final moments by Sherman Deborah Witt

Author:Sherman, Deborah Witt [Sherman, Deborah Witt]
Language: eng
Format: epub
Tags: ebook, book
Publisher: Kaplan Trade
Published: 2009-01-06T07:00:00+00:00

An End to the Madness

Emily McGee, RN

WE EACH DEAL with death in a different way. As nurses we are expected to remain strong, rarely discussing how we are affected emotionally by our jobs.

I opened my email a few weeks ago and cringed: yet another requirement to be fulfilled in the next three weeks for our accreditation, eight hours of clinical to be shoehorned into an already insane schedule. Opening day of trauma season had come and gone, so the slow winter shifts were officially over.

Cardiology has always been a weak area for me. I used to look at Chris (one of my fellow students and partners in crime) during my grad school days and laugh as he made a box with his hands over his heart saying, “This is all I care about, Emily. You can have the rest.” His great interest was cardiology — about which I would passionately express my distaste.

Fast-forward to a conversation with Ben, who works in a cardiothoracic intensive care unit. He, too, loves everything about cardiology; he has an amazing passion for it. So as the stars aligned, I received permission to spend a shift with him.

Because I have no credentials at his institution, I was looking forward to 12 hours of being the newbie. You remember those days: no license to do anything other than follow an experienced nurse around with awe in your eyes. Strange to be back in that mindset knowing what I now know.

Late in the day, we recovered a double bypass patient, but this story isn’t about Swan-Ganz catheters, cardiac parameters, or vasoactive drips. This is about another patient: one who gave much more to me than I to him, as only our patients can do.

David’s spinal surgery went well. Although his extensive cardiac history made it risky, the surgeon deemed him well enough for the operating room, his young chronological age, I’m sure, being part of the decision-making process. His physiological age seemed much greater. HIV had done a number on him, as had his multiple previous myocardial infarctions.

Just prior to discharge, the patient suffered “the big one”: a heart attack that landed him in the CT-ICU, assigned to Ben, and by default, to me. His DNR/DNI (do not resuscitate/do not intubate order) was a source of early discussion.

David became an exercise in clinical medicine versus patient care.

I have known Ben for quite some time in a U.S. Army capacity and as a friend. Caring for David with him opened my eyes to a side of Ben that could have taken years for me to see otherwise.

The intern shed her lab coat and took an inordinate amount of time to gather her supplies. Somehow the physicians convinced David to have an arterial line inserted. To Ben and me, it was obvious that this was something he didn’t want. David knew his days were numbered and was at peace with this fact. They explained in depth how the muscle of his heart was not going to continue working well.

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