Sunday, January 30, 2011

You'll find me in the bathroom crying.

I followed a respiratory therapist around the hospital on Friday.  Each student does a round with respiratory therapy, physical therapy, ICU, and same day surgery.  Respiratory therapy was my second stop on the outsourced train after physical therapy which was less than exciting. 

The morning began slowly.  My voice had decided to take a vacation so communication was a bit of a struggle, but the sweet lady I was following made sure that I got to hear some "good" breath sounds.  Of course crackles, ronchi, and rails are bad for the patient, but a great learning experience for me. 

Early in the morning she'd been told she'd have to extubate a patient.  When I heard her talking about it, the only thing I though was "Cool, I'll get to see a breathing tube removed."  It wasn't until after we visited ICU that I realized she would be pulling life support.  I don't know why my brain hadn't made the connection.  It's strange to be in a clinical setting.  It's strange for everything to be so procedural when dealing with a persons life.  In a way the procedure allows you to step away from the emotional side of things.  Procedurally, I understood that we would remove the tube and the patient would slowly let go, her lungs unable to keep up with her bodies demand for oxygen.  I have only ever been on the emotional side of this situation.  The stranger in a land called ICU where everyone speaks a different language and regardless of how well they try to interpret the information it never adds up to anything you want to hear.  On this side, I was able to see things more clearly.  The patient had undergone several procedures, and the family had slid down the slippery slope of saying "yes" only to arrive at this point and realize their beloved family member would never have wanted to be on life support.  And so they had to make the impossible decision of undoing what had been done.  I stood just  out side the room as the patient was extubated.  The family stood in a small hallway across from me.  The respiratory therapist had told me not to look at the family.  She said it was easier that way.  She said it was important to maintain a sense of professionalism.  I knew she spoke the truth.  The last thing a family wants to see are the medical professionals falling apart.  I did look at them though.  I saw the grief in their eyes and instantly I felt connected to them.   I wanted to wrap my arms around them and let them know it would be okay.  With no voice and no real idea of what to say all I could do was simply bow my head in respect and say a silent prayer that grace would find them. 

I held it together just long enough for the respiratory therapist to send me to lunch.  Then I made my way to the bathroom where I cried for the family, for the patient who was letting go, for the frailty of this existence.


Christi said...

I don't know what to say, other than I couldn't do it.
I've been in the room when someone died. It was sad, but since that person was my great-grandmother it was a good experience too.
I am so thankful that there are people like you out there.

Jen said...

I wouldn't have guessed that extubating a patient meant that they were taking a patient off of life support. I'm sure that's not always the case.
I'm sorry that you had to experience that, but glad that you are able to recognize that your patients are people and not procedures.
What you describe is the reason I work in a school rather than a hospital or nursing home. After my rotations there, I knew I couldn't do it.

Sandra said...

Christi, I don't know how I'll handle it when I'm the nurse they are looking to for answers. I hope that I will handle it with grace and wisdom.

Jen, extubating doesn't always mean pulling life support but given the context of the situation and her hesitancy when she was chosen to do it, it should have been fairly obvious to me.

I think that the medical profession requires a balance of understanding that life and death go hand in hand and knowing that even though the above statement is obvious and we all know we're going to die, death is never easy. It's painful and heartbreaking for those experiencing the loss.

aola said...

OMG.. I cried for you and I cried for them and I cried for little Issac... our friend James' little seven year old step brother who was taken off life support just today.

Life is hard. I hope you can stay as soft as you are now.

Sandra said...

I couldn't imagine having to do it on a child. I can't imagine watching the grief of someone who has lost a child and ever being able to be the same again.
When we lost Diana, it almost did me in. Eight years old..I couldn't and still can't understand the way of that type of loss. I know it happens all the time, but I can never make it make sense. I know I look at it all wrong. I know there are answers beyond what we can comprehend. I still struggle with it though.

Cara said...

It is tough to be in those situations, and I do remember some very hard situations when I was taking care of people who died.

This learning experience is crucial to your success as a nurse, both physically and mentally.

Much Love,