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Tuesday, July 21, 2009

 

really, don't

Conditions I've witnessed and am glad I don't have:

  • Calciphylaxis in end-stage kidney disease.

  • A colostomy resulting from a rectal foreign body and subsequent intestinal perforation.

  • A collection of problems that were all making each other worse: congestive heart failure, acute renal failure, necrotizing pneumonia, and protein deficiency due to lack of interest in eating. Also, did you know that when part of your lung tissue dies, you pretty much have to cough out the dead stuff to clear your lungs?! Gross.

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  • Thursday, July 16, 2009

     

    endings

    Today was a difficult day.

    My patient was 20.
    He'd had a drug overdose.
    His family had made the difficult decision to put him on comfort care.
    Today was the first day I'd cared for him.
    Today was the day he died.

    Normally this kind of thing doesn't get to me that much.
    But he was so, so young, and the family was so, so heartbroken.
    It was tough to watch.
    I cried.
    More than once.

    But you know what?
    I did a f*cking outstanding job as their nurse.

    The patient died peacefully without signs of pain.
    The family was all gathered at the bedside singing and praying.
    I reassured the family that the patient's signs & symptoms were normal, that he was very near the end, that their feelings of guilt/anxiety/relief were all nomral, that they didn't need to worry about any logistics, that they were doing the right thing by holding the patient's hands and touching him.
    My excellent coworkers took over care for my other patients for a while so I could devote my time to this family.
    I got the chaplain, the palliative care doc, and the medicine attending doc to stop by before the patient died.
    I did postmortem care to get the body ready for friends and family to see.
    I paged a couple other doctors who had cared for the patient so they could visit the family.

    The nightshift nurse who had asked for me to be assigned to the patient came in at the end of my shift and we hugged and told each other what a terrific nurse the other was.

    I called another of my coworkers on my way home to give her some positive feedback the family had shared with me.

    Now I am drinking a large alcoholic beverage.
    And wishing there was some way to tell people not to use heroin and aprazolam together.

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