Nursing: A Passion

You know moms have to make all of the holiday magic happen and it is so stressful and frustrating. Even if you are a fucking mom who is 200 miles away doing training for a new job, staying in a hotel lonely, you have to go online and order all the things for Easter Baskets and then describe how to put them together to your husband. Then you plan the meal and order all the ingredients. Then you make sure a house cleaner comes before the day and cleans the house. Then you work Saturday night from 7pm until 7:48 am on Easter morning in the ICU caring for sick patients. Then you drive home for 3 hours making it home at 11am and everyone in your house is crabby. The kitchen is a mess. The groceries aren’t put away. Your lovely husband didn’t hide the Easter baskets and told your youngest child that the Easter Bunny, Santa, and the tooth fairy aren’t real without preparing you. He is cooking but yelling at everyone about it. After about an hour you can’t stand it anymore so you go to bed and cry because you couldn’t make the magic happen and you are physically, mentally, and emotionally exhausted. Two hours later they tell you dinner is ready so you move your lump of a body to spend time with the family you love and they haven’t cleaned off the table, your oldest is drunk, your middle child is eating in the living room, your youngest is crying trying to make herself a plate, and your husband is in the living room pouting. So you sit down in the living room and get yelled at for sitting in someone’s spot. You then get up and go back to bed. Holiday magic is not happening today. I have no more to give. Did I mention that the oldest then comes in and says stop pouting? I’m not pouting I’m exhausted and my body hurts. FML.

I can’t sleep anymore. When I close my eyes in the dark I hear the alarms. The constant noise of the monitors soft beep warning me that the patients oxygen level has dropped below 85% despite intubation, sedation, paralytic, FiO2 of 100%, PEEP of 20, nitric at 40 ppm, and proning. The insistent beep that the blood pressure is low and I need to add another medication to force the tired body to perfuse organs that need oxygen to work. The R2-D2 noise of the CRRT warning me that I need to attend to the machine working as kidneys. The scream of the ECMO ( the machine bypassing the lungs and heart)has an altered flow. The beep that is the IV pumps warning me that the medications need to be replaced or that the IV is occluded or there is air in the line. The gasping of the patient in the next room on maximum bi-pap setting. The begging to not let them die. “I can’t breathe. Please save me.” “I am right here with you. We are going to do everything we can do help you. You are going to go sleep now and we are going to put the tube in.” The phone conversations with loved ones and the tears via the phone. “Your loved one is not doing well. We are doing everything we can to keep them with you.” The organized chaos and noise as we crack ribs, push medications, shout times and medications, the noise of the defib powering up. The FaceTime,”You told me you would fight please don’t give up. You promised you would come home to me.” The silence as we turn off all the machines. As we silently mourn a life passing. I can see all their faces. I carry them with me. All the hands I held. All the times I said, “You are safe. We are going to do our very best.” The images and sounds torment me now as we head down even further into this pandemic. I am not the nurse I was before March 2020. I am not the person I was. Death walks beside me now. We lose more than we win. We went from 1-3 deaths a month to 1-3 deaths a day. The ghosts haunt me. In the quiet dark I remember and I am haunted.

Kick a patient while they are down. My pt is paralyzed from the nipple line down as a result of their injury. They have a trach with blow by o2 so unable to speak. Esophageal tear so lots of antibiotics. Have been in the ICU for 2 weeks due to trauma. Guess what they got c diff. They needed to be cleaned up. My colleague was complaining of the smell In front of the patient and literally took a break in the middle of cleaning them up. I am so embarrassed my colleague acted like that and I am so mad. Be conscious of what you are saying in front of the patients. Especially a newly paralyzed person in the prime of their life that already has lost all control. Be thoughtful in your interactions with everyone but especially with those whose plate is already full. If you had to carry their plate it might break!!

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Kick a patient while they are down. My pt is paralyzed from the nipple line down as a result of their injury. They have a trach with blow by o2 so unable to speak. Esophageal tear so lots of antibiotics. Have been in the ICU for 2 weeks due to trauma. Guess what they got c diff. They needed to be cleaned up. My colleague was complaining of the smell In front of the patient and literally took a break in the middle of cleaning them up. I am so embarrassed my colleague acted like that and I am so mad. Be conscious of what you are saying in front of the patients. Especially a newly paralyzed person in the prime of their life that already has lost all control. Be thoughtful in your interactions with everyone but especially with those whose plate is already full. If you had to their plate it might break!!

I miss baby docs. I miss the camaraderie. I miss the education both ways. I miss being able to remind them that they are a real doctor and to stop putting themselves down. My baby docs had all the education. The reason I can tell them what the attending in the ICU is probably going to order: real life hands on experience, the been there learned from it phenomenon that they were going through. I love their passion, compassion, listening skills, intensity, and even their fear. The fear we all have, even the most confident of us, that makes us take the time to ensure that the decisions we are making are the best ones we can make at that time. The decision is the one that will lead to the outcome the patient desires if possible. I loved being the mama bear nurse that reminded them to take care of themselves. I loved that in times of trouble in my personal life and they walked in the room while my daughter was the patient they knew me and we already had a connection. I could trust them not to bullshit me because I don’t do well with bullshit. Lay the facts out however hard it is to hear and let’s figure out how to make our way forward. To all the resident physicians that helped me grow as a nurse I want to say Thank you. Thank you for treating me like a member of the team. Thank you for being by my side as we cared for those critically ill patients. I hope I end up somewhere with residents again!