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...?