Q&A of sorts

Dear bloggy friends,

I am have having trouble wrapping my head around some things from my patient's death. Maybe you guys have some insight into helping me see things a different way. A fresh perspective/insight may be helpful.

One of the things I that has been on my mind popped up when I heard the doctor say to my patient's wife, "I'm sorry, ma'am, but there's nothing left for us to do. He's going to die". My problem with this is how we as healthcare workers determine the line of when to stop lifesaving treatments. When the patient doesn't improve quickly enough? When their insurance stops covering treatment? When the unit gets over-crowded, When the patient's "quality of life" isn't going to be the same as before, even if they do live? What makes us think we can determine someone's fate? Who are we to be the dictator of someone's lifespan? I am not the Creator God, nor do I want to be. I shouldn't choose when a patient lives or dies, and I shouldn't listen to other people's orders of when a patient lives or dies, right?

This weekend, there was a point when the doctor ordered more vasopressins to increase my patient's blood pressure, and as soon as I went to give it, he stopped me and said, "No more. We are not doing anything else for him". After he said that, he walked to the patient's wife and said that she would lose her husband today.

I have witnessed miracles, and seen people walk out of near-death situations unscathed; maybe this is the reason why I struggle with other people, such as doctors and nurses, calling the shots on someone's life. If we listened to doctor's all the time, many "miracles" would be dead right now. Heck, if we listened to my grandmother's doctors and nurses, she would be dead right now. I guess I just think that every has their chance of a miracle if they hold out long enough.

I guess I just want to know what my role in this is. What does God expect from me as a nurse when it comes to healing? How do I know when to listen to the doctor and stop treatment? How will I know what to do, and if it is the right thing to do? Who am I to determine someone's lifespan? At what point do you determine that someone's life is no longer worth saving?

Death

This weekend I lost my first patient. He passed away near the end of my clinical shift. I spent the morning caring for him, and trying to do my best to keep him comfortable and stable, but he didn't make it. He died of a sepsis from a catheter infection.

I have only ever seen a person die once; my fiance's grandmother. I was hesitant to blog about this experience yet because I haven't had time to sort through my thoughts, but it is something that I want to remember, so blogging about it is a must.

Around noon, my patient's condition was becoming very unstable. He was in multiple organ failure, and the physician decided there was no medical treatment available to help him. Keeping him on the ventilator and pumping him full of medications was just prolonging the inevitable. The nurse in charge called his wife, and she came quickly. She made the decision to change him from a full code to a DNR (do not recusitate). His blood pressure fell quickly when his wife arrived. We were getting ready to administer a vasopressin (a medicaiton to increase the blood pressure) when the wife changed his code status, so we let him go. He passed away peacefully holding his wife's hand. It was the saddest thing I've ever seen.

I had to step out of the room and shed a few tires as he passed away. I couldn't bear to hear the wife whispering to him about the house they just bought in Florida, and the 45 years they spent together. It broke my heart into 10,000 pieces knowing that she walked into the hospital as a married woman of 45 years, and walked out a widow. I cannot imagine her grief. She plans to scatter his ashes on the beach in Florida. I hugged her as she left the hospital; she didn't want to let go of me, and I didn't make her. I just let her cry, and cry, because I know that's what she needed. None of the other nurses hugged her, and it made me very sad that they have become so hardened to death.

Seeing someone die is one of the strangest, creepiest, most peaceful and beautiful things in the world. One moment a person is breathing and living, their soul one with their body, and the next they are flat-lining and dead, their soul moving on to another place. His death was peaceful. His eyes never opened, which I thought was weird. He looked at peace, which was relieving for me.

The patient tech on shift showed us how to do after-death care, which wasn't as creepy as I imagined it to be. I removed an arterial line and stitches for the first time on my newly-deceased patient. That was kind of fun (removing the line and stitches, not the dead patient part).

All in all, I am thankful for the experience. Few student nurses get to experience this during nursing school. I was lucky enough to share it was with my best nursing school friend. We cried together, shrouded and bathed my patient together, and walked to the morgue together. We were so thankful to have each other's support during the experience.

I have never been so honored to take part in someone's care. I am working on not looking at death as the enemy in healthcare. As a nurse, I want to save my patients from death- isn't that the point? Actually, no. There comes a point in some patient's lives when death is imminent, and my job is to keep them comfortable and help their transition to the next life to be as painless as possible, so that when death comes, it is peaceful. During the dying process, a person is at their most vulnerable state, and it is such an honor to help someone through that stage in their life, as they literally put their life in their hands. I love my profession, and I am thankful for being able to care for my patient as he passed on yesterday. Without saying a word, he taught me so much.

21st birthday

Happy belated birthday to me. It wasn't a big deal, really. I kept forgetting it was my birthday.

