07-22-06
There's only a fine line between life and death. Humans do not appreciate what we have, we take everything for granted and when what matters is gone then one will start realizing its importance.
It was a normal day at work yesterday with the same patients. I have two patients on the dangerously ill list and both of them were on do not resuscitate status. One was more ill, on hourly monitoring with inotrope infusion and high level of oxygen to sustain her vitals while the other was a stable patient who was on palliative care and comfort measures only.
The palliative patient was my old patient, always coming in and out of hospital for fluid overload and low Hb levels. This time it's fluid overload and she has been quite restless during the stay. She has applied for a hospice and yes the unexpected happened, we found her in distress and soon unresponsive. When the callbell sounded off, I had this gut feeling to go attend to her immediately (usually I would wait for two-three beeps) and there I found another staff nurse, struggling to arouse her, getting her to stay awake. You can never imagine how afraid I felt inside, to see her in distress despite all the comfort care we'd provided. It was all wrong. Emergency button was hit and no resuscitation was the order from the doctor. But we nurses still went ahead with all we could, we hooked up the leads and monitored her heart rhythm, slapped on the ambu bag, gave her oxygen and even did chest compressions. I watched her breathing creased, felt her carotid pulse weakened then slowly the colour draining from her face. She went rigid, pale and cold. Lifeless. The doctors pronounced her dead. I was holding back my tears during the "resuscitation" process but I broke down. I cleaned her up and exited the curtains for the restroom. I'd felt so helpless, so useless. I couldn't face her family, they were grieving and so am I.
She was a wonderful old lady who is blessed with a son who looked after her throughout her multiple hospitalization. She had a wonderful caregiver who attended to all her needs and kept her company for years. I'm glad my patient had them in the last phase of her life. Her son was with her earlier on but left and she had the company of her daughter and a new carer. Her son rushed back after her passing, crying aloud for his mum. Gosh I broke down for a second time, this time at my own incompetence. But still he thanked us and even gave us a hug, expressing his gratitude towards all the staff and doctors. I don't deserve that. I don't deserve a single thing from them. I did my best but my best was not enough to keep her. There's alot of "what ifs" in my mind and I can't turn back time to salvage the situation. Maybe her time was really up but it wasn't in a way I'd imagine. I'd always thought she would pass on peacefully, like maybe deteriorating slowly in her sleep, painless with family members around. But no, the unexpected happened. This is life, her life. I really wonder when doctors say "we did our best/we've done everything we could", did they really do everything within their control? Or did they give up on patients who do not have the potential? I guess it will be a question I would never get an answer to.
Anyway I hope her family is managing their grieves well and may ah po finally rest in peace.
It was a normal day at work yesterday with the same patients. I have two patients on the dangerously ill list and both of them were on do not resuscitate status. One was more ill, on hourly monitoring with inotrope infusion and high level of oxygen to sustain her vitals while the other was a stable patient who was on palliative care and comfort measures only.
The palliative patient was my old patient, always coming in and out of hospital for fluid overload and low Hb levels. This time it's fluid overload and she has been quite restless during the stay. She has applied for a hospice and yes the unexpected happened, we found her in distress and soon unresponsive. When the callbell sounded off, I had this gut feeling to go attend to her immediately (usually I would wait for two-three beeps) and there I found another staff nurse, struggling to arouse her, getting her to stay awake. You can never imagine how afraid I felt inside, to see her in distress despite all the comfort care we'd provided. It was all wrong. Emergency button was hit and no resuscitation was the order from the doctor. But we nurses still went ahead with all we could, we hooked up the leads and monitored her heart rhythm, slapped on the ambu bag, gave her oxygen and even did chest compressions. I watched her breathing creased, felt her carotid pulse weakened then slowly the colour draining from her face. She went rigid, pale and cold. Lifeless. The doctors pronounced her dead. I was holding back my tears during the "resuscitation" process but I broke down. I cleaned her up and exited the curtains for the restroom. I'd felt so helpless, so useless. I couldn't face her family, they were grieving and so am I.
She was a wonderful old lady who is blessed with a son who looked after her throughout her multiple hospitalization. She had a wonderful caregiver who attended to all her needs and kept her company for years. I'm glad my patient had them in the last phase of her life. Her son was with her earlier on but left and she had the company of her daughter and a new carer. Her son rushed back after her passing, crying aloud for his mum. Gosh I broke down for a second time, this time at my own incompetence. But still he thanked us and even gave us a hug, expressing his gratitude towards all the staff and doctors. I don't deserve that. I don't deserve a single thing from them. I did my best but my best was not enough to keep her. There's alot of "what ifs" in my mind and I can't turn back time to salvage the situation. Maybe her time was really up but it wasn't in a way I'd imagine. I'd always thought she would pass on peacefully, like maybe deteriorating slowly in her sleep, painless with family members around. But no, the unexpected happened. This is life, her life. I really wonder when doctors say "we did our best/we've done everything we could", did they really do everything within their control? Or did they give up on patients who do not have the potential? I guess it will be a question I would never get an answer to.
Anyway I hope her family is managing their grieves well and may ah po finally rest in peace.
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