06:38 - day shift is slowly trickling in as I let my r/o ACS patient up to the bathroom.
06:45 - said patient diaphoretic in the bathroom
06:52 - coding said patient in the trauma room
08:39 - TOD
In the few minutes that it took us to get the patient out of the bathroom and onto a stretcher felt like agonizing hours. Like watching molasses drip out. Already feeling completely defeated after no break and no food all night, this was enough to push my limits. Emptied 2 code carts, central line kit, art line, every drug you could think of, and all of my emotional reserves. It's been a very long time since I've cried over a patient, but this morning it came in stifled sobs, snotty sniffles, shaky voices, and trembling hands. I sat in the corner of the trauma room, feeling completely drained, lost, and confused. After most codes I try to keep busy, cleaning up trash and straightening up the room for family to come in. This was the first morning where I didn't have the strength to do that. I felt like a part of me left with her, and what remained behind was broken and scared and lost and confused.
Photo Credit: Brandon Plyler (Haynes Ambulance of Elmore County, Wetumpka, AL)
Coworkers said plenty of gentle words to try and comfort without much avail. Two hours later I finished charting and went home. I got to go home and she didn't. And she never will. For days, the what ifs will haunt me and keep me up at night. As always, forever will I be haunted by the agonizing screams of a family that lost a loved one. And I pray that the only thing the family remembers is that I treated her with kindness and respect, bringing her footies and warm blankets, calmly explaining everything. Her granddaughter spent the night in the ED and I arranged a hospital bed AND an ER stretcher in the same room so they could sleep together. I pray that's the last memory she keeps. Not the one where she's standing in the hallway, watching us wrestle her grandmother off the toilet onto a backboard.
The good thing about all the tears is that I know I'm not as dead inside as I seem sometimes. The cynical, gruff, tough ER nurse has a heart. It's hidden far away, behind walls built up to keep the evil out, the evil of having witnessed too many codes, too many near-codes, too many traumas, too much violence, too much sadness, too much circumstances of life. Occasionally some stories find a way under your skin, through the walls and into your heart. Those will stay with you forever.
Photo Credit: Katie Duke
A photo by another ER nurse (who was fired from her ER job for this photo) sums up so much in one image. You can almost smell the sweat and tears of the staff present in a resuscitation. You can hear the equipment in the background. You can feel the ribs cracking under your hands. You can feel the hair stand up on the back of your neck. You can feel your own heartbeat thumping in your temples as you search for a pulse during a rhythm check. You can feel your heart sink to the lowest pit of your stomach when you know it's over.
My hands shake as I lower her eyelids over bloodshot eyes. She trusted me and I can't help but feel like I failed.