I took the day off work and school. I felt that I deserved it.

My parents got me a sweet new camera, with which I took the following photos, since my mom fell in a sinkhole at the beach and got sand in my other one.

Hello, Mr. Moon.

Wait for the one that you can't live without.

Sunset outside of Olive Garden.

My 1st legal "big girl drink" (as my fiance calls it). Happy birthday mudslide (yum).

It was a relaxing birthday. Here's to many more.

I am going to miss my neurology patients. My heart is in midwifery and neurology; orthopaedics is stinky.

Stream of consciousness

I secretly love embarassing my Korean sister. She is super conservative and modest; she shares nothing private. I am pretty much the opposite, around my house anyway. Sometimes I like to do things just to get her reaction. I think sleeping nude, or at least partially is comfortable. She sleeps in 10 billion layers. She changes clothes with the bedroom door locked, even though no one will come in. I rip 'em off and run around like a banchee (which is why I've flashed my 60 year old neighbor one too many times). She refuses to ask us to buy her pads or tampons, so her mom sends them from Korean. Whole boxes of them. She has a drawer in our bedroom dedicated to them, but she keeps it tucked under a thin layer of clothes. I openly wash my cloth pads and store used ones in a bucket under my bed. Opposites. Yet so much alike, in ways only we know.
I walked through my new clinical site hallway. All I smelled was poop. I didn't know orthopaedics would be so stinky. My patient was the source of the stench. If he smells like that tomorrow I am going to shove a plug in his butt get some of that awesome deoderizer from the Pyxis. Should be interesting tomorrow. I have 2 patients with total hip replacements, just on opposite sides. My other patient was making strange noises when I left. Strange noises freak me out.
My Marine cousin is home. He is proposing to his girlfriend in 8 days. She has no idea, and I'm so happy for them.
I am working midnight shift tomorrow (blegh), and after clinical I was supposed to sleep, but my preggy cousin is supposed to find out her little home-wreckin' peanut's gender and asked me to secretly deliver flowers to her mom in either pink or blue, depending on the gender. I am hoping to do some maternity pictures within the next few weeks/months. Probably in May. If I get a new camera for my birthday, I will try to post some photos.
Yesterday I got a flat tire.
 Today I spent my tex check replacing my tires.
The best part of yesterday was the amazing photo my fiance texted me of the keys to our cabin. It's ours; all ours. We picked out paint colors and are going to paint as soon as we get a day off together. After he picked me up off the side of the road with my flat tire, he drove me out in the middle of nowhere to our pretty little house, and we dreamed. We dreamed about putting the lemon and limes wall vinyl in the kitchen, and painting the living room blue. We dreamed of me taking a bubble bath and him sitting on the side of the tub talking to me. We dreamed of building our bed from Ikea and seeing the lamps on the nightstands. I won't tell you what else we dreamed about.

I change my blog layouts like I wash my school uniform... almost weekly! However, I wanted something to reflect my current state of mind: positive, cheerful, and wanted to keep it that way, which meant I really wanted to love the way my blog looked. I think I like it, and I should after changing it about 20 times tonight.

Don't be surprised if it changes again, though.

Spring break

Things I learned on my spring break...

...That my tuition assistance from my job that I recieve for school is being cut becuase I am not a full-time employee. That's around $7000
...How to cook salmon
...How to overcook salmon
...That my fiance loves our cat more than me
...That my dad doesn't give a hoot about my well-being. I'm okay with that
...That Ireally miss seeing my fiance, and it's going to be great when we get to wake up to each other every day
...That bad things happen when I forget to take my happy pill
...That my fiance thinks I'm some super-fit chick who can hike up a moutain, go for a 6 mile bike ride, and do the deed in one afternoon
...That I am getting married in less than 7 months (!)
...That there is such thing as too many BJs
...That I have a super weak bladder (thanks babe, for making me laugh so hard I peed myself in bed, again)
...That I really missed my best friend
...That seeing your fiance's boss after you did IT in their house is really awkward
...That my fiance has a fear of hand-washing dishes
...That my schedule for next semester is going to be really great, I think. I am taking pediatrics and OB (!),a among some other nursing school BS classes

...That you should always check how much fiber is in something before you eat it. I ate a bowl of Bran Buds for dinner and other bowl for breakfast. The following 4 days were misery. 13 grams of fiber in 1/3 cup, baby!

...That you can actually find a dress for $99 at  David's Bridal on their "$99 sale". I got this for the Trash the Dress pictures we are doing the day before our wedding. It's much prettier in person

...That my baby brother isn't a virgin

...That you're automatically accused of clogging the toilet when it starts flooding the floor, even if you were just taking an innocent pee

...That seeing co-workers at the gym is pretty awkward