The surface is gone, we scratched it off
We made some plans, and let them go
The beep of the call bell broke through the bustle of the unit.
I knew without looking it was my patient’s wife. I took a deep frustrated breath and walked to the door. The wife started chattering incessantly when I walked in the door, her eyes frantic and almost manic as she went on a tangent. I internally tried to suppress my frustration. She had called me into the room for the 5th time for a false alarm bedpan need. Her confused husband looked at me with a look that told me he had forgotten who I was, again.
20minutes later I exited the room and returned to my other patient. It was already 3pm and I had yet to finish even my 8am assessments. I hadn’t eaten and my coffee level was low.
I finished with my other patient and sat down to chart. Seconds later, the wife approached me.
“He needs you again…” she said. I stifled a groan and made my way towards the room.
The patient himself was a pleasant man in his 40s. An unlucky chain of events had led to surgery, two codes and now an anoxic brain injury that left him forgetful and anxious.
He was tachypneic in the 30s, diaphoretic and febrile at baseline- related to his brain injury. I looked at him as I entered the room and tried to ignore the wife as she talked incessantly. I quickly established that he now did not need the bedpan and that he wasn’t in pain like she had told me. He let out a string of profanities and I went to get him an antianxiety pill.
30 minutes later, I again escaped the room and encountered my charge nurse.
“Do you think he can lateral? We need surgery beds…” She said trying not to be pushy. I looked at her gratefully.
“Yes! I’ll page whoever you want.” I said.
An hour later I pushed him down the hall into his new ICU room. The wife was anxiously trailing behind us. I had tried to give the new nurse a fair warning about the situation.
As I said goodbye and walked out, I felt relief and a twinge of guilt. They were encountering something I couldn’t comprehend. From a medicine standpoint he was stable aside from a few issues with breathing and tachycardia. To me he was the most stable patient on the unit with the most unstable family. As we pushed the empty bed down the hall I realized she probably had no idea how to cope. Her endless calls and nonstop questions and chatter were her coping mechanism.
“Is he ok? Is that good? That’s good right? I think it’s good. Am I grasping… I am grasping aren’t I? I just want good news? Is it good news? What did the doctor say?” She had barely allowed answers as she just continually spewed words. But here she was facing a new life with a husband who forgot what happened 3 minutes before. A husband who said whatever came into his mind because of damage to the frontal lobe. I felt bad that I was so frustrated. I had only spent 2 twelve hour shifts with them.
This was just the beginning of the rest of their lives.