The Things You Don't Want to Think About

In my job, I see a lot of things.  I see so many sad situations that if I let them all into my heart, I would not be able to function.   I think I do an excellent job of providing compassionate care to my patients and their families, but at the end of the day, I let it go.  I mostly let it go.  I come home and give Matt a rundown of the shift.  That is my daily debriefing.  I need it.  I helps me to let it go.  If I don’t do that, I often dream of work.   I usually remember the patients and their families in my prayers, but I try not to dwell on situations for days or weeks.  I have thought about having a blog for debriefing purposes, but there are laws that protect the privacy of patients, and you can get in big trouble if you give enough identifying information for a person to be known, even if you don’t state a person’s name.  In a small community if you took care of “a 20 year-old motorcyclist with a broken neck and a closed-head injury”, most people will know who you’re talking about.  So I get it out verbally as soon as I get home, and I’m done.

All that being said, some things get me, and this is one.  We have had a man in the unit for several weeks.  He had abdominal surgery for a dead gut and went into respiratory failure and renal failure.  He has been one of our most acute patients.  So acute that several nights he has been a one-on-one patient because of a special kind of slow, gentle dialysis he had to have.  This man’s wife was at his side at every opportunity.  We have visitation four times a day, and she never missed one.  We have two courtesy rooms outside the unit doors.  They are empty hospital rooms.  Nothing fancy… just a hospital bed, a chair, and a bathroom. But being able to sleep in a quiet place and take a shower can mean a lot to a family member.   She was staying in one of the rooms.  She came to evening visitation on Monday night and went to bed.  On Tuesday morning, family members started calling the unit saying that they could not get in touch with her.  When she did not show up at the first visitation of the day, the secretary went and knocked on her door.  When she didn’t get an answer, she got a key from Security.  When she opened the door, she found her dead in the bed.  According to family, she most likely had a brain aneurysm because she has a strong family history and had told a family member that she had a terrible headache before she went to bed.  

This week the man was doing much better.  He still had the breathing tube in, but he was alert, was able to communicate,  and seemed like he was feeling better.  On Tuesday when his wife didn’t come visit him, he started asking for her.  Around the breathing tube, you could tell he was mouthing “Where’s my wife”?  All day long, she didn’t come, and he kept asking.  The rest of the family was reeling from her sudden, expected death, so they weren’t there.  But they didn’t want him to be told because he wasn’t stable enough.  I went in the room two times to help his nurse turn him, and I could not look in his eyes.  I know he was sick, but that is such a horrible deception.  I could see the concern all over his face.  The next afternoon, his family came in and told him.  He pulled his breathing tube out.  He was almost ready to be extubated anyway, so he did fine with just an oxygen mask.   But bless his heart.  I can’t imagine what he must be feeling.  Grief because he has lost his mate, helplessness because he is lying in a hospital bed and can’t help with arrangements and such, possibly guilt because of the stress his illness put on her, fear about going home alone when he is discharged, loneliness because of limited visitation in the unit.  Just bless him.  It is pitiful.

The other thing that gets me is when little kids lose their mothers.  My church family has lost two young mothers to cancer this year. One of them was in the unit this week.   It just breaks my heart to imagine having cancer and having to say goodbye to my babies.   :-(