Juxtapose

Two people coded on my floor today, near-simultaneously. One was just getting stabilized when other started crashing. By coded I mean they went under... went into ventricular tachycardia... died.. sorta. One of them was my patient. I had this really bad feeling about that one patient from the very first thing in the morning when I saw his name on the assignment sheet. Nothing was emergently wrong, but when the techs called me over to the EKG monitors, I had this huge sinking feeling in my gut, and by the time I got a set of vitals on him and he was breathing a million times a minute and turning blue and clutching his chest, I knew that his blood pressure was lower than reasonable. I called the doc and after that I sorta had to step back. My hands were shaking and I was giving medications and I just couldn't make them do the things I wanted to. It was totally terrifying. I was happy, afterwards, that I knew what the warning signs were, that I didn't wait longer, that I didn't let my pride take over for once and asked for help when I desperately needed it.

Anyhow, now both people they are alive again, thanks to modern medicine, one for a little while, one for a longer while (I hope). My third patient is dying. I watched her dying all day and I couldn't do anything and the doctors were doing all sorts of things that didn't make much sense supposedly to "cure" her, though that cannot be done unless she goes for surgery, which she will most assuredly not survive. Damned if you do, damned if you don't. They were asking me to do lots of things that didn't help because she was already dying, they were saying that I should provide comfort measures. But I didn't think they were comforting, or the right kinds of comforting, but no arguing with the doctor could change their minds, so I did them. My patient, I am 97% sure, won't make it through the night and that really weirds me out. I found myself near tears and frustrated, my voice approaching a yell as I told my charge nurse about how upset I was that we were doing these things for the patient that were prolonging things that shouldn't be prolonged. I have never felt so ethically torn and so upset over the care of one patient as I have today. I know, I have been told, and I believe - it's okay that people die. Just some ways are better than others. The world weighs on my heart.

I'll be vacationing in the snow this weekend with my husband and a few good friends, and it couldn't have come at a more perfect time. Happy weekend, everyone.