Becoming a Nurse by Sonny Kleinfield

Author:Sonny Kleinfield
Language: eng
Format: epub
Publisher: Simon & Schuster
Published: 2020-08-18T00:00:00+00:00

11

The wizened woman with bristling eyebrows lay unconscious. She was curled up, her head bowed and aslant. A stuporous man with horribly swollen feet was having trouble breathing and occupied the next bed. Two people in rebelling bodies tired of arguing with disease, in the tight sphere between life and death.

Everyone was scrambling, the ER having just received a burst of patients. Lampert was working on the woman’s chart when a doctor told her he was calling a Code Fusion. She was bleeding internally and her family wanted a transfusion. Her hemoglobin level had dropped to 3 grams per deciliter. Normal for a woman was 12 to 15.5.

Lampert and a fellow nurse hustled to her bedside. She told the other nurse, “This wasn’t supposed to happen. The initial conversation was comfort care and it blew up to this. Oh well. It is what it is.”

There are many codes in the hospital, something like fifteen in all. Code Fusion is for a blood transfusion. The famous Code Blue, of course, is cardiac arrest. Code White is pediatric cardiac arrest. Code 100 is neonatal resuscitation. Code Red is fire. Code Amber is pediatric infant abduction. Code Green Active is active shooter. Code Flight is adult patient is missing or has “eloped,” meaning the person, without preannouncement, simply took off.

Not everyone who comes to this room leaves. The woman was accompanied by her husband and other family members. She was eighty-eight. She had advanced, untreatable cancer among other grave conditions, her life being pulled irreversibly to whatever lay next. Her family recognized that doctors could no longer patch her up and had agreed to take no more steps to keep her alive. Mortal decision-making, never easy, but made. As it turned out, though, she had a private nurse there, a woman moonlighting from another hospital. When the hemoglobin level dropped, the nurse convinced the family to do a transfusion. Neither the attending doctor nor Lampert felt that course of action was wise, but they needed to obey the family’s wishes.

“That’s so common in the ER,” Lampert told me. “The family reverses itself. When they actually face life and death—and this is literally life and death—they can’t make the call.”

Duels like this over when to let go of someone and permit them to die, frequently prickly in nature, go on between siblings, friends, ex-wives, ex-husbands, and all combinations of interested parties. One person feels they know best or they hold more love or they simply relish being argumentative. All too often these disputes occur over comatose or incoherent patients unable to speak for themselves. If they could, they would wish away the sometimes-tortuous medical invasions that won’t bring back their health. It was a troubling issue of medicine, the questionable lavishing of medical technology on people done with living.

This particular duel, Lampert suspected, was not based on the private nurse’s reasoned assessment of what was humane. “I think she doesn’t want to lose her moonlighting job,” she said.

The transfusion finished, the doctor talked more to the family.

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