Thursday, June 22, 2006

Can't sleep, the night weasels will eat me...

Once again, here I am, can't sleep. I'm bothered and even a bit embarrassed considering how much I love night shift and being up at night and sleeping all day and how much I rave about the fact that I'm a night person and have no trouble with this bizarre schedule at all... But it's the middle of the night (early morning, to some) and I need to be sleeping so I can be awake tomorrow during the day....

I don't have much to say about work or nursing these days...I'm still taking care of "Billy" and he's still really sick and I'm much too attached to the whole situation and it's really getting to me. But I don't know how to deal with it, and I don't want to change assignments, and I don't want to talk about it, and blah blah cancercakes. Two nights ago, my shift started like this: "Uhm, this is R on XYZ Unit, and my patient's sats are in the 70s at 100% fiO2, can you come help me out?"

"Sure, be right up. In the meantime, why don't you take him off the vent and bag him?" gah. NewbieICU RN (that's me!) gulps and wonders, "Hmm, now how exactly do I disconnect the trach tube and attach the ambu-bag? Of course I SHOULD know this..." And also, as your patient breathes 60 per minute and his sats drop to the 70s, is not the BEST time to have a learning moment. But we have these handy super loud alarm thingies that ring out all over the unit if your patient is in trouble (the kind they don't have on Grey's Anatomy!) so another RN popped his head in the door and helped me bag my patient. He recovered fairly quickly and the rest of the night was uhm...okay. My shift ended with helping the surgeon to take out Billy's third chest tube and I think I said, "Whoa, cool" out loud as the big tube slithered out, making a cool slurpy noise.

I got a lump in my throat when Billy's mom called to check on him, as she does nightly. I filled her in on how he was doing, and she choked up a bit as she said, "Tell him I love him. A lot." Then hung up. I got another little lump in my throat as I was giving him his bath and felt how emaciated and fragile his limbs were. He still opens his eyes on his horse-killing doses of propofol and versed, but he's not as responsive as he was. But he'll look right at me, and watch me as I move around the room, and I think he just thinks that he'd rather be dead than be how he is. I read all the latest physician progress notes in his chart, which all stated in one way or another, "Pt has been intubated for 30 days and has not made any progress or improvement. Will address this in a Family Conference."

So lately I just move numbly through the days, getting irritated at everyone and everything, trying to sleep when I'm not tired and sleeping because it's just something easy to do when I am tired. I have a headache that won't completely go away and my back and shoulders ache in sympathy and consequently I'm probably pretty whiny. I continue to think vaguely about a job change, maybe to a unit where not everyone dies...?


Surgeon in my dreams said...

You CAN do this! Tessa will help you. I know it has got to be so hard, so ultimately you follow your gut.

We need nurses who care. You know that guy knows you care during his few lucid moments and what a blessing that must be to him.

Besides, any "weenie dog mommy" MUST be a strong lady.

Love your blog- just found it today but am sure I will be back because I live vicariously through all my medical blogger "friends".

Jan in SC

Mama Mia said...

Oh, Rosebuttons, my heart aches for you. I know how hard it is to be in a situation where you care and can't change the outcome.

My thoughts are with you.

Anonymous said...

Hang in there. I hope you will continue/start talking to Billy a lot. Treating him as if he is still worth something means the world right now. Is he getting any visitors? Friends, relatives?

Sid Schwab said...

The ICU is tough. I've seen more than one nurse giving care through tears. But know these few things: the ones that don't make never had a chance at all without the care they received there, and the ones that do have done so only because of that care. Not too many years ago, many of those saves were simply impossible. And this: as a surgeon, I appreciate ICU nurses beyond all measure. The most important care starts when the bandage goes on. So hang in there. The world needs lots more just like you. You'll have plenty of moments of gratitude, and they'll more than make up for the losses.