interleukin 8,958 Views
Joined: Jan 10, '07;
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After returning from vacation, I was assigned to "Robert", a 24 year-old suffering from septic shock, multi-system organ failure and late-stage muscular dystrophy. He was maxed out on chemical and ventilatory support.
In his room, the wasted young man lay in the center of large specialty bed. His angular contracted body was dwarfed by a puffy blue mattress that appeared to be in process of swallowing him whole.
During his short life, Robert had been hospitalized multiple times. But this would be his last, his body slowly surrendering to a bacterial juggernaut unconcerned with strong wills or the code of human decency.
Alongside the bed sat Robert's mother. She was short, her face drawn. She stood when i introduced myself. A meek smile betrayed none of her accumulated heartache. Her grey eyes hid none of her fatigue.
I asked her about Robert's life and she began to talk about the photos that were taped to the room's bulletin board. In one, a frail red-haired little boy wearing water wings was splashing in a backyard pool. In another, he was in a toboggan, wedged between the knees of an adult. With his mother's eyes, he was staring directly into the camera. A third photo showed him in a wheel chair crookedly holding an ice cream cone, ready to take a lick.
This was Robert's third day in the ICU. But because the bed was large and Robert's mother so small the only physical contact she could manage was stroking his arm.
I left the room in search of the stool we usually keep in the unit. Unable to locate it, I grabbed a heavy box of computer paper and plunked it down at the bedside.
"Would you like to kiss your son"? I asked her.
I pulled Robert over and then helped his mother onto the packed box. With heartbreaking tenderness, she kissed her son's face.
The following day, this mother decided it was time for her son to rest. With him held firmly in her arms, we extubated. The boy passed quietly, finally free from his incarcerating body.
Ive been an ICU for 16 years. I am no longer intimidated by clinical complexities or traumatic injuries. To me, they're just variations on themes which oblige me to perform the technical balancing act until a body, hopefully, regains its footing.
Today, I am motivated and rewarded by the challenges of assessing and interpreting the behavior of loved ones who suddenly find themselves thrust upon life's razored edge.
For me, therein lies the power and privilege of being a nurse.
Sometimes, a family member's behavior is so clouded by the grief and shock of a loss that we must be courageous enough to practice outside the box.
My patient had been ejected from his car after hitting black ice. His prognosis for any recovery was a hairs-breath above zero. We knew he would never again walk this earth.
The family was large and streamed in and out of the room. All were polite and respectful. The wife dutifully provided explanations and “stability” for the large family and the throng of visitors.
From the periphery, I observed her. She kept her emotions in check, only occasionally tearing up. It almost seemed she were “hostessing” the “event”. But her slow-motion movements belied a simmering grief that needed to be processed.
Having worked in ICU for ten years, I knew there was nothing humanly possible to change his course. I knew soon his heart--the heart that beat for so many years in unison with the woman--would stop, and the body that warmed her would grow cold, and the soul that united them and breathed life into her, would slip away.
The family and friends were “there” for the wife but they seemed unaware of the need I saw simmering just beneath her expression. And as the people kept calling I could sense a growing need within her. She began seeking my approval about letting anyone else in. I told her these would be the last. There was something we needed to do. The final visitors let the others who had gathered in the waiting room know that visitations would now cease.
I led the woman into the room. I rearranged the mechanical lines of life support and gently pulled the husband over to one side of the bed. I let down the rail.
“You need to lie beside him,” I said.
She looked at me with utter astonishment. It was as if I had just told her I could bring transport her back to the day before when her husband was home and alive and this place never existed. Her tears streamed down her cheeks. She cried and cried as I helped her in beside him.
I assured her she would not be disturbed by anyone, for any reason. She could emerge from the room when she was ready and could stay as long as she needed. I would guard against any disturbance.
I covered her with a blanket and put chairs against the bed as a reminder to her that the railings were down. I handed her the call bell and closed the door and curtains behind me.
Some weeks later I received a letter from her. She had difficulty describing the torrent of emotions that enveloped her while she lay with her husband that final afternoon of his life. But she said that being able to fully embrace him provided her a comfort and peace that would warm her for the rest of her life.
It’s so simple, yet too often we lose focus on what really matters.
Have the courage to let your humanity lead the way.
You passed...that's what's important.
Don't compare yourselves to their results...it's a losing game of anxiety and stress.
My sister was told she's never be a nurse....average grades. She's now a powerhouse in nursing.
My cousin did just ok on tests, at or below average. She now teaches the medical residents in a big city ER.
No test result ever made anyone a better nurse.
I think it is a good thing that people display such spirituality in such a field. I think it is God and God alone.
At risk of being barraged with hate mail, I offer the following;
First , if prayer makes you, or someone else, feel better then by all means do it. After all, prayers can't hurt.
But suggesting that praying for someone's recovery, from a remote location, can actually contribute to that recovery is magical thinking that undermines the integrity of the Western nursing profession.
I wonder how many doctors maintain such beliefs?
Prayer is hope, and hope is a good thing...as long as there's a reasonable chance. Otherwise, we end up prolonging suffering "waiting for miracles."
People pray everyday for recoveries that never happen. Was it, then, just a matter of too few people praying or not praying loud enough?
I will quickly be labeled a "nonbeliever" so that my perspective can be rendered irrelevant...just someone who either "doesn't get it" or is "a lost soul."
You can be be either scientists or a witch doctors...but not both.
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