fast enough. No matter how experience and collected these people are, it's still a total and utter chaos.

Now, the code didn't do anything to me. It was actually exciting, to be honest. This patient was actually in a much somber situation than my dying patient, but I was fine. I've never had to watch a family member going through a code, having tube inserted down their throat, surrounded by doctors and nurses doing everything to revive them. After 30 minutes--that seemed like hours--the patient was stabilized and transfered to an ICU unit.

And then I knew there is a difference. In some cases, I'll be fine. In some others, I'll just have to deal with that weird feeling. That's just the way it goes now, and perhaps for the rest of my career. All in all, for me, it's still an other wordly experience to witness births and deaths. They make me appreciate and respect life more.

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