~ the importance of being earnest ~

Saturday, November 28, 2009
My brother says that I need to blog more about my job. People that don't work in the medical field find it interesting I guess, while those of us who do become so worn out that the last thing we want to talk about when we leave the hospital is, the hospital.

For the last few months my job has seemed very "blah" to me. I like to be moved and inspired by my work. The first year of my career I was...daily. Lately it's been hard for me to care about much other than my "to do" list while I'm taking care of patients.

It's funny how God begins to move just when you think your ordinary life is...well, ordinary. Last night one of my patients passed away very unexpectedly. I cared for three patients in the 36 hours I worked Thursday through Saturday. One of them a 19 year old pregnant girl, one a man with a neuro injury who fell from a building and has now been in the ICU for a month, and a new admission; a motorcycle accident who did not have a scratch on his body, but fractured two of his vertebrae leaving him paralyzed from the waste down. It was a hard three days, made even more difficult from the lack of staff and emotions of families over the holiday.

Even now I feel emotionally and mentally exhausted.

I did see improvements. I was able to take my fall victims restraints off, which brought tears to his fathers eyes. (He had been tied to his bed for 20 days...for his safety). My pregnant girl went from possibly having H1N1 to plans to take her off the ventilator today, but my motorcycle patient shocked us all.

He was my only awake and alert patient. A sweet uneducated black man from South Georgia with a stutter. He had five numbers in his cell phone and could not tell me of any family to contact. He had no complaints but was very anxious to understand why he could not move his legs. The doctors told him that they didn't know if his sensation would return or not, but we all knew there was little hope.

Mr Barry was scheduled to have a spine fusion yesterday, what is known as an uncomplicated quick surgery from our end. The OR was backed up and he was anxious all morning hoping that his surgery would fix his legs. He must have asked me five times when he would get to go.

When he didn't get back from the OR for six and a half hours I started to worry. When the Neurosurgeon busted into our unit demanding to see Mr Barry's family I knew something was seriously wrong.

I located Mr Barry's sister, who lives over an hour from him but had somehow been contacted by the police after his accident. She seemed to have little if any relationship with him, but had waited patiently in the waiting room during the surgery, because there was no one else.

The neurosurgeon explained briefly to all of us that Mr Barry had come through the surgery smoothly but was having trouble in recovery. His blood pressure had dropped, they had to put him on the ventilator and were now having to do compressions on his chest to keep him alive.

I think my mouth was hanging open. He was my patient that was healthy. Yes, he had broken his back, but as far as being sick, he had shown no signs.

As a nurse you automatically try to figure out what could have happened. What did I miss? Were his complaints of belly pain more than radiation from his spine? Did I miss something in the heath history. Could I have impacted his outcome?

I never let my mind wander on those things for long, because I know that ultimately I have no control over life and death. I don't struggle with guilt on a physical level.

After shift change I went down to the Recovery Room. No one seemed to know what was going on with our patient so I wanted to see it for myself. I walked into an empty room except for my patient. He was surrounded by surgeons, anesthesiologists, nurses and respiratory therapists all fighting to save him. They said they had been at it for over an hour. The monitor was flashing "asystole" as they continued to give him drugs. He had a heart attack, one of the residents told me. No one saw it coming.

I often wish that I would say something to my patients that matters. My guilt is on a spiritual level. Why did I simply ask him how his pain was and what I could do for him, rather than asking him if he knew Jesus? I was probably one of the last ten people he spoke to before he passed, and I did not speak earnestly about anything.

Sometimes I choose to believe things just because I have to cope. I know my "super christian" and Calvinist friends would probably find something wrong with that. In fact, I'm sure it's not theologically correct, but I don't care.

Last night through journaling I realized, or chose to believe, that God knew Mr Barry had no one to care for him in his paralyzed state. He lives alone, has no contact with his family, and the five numbers in his phone likely could not help him get on and off the toilet for the rest of his life. God wanted him home.

I hated it at first, but I believe in God's goodness. Even when I watched a patient I really enjoyed losing his fight. I know God is bigger than nurses pushing drugs and surgeons shaking their heads.

Mr Barry is walking in heaven with Jesus now. That's what I'm choosing to believe. And I will pray that in my ordinary life I will more often remember the importance of being earnest.