perspective is a lovely hand to hold

And when He had come into the house, the blind men came to Him. And Jesus said to them, “Do you believe that I am able to do this?”  They said to Him, “Yes, Lord.”

Then He touched their eyes, saying “According to your faith let it be to you.”

-Matthew 9:28-29

The chaplain  was chatting with the nurses lounging at the nurse’s station as I charted nearby.  The topic was advanced directives and living wills.

“Too bad 8207 doesn’t have one…” One of the nurses chimed in.  

A pause filled the room.  

“The family is never going to withdraw care…They are waiting on a miracle.” the charge nurse said sadly.

I scoffed from my seat and firmly shook my head as I hopped off my chair to go to my patient’s room.

“There are no miracles happening in that room.” I said flatly.  The chaplain looked at me without judgement but a sadness was in his eyes. I looked away and went into my patient’s room.

Away from their eyes my face flushed and I felt sick.  I have no filter when I talk.  Words pour out of my mouth before I think them through and more often than not what I say is exactly how I feel- no barriers.  I had said what I said without thinking…Was that really what I thought?  

My patient was intubated and sedated so I could hide safely in his room and fight the nausea.  I glanced at my reflection in the window, a vague blur of navy blue and pale skin… how accurate. 

My life, my belief… a vague blurred reflection of the person I used to be.

The patient died three days later. The family never withdrew support.

And, my lack of belief though seemingly justified…left me feeling completely empty.  

Reasons Cardiac ICU nurses should NEVER get to see their EKG rhythm.

Nurse 1: I have a ‘U’ Wave! Hypokalemia or hypercalcemia… or intracranial hemorrhage…Crap!

Nurse 2: My ‘P’ waves are peaked… I am worried about right atrial enlargement…

Nurse 1: Why is my QRS complex so TALL?

Nurse 2: What is my axis deviation?

Nurse 3: Uhh… Guys? They both look like normal sinus rhythm to me…

I wandered into a co-workers room to double check a heparin drip she was starting on her intubated, sedated patient and we started gossiping.

Half way through the conversation, I glanced up and noticed the eICU camera was facing into the room.  

Motioning at the camera I asked, “Hey- Is that camera actually ON?!”  and we exchanged mortified looks…

Seconds later a ding sounded and the voice of the most anal retentive, critical, confrontational doctor that we work with, filled the room.

“Good story, girls.”  He said dryly and laughed.

He won’t tell us how much he heard…

“You’ll forget me tomorrow… You don’t remember me today.”

Yes, I understand that every life must end, uh-huh
As we sit alone, I know someday we must go, uh-huh
Oh I’m a lucky man, to count on both hands the ones I love
Some folks just have one, yeah, others, they’ve got none

Stay with me…
Let’s just breathe...

-Pearl Jam

Oh, the day….

Oh, the day is as gray as the air from your lungs.  The clouds crossing the sky throw meaningless shadows across the crags in your face. Leaves, as bright as a fresh coat of paint, blow in the fierce wind outside your window, but the air is stagnant in here.

A line was drawn today between death and life.  Darkness and light.  We played tug-of-war all day on that line. No clear winner named.

Your body was quitting, your nurse was not.

The majority of the 12 hours we spent together I stood in your room, at the end of your bed.  My arms crossed, brow furrowed, fingers drumming.  I was your silent watcher. You didn’t even know I was there.  Your body sedated, your lungs filled with oxygen by a machine, your heart supported by 5 medications- you were chemically living. 

Touching you risked stealing what little life you had left, so we watched.  You pressures touched 60/40 before chemicals brought you back.  Your oxygen slouched to the 70’s until chemicals brought you back.

I stood elbow to elbow with doctors, other nurses, and respiratory as we watched your body fight to die as the chemicals fought for you to live. 

Your family didn’t hear us.  Your wife nodded blankly and mumbled words about going to eat or smoke cigerettes.  The words, “critical”, “unstable”, ” extremely sick”, ” not doing well…” had no effect on them.  They filtered in and out, crying one moment and inappropriately fixated on something else the next.  I couldn’t get across how dire your situation was…how easily you could die, and just how hard you were trying to die.

I looked at your body in the bed as your blood pressure dipped again and my only thought was how easily I would break your ribs when I started CPR on you.  You were so thin I could see your heart beating out of your chest.  I glanced at the code cart silently waiting at your side and cringed. 

  A phrase I have heard before came to mind, “Better living through chemistry…”  I shook my head as I walked out of your room. I wish whoever said that could come pay you a visit…chemically living is not really living at all.

I noticed in less than 30 seconds after my patient’s husband arrived that his fly was down… 

And, then felt excruciatingly uncomfortable that

 A) I noticed at all and B) that he felt the need to lean against the door and chat to me… for 30 minutes…about who knows what…

FIX your pants, man!