Who was the last patient to just break your heart?
- 17Oct 4, '10 by ChristaRNHello everyone! I love lurking around here and leaving the occasional post but I rarely start a thread. I thought that is something I would like to do right now. As nurses, most of us will experience many situations which challenge our emotions and our ability to keep our composure, evoking so many feelings from anger to sadness and so many others. I was wondering if some of you would like to share a little bit about the last patient/situation at work that shook you to your core or finally broke down a wall that had been building up for awhile. Perhaps we can through this take a little look into each others minds and hearts and appreciate each other for the awesome care we give to our patient's everyday. I work on a pediatric floor currently where we care for many heme-onc patients and of course every time we lose one of "our kids" it's terribly difficult. The last patient who really took me on an emotional rollercoster was not one of those kids but a trauma patient. Adorable 3 year old girl who was in an MVA with her mom and sister - mom died instantly and sister fortunately suffered only minor injuries. I assumed care of her upon her transfer from PICU some 4 days after the crash, and keep in mind that as of this time her family had not even attempted to broach the topic of her mom's death with her. She had fractured her pelvis, both femurs, the radius and ulna on one arm and the radius, ulna and humerus on the other. Her face was covered in bruises and abrasions. On report I was told that dad had only visited for about 30 minutes twice since the child was admitted to the hospital; her sister had been separated from her since the crash and was now at home. I struggled with trying not to judge this father; he was a grieving husband but this is his BABY! How could he not be there for her? She was such a stoic child, wouldn't speak to us and didn't cry either, just stared blankly at the ceiling. She wouldn't eat, wouldn't drink and ignored everybody and everything around her. In between patient rounds I would park my chair and COW right outside her door in case she started to cry or talk. It was the middle of the night and a couple of coworkers were right there talking with me when we heard her little voice for the first time floating out of the room. She wasn't yelling for us, she wasn't crying, she wasn't moaning - we stood at the side of the door listening to "Mommy, no Mommy. I can't come too, Mommy? Why Mommy?" I walked into the room and my heart broke as I saw that baby raising her casted arms out as if in a hug. I got such goosebumps and it was obvious to me and my coworkers that her Mommy must have been there with her baby. I cried the whole 45 minute drive home that morning thinking of that poor child all alone in the hospital for more than half a week, her earthly family nowhere to be seen but her mother sure wasn't leaving her baby alone, I'm sure of it. Fortunately in the next couple days her father and sister began coming regularly to visit her and Dad seemed involved and interested at that point. She began slowly doing better and interacting more with us, she began eating and a few weeks later we were sent pictures from the Peds rehab hospital of this beautiful child playing with other patients and seeming well on her way to recovery. While I hope the care I gave her for 4 nights helped her recovery some I give the majority of the credit to that literal Angel of a mother. I will always remember that little girl. So what's your story?
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- 2Oct 4, '10 by TiffyRNI do see many great stories in the NICU, many of them are unfinished stories, others, we know all too well how poorly things are going to end. Sometimes the only consolation is that my patients are too neurologically immature or damaged to know anything.
The time that took my breath and seared my mind was a little one that was unable to move, completely frozen, urged by the MD's to provide only comfort care at birth. Parents insisted on all measures as they waited for his "healing". I cared for him after he had been trach'd and had a G-button so his parents could take him home. One night as I provided his care I was talking to him and we made eye contact, he was "in there". Everyone had assumed his brain was as inactive as his poor frozen body.
Later we heard of his final "healing". He did not go gently into the night. I try not to think too much about it.
- 6Oct 4, '10 by ChristineNI work peds and adults so I see my share of pt's that break my heart. However, no one will ever break my heart like T. T was my baby. I started taking care of him when I was a PCT finishing up nursing school, and then took care of him as a new nurse. All told, I knew for for close to 2 years. T had cystic fibrosis, and was by no means terminal when I first met him when he was 17. Yet, for whatever reason, he started having exacerbations more and more often. For his 17th Christmas he was intubated, and actually made a DNR as he was doing so poorly, yet amazingly survived. Yet he wasn't out of the woods. T had lost 20+lbs during that horrific ICU stay. He vowed to do everything to take care of himself, yet he was intubated 5 more times in a 6 month period.
From Dec to July he was only home for maybe 2-3 weeks total. He spent all that time either in the hospital or rehab. He was in the hospital for his 18th birthday, high school graduation, senior prom, Christmas, and most of the other major holidays. The ones he wasn't intubated for he we tried to make as pleasant as possible for him. We were trying so hard to get him qualified for the lung transplant list, yet he kept getting weaker and weaker, getting admitted more and more often.
