No, really - what is your EMERGENCY?

This used to be the journal of a nursing student at a prestigious 4 year university that will still remain unnamed. This is now the journal of a Registered Nurse working in an Emergency Department in a major US city. All names have been changed to protect the stupid and the mean. There is no educational value in this journal, sometimes it will be downright mean and catty - this is where I come to vent!

Monday, February 14, 2005

Losing Patients

One of the tough lessons to learn in nursing school is that unfortunately some of your patients are going to die and you have to figure out how you are going to deal with it. You would think it would not be as difficult since we only usually see our patients one day a week. But, some of us found out last week and this week that it still really sucks.

Last week, one of my friends handed me a newspaper article from our school paper. It was an obituary for one of our patients from last semester. She was a student and had been very sick with chronic illnesses that seemed to compound each other. We had discharged her late last year in relatively good health, so it was a bit of a surprise to read that she had passed away. She had spent quite a long time on our floor and so we really got to know her. Even though she was a bit of a pain in the ass, she was smart and had made the most of her life depsite many disabilities. Anyway, she was my first patient to die.

One of my other friends had a patient die on her today. She is working in a Hospice House, so patients dying is to be expected. This still doesn't make it any easier. Here is what she wrote in her clinical journal (we email this out to everyone in our clinical group):
"We walked in and the nurse, looking at the patient, said "this isn't good." The patient's eyes were half open and he was not blinking; his breathing was very shallow and his fingers were blue. She tried to get a blood pressure and couldn't, then went to call the family. He died 15 minutes later while we sat in the room with him. She encouraged him to "go ahead and let go", telling him that she had called his wife and daughter and they were on their way, and that he didn't have to wait for them - he could go on without them. And he did, moments before they got there. I was really saddened by the event, especially because his family wasn't there with him when it happened. But I was glad that we were, so that he wasn't alone. I
didn't really like the business aspect of what happens after a patient dies (cleaning him up, doing the paper work, throwing away all of the extra supplies, calling the funeral home), because it seemed like two minutes ago all was somber and quiet, almost reverent, he dies, and then we turn all of the lights on and start getting him ready for his family, throwing things away, taking out his foley, etc. I understand why, it just felt weird...too business like."

Sorry for the "not funniness" of this post. There haven't been too many funny things going on at school. The same people are stupid, the same people are doing stupid things and saying stupid things! I think we are becoming immune to them. When most of them talk, all I hear is the voice of the teacher on the Charlie Brown cartoons.

And for even less funniness for me, but probably funny for others, I am going to have to have a wisdom tooth pulled tomorrow. After years and years and years of it not doing anything (I only have one), it has decided to now push through my gums. And hey, it feels great. Nice, couldn't do it when I had free dental care, NOOOOOO, it has to do it when I have NO DENTAL COVERAGE. At least I only have one exam this week.

Happy February birthday to Megan, Jennifer, and Pablo!!


  • At 10:13 PM, Blogger Juliet said…

    Seeing as nursing students are taught how to save lives, watching a patient peacefully die, without doing anything, is a strange scenario to be in. The idea of Hospice is one that I really enjoy, because it recognizes that people ARE dying and that they want, no deserve, to die without pain and without being alone. They are supportive, caring and compassionate people who empower and encourage their patients to die with dignity, and not to be ashamed. Somehow our society has decided that we are suppose to live forever and that dying isn't really encouraged or allowed. So those who do "give up and die" aren't worth the skin they were born in. Dying is just as much a part of life as birth is; what 2 processes are more natural than these?

    I felt helpless watching that man die, not doing anything to save him. But in reality I was doing something...I was a presence in his room, alongside the nurse, so that he wasn't alone. The nurse encouraged him to let go, to go on ahead, that he didn't have to suffer anymore. What more can you do, but encourage them to release all the stress and worries that being human carries? allowing them to be free spirits. I think this aspect of nursing is just as important as monitoring a heart transplant patient after surgery. It means that no matter what I do with my life - I can make a difference. How empowering is that?!


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