Blood, Sweat & Tears

[KDICURN]

Let me start off by saying, I don't want to be praised, idolized or made out to be a hero because I'm neither of those things. I'm a simple 26 year-old woman who decided to dedicate her life to helping people. I made that decision just about 10 years ago when my great-uncle, the man who raised me fell victim to an illness that almost prematurely took him from this earth. His nurses were not so nice. They were insensitive.” And I vowed to make a difference, to never be that nurse. To treat every patient I encountered with respect and dignity.

Okay, now you know why I chose Nursing. Lets move on. Nursing school sucked. There's no better way to put it. I didn't get the normal college experience. No crazy parties. I worked through school and spent most nights stuck in a library. Every exam could seal my fate. Anxiety, exhaustion, stress. Sleep? What was sleep? I survived off of naps, caffeine and one hell of a support system. But it was worth it. I graduated, got a job. Whoo, I'm college graduate. I'm a professional. I'm a nurse?!

Now, Lets fast-forward 3 years. I'm an experienced Cardiac ICU nurse that has seen things that would haunt you for decades. And it's only been 3 YEARS! BLOOD, SWEAT and TEARS. It's not just a saying. It's real. Now bear with me as I tell you a story.

Day 1 of 3: I admit a patient who suffered a cardiac arrest. He's undergoing hypothermia. He keeps me busy. I spend the first 4 hours of my shift on my feet drawing blood, titrating medications, transporting to and from CT. Chaos. But it's okay. It's good chaos. My patient is as stable as he's going to get for the day and I can relax. I eat my lunch at an appropriate time, chat with the family. And the bonus, I leave on time. Thank god, I have to be back in less than 12 hours for day 2.

Day 2 of 3: I take my patient back from the day prior. Because of his condition, he is a 1:1. This means he is my only patient today. He is my only responsibility. But he's showing signs of improvement. I think today is going to be a good day. My nurse friend next to me is getting an admission. Another cardiac arrest patient. I know she's going to be busy so I offer to help. TRAINWRECK. This patient hardly has a blood pressure, his kidneys aren't working and he just doesn't look good. It's sad. GIVE THIS, DO THAT, HANG THIS, SEND THAT. Nurses, doctors and respiratory therapists all working together as a team to try and get this man stabilized. Finally, after 3 hours, he seems to be okay. SHUFFLE ASSIGNMENTS. I have to give up my stable patient from the day prior to take this new patient that I just helped stabilize. He's too sick for my nurse friend to care for. She's a newer nurse who hasn't been trained on all the equipment this patient is connected to. So we switch assignments. It's okay. Most of the work has been done. And look at that. Almost 4 hours into my shift. This day is going to fly.

I let the family back to see their loved one. They have been waiting anxiously in the waiting room for hours. I explain each machine to them. What it's doing, how it's helping and why their loved one needs it. Then, ALARMS. My patient's blood pressure is dropping, and its dropping fast. I say excuse me to the family and run over to the IV pump while I'm dialing the doctor on my phone. I need you in room 207, his blood pressure is dropping.” I stare at the monitor anxiously waiting for this IV medication to kick in. Please go up. 60/30…58/32….42/24….I check for a pulse. Nothing. I yell for someone to press the code blue button and chaos ensues. 45 minutes later I'm running family back to the room. We got him back but he's not going to last long. There's nothing more we can do. Please hurry, we want you to say goodbye.” DISBELIEF, DENIAL, HEARTBREAK I stand there holding up my patient's daughter as she sobs on my shoulder. I fight back tears and all I can say is IM SORRY. They're mourning; I can't take it. I walk out of that room and into an empty one. The tears begin to flow. We failed, I failed. We didn't save him. We couldn't. When I finally get myself together, its time to clean up my mess. I ask the family to step out while I make the room more presentable. It looks like a war zone, trash, needles, blood, medications scattered everywhere. But it gets done. The family gets their time alone in the room while I try to piece together what happened and chart every move I made over the last 6 hours. Done.

I grab a bottle of hydrogen peroxide and head for the bathroom. I pour some on my scrub top and brush hard. When I was doing compressions on my patient , blood was spraying out of his breathing tube all over me. But I couldn't stop. I kept on. It's just BLOOD. It'll come out later I thought. I look at myself in the mirror and my hair is sticking to my neck. SWEAT. 2 minutes doesn't seem like a long time but when your pushing on someone's chest over and over again, those two minutes can feel like an eternity. PUSH HARDER. PUSH FASTER. Over and over. PULSE CHECK! Please have a pulse. RESUME COMPRESSIONS. 45 minutes of that. The smeared mascara. From the TEARS that no one saw me wipe away. Proof of the pain that I silently shared.