For his last admission, he was now 18, a man, and able to make his own medical decisions. The doctors told him that he was dying, and that if they re-intubated him they doubted he would ever be able to be extubated. Never the less T begged to be intubated one last time. His family wasn't there, despite being notified to get to the hospital ASAP, they lived 3 hrs away. T didn't want to die without giving his family a chance to say good-by.
I was there at his bedside as his family said their good-byes and made the decision to pull the tube, knowing it would be the end of T's life. At this point he was on BP drips, and his pressure was still 70's/30's, and overall his perfusion was shot. It was very emotional. The family thanked me for all the care I had provided for their grandson. How they knew that even when they couldn't be at the hospital with him, I was there looking out for him. Even when I wasn't his nurse I made a point to visit him.
I will never forget T.Last edit by ChristineN on Oct 4, '10
- 5Oct 4, '10 by Tina, RNLast night I was at work. One of my patients was an elderly man with CVA, left sided weakness. Extensive medical history, including prior CVA which had affected his speech. But, he is alert and oriented and able to make his needs known. He has family, and had visitors on and off all day. As I was walking around checking on everyone, I saw him sitting up in bed, with his dinner on the bedside table, across his lap. He was feeding himself with his right hand, and doing a pretty good job. So, I went in and chatted with him for a few minutes, making sure he was OK and didn't need any help. I don't know why, but the sight of him sitting there and feeding himself broke my heart. Don't get me wrong, I am thrilled that he is well enough to feed himself. It could be much worse. But for some reason, my heart ached for him right then. Maybe because I always feel for my "old guys" that need to adjust to new health issues. But for whatever reason, he really affected me at that moment.
- 9Oct 4, '10 by kloneA lovely couple who came to our hospital to have their second child. They had learned only three weeks prior that the baby had Trisomy 18, which is generally incompatible with life. In most situations, the baby dies in utero, and those that don't, usually die the first few days.
This baby was born alive and the family spent two days in the hospital, learning how to take care of this special baby. The day of discharge came, and the case manager from the home hospice agency came to the hospital. The case manager was my husband (that has been two times now that I've been the OB nurse for a sick baby, and then I transfer the child's care to my husband, the hospice nurse). The local medical transport service refused to transport this child (I can't remember the reason), and the family did not feel comfortable driving home alone with this baby and nobody to help him if he stopped breathing, so my husband actually drove the family and their baby home, an hour away. We got a call at home that evening, letting us know that the baby had died, about 6 hours after they had settled in at home. He held on long enough to be taken home.
- 4Oct 4, '10 by taz628Maybe I'm just a softy, but in my little more than 2 years as a nurse I have several pt's already cemented into my mind and will never leave my memories.
Just this past week I refused to leave my pt's side until he was safe into the OR. Dissected aorta from descending arch all the way down the whole trunk. He said he had recently had a dream where the blessed Mother told him she couldn't save him again. He also had a child due to be married in the short term. I spent an hour dumping labetolol into him (pressures 240/100) and was just about to start a nitro drip when CTVS finally said OR was ready for me to take him. I prayed, HARD, that night for him. Turns out radiology read the initial report wrong, it wasn't a type A dissection but a type B afterall. Thank God for that though. I hear through the grape vine he's doing well enough, I sure as heck hope so.
The other pt was a pediatric trauma. 15 months old, fell head first out of a 2nd story window onto a cement patio. It was my first major trauma I helped with off orientation when I transferred to the ED. She was almost lost in CT. She still had perfusion in the base of her brain, but not much else. The story of HOW she managed that fall changed about 3 times... it just didn't make sense.
I used to work in ICU step-down, and one pt was end stage ALS. Younger guy, you could tell he was extremely handsome before the ALS started wasting him away. He was on our until some 4 weeks before being transferred to a vent facility (we had him on BiPAP). I took care of him almost every night I worked, myself and one other nurse seemed to be the only two who could effortlessly communicate with him. His personality still managed to shine bright despite only having eye movements, the ability for a weak smile, and being able to contract knees JUUUUUUST enough to use a pancake call bell. A year after I last took him, he was brought into the ER for some respiratory complications. I walked into his room and I was greated with a HUGE smile (for him). His primary nurse said he hadn't smiled once until I came in. I talked to him, managed to amuse him, and was honestly surprised he was still alive at that point. I miss that guy... he was a real sweetie and his whole story just pulled at my heart strings.