I dry my scrubs, clean my face, fix my ponytail and walk out of the bathroom with my head held high. Why? How? Because it's my job. There's 4 hours left of my shift and two new patients that need my attention. I punch out on time that day. I make it to my car and begin to sob. I'm physically and emotionally exhausted. I didn't even eat my lunch. God give me strength, it's only day 2 of 3.

Day 3 of 3. I walk into work expecting the worst but hoping for the best. My prayers were answered. I had an easy day. My patient's that day were step-down borders who didn't need much from me except medication and snacks. I spent most of my day catching up on online training modules and chatting with my co-workers. I even ate lunch and got out on time. Phew, a few days off.

I think back to why I became a nurse in the first place. It was those insensitive” nurses that cared for my great-uncle. If it weren't for them, I wouldn't be where I am. I apologize to them everyday. I apologize for being insensitive myself, for not realizing that they may have just gone to war in a patients' room down the hall without me even knowing it, for expecting them to be perfect. I apologize for judging them without having walked in their shoes.

***4 days off a week may seem like a luxury to most people, but trust me its very much deserved. Let them rest.

***See a group of nurses sitting down, chit chatting at a nurses station? They look like they aren't doing anything but they are watching monitors and listening out for alarms. They are always prepared to jump into action because hell could ensue at any moment. Don't judge them. Let them enjoy their downtime, they may not get that luxury later.

***Your family member who happens to be a nurse, doesn't show much concern that you're in the hospital for a scheduled tonsil removal? They care, they're concerned, but they also know that you are one of the most stable patient's in the history of the world and that you are going to be fine. Cut them some slack, its their job to not show you that they're worried.

Moral of the story you ask? There isn't one. I just ask that you be kind to your nurses. Be patient. Whether it's a nurse in the hospital, doctor's office or your family's own, remember that you don't know what they've been through. It may seem like they are heartless and insensitive at times but they wouldn't be a nurse if they weren't devoted to helping people.

[jadelpn, LPN, EMT-B]

Nurses who get emotionally invested in their patients suffer burn out, and pretty quickly.

Nurses who believe it is a personal failing when a patient codes and is unable to be revived suffer burn out, pretty quickly.

A layperson can think heartless and insensitive, however, if blood sweat and tears is on repeat every day, multiple times a day, a nurse needs to decide how to create professional boundaries.

I don't mean to be harsh, and hear me out--going forward, out of your story, OP, I would say that if you are compressing and there is blood spurting from the intubation tube, then that needs to be dealt with. In all seriousness, soaked in a patient's blood is not doing that patient any good, nor you. There are usually 952 people at a code--"someone needs to redirect that tube".....which was attached to what exactly? Who was doing the airway? In any event, I was taken aback by your blood soaked scrubs.....that may happen here and there, but honestly, shouldn't.

There are some things that one can control. Patients (especially critical ICU patients) are not one of them. It sounds as if you may have gotten into nursing to become emotionally invested, and the reality is that a nurse just can't. So take some time to reflect on how you can be professional, you can be invested in doing the right thing by your patient, but never the less emotionally detached and set up your boundaries.

[KDICURN]

Nurses suffer from burnout as a result from a lot of different things. Losing a patient that you have been emotionally invested in is a definite cause and I will not argue with you on that. However, I think you may have misinterpreted the meaning behind my post. So if you would be so kind as to bear with me as I explain.

I apologize if this comes off rude but I had to laugh at your comment regarding the blood from the ET tube. Obviously, blood spraying all over people during compressions is bad. Of course, I said something to the respiratory therapist who was bagging the patient. No that shouldn't happen. But it did. The problem was fixed during my round of compressions but it didn't save my scrubs. Thanks for the concern, but that wasn't the point of the story.

This post was written out of frustration. It was a way for me to vent. As of late I have seen many nurses fall victim to judgements for being lazy, insensitive and receiving too much praise for the work they do. I took 3 days of my nursing career and posted it here for the world to see. I never said this was my life, that this happens every day or that I am upset that this happened. As an ICU nurse, people code on me more often than I'd like. Am I disappointed when my team and I are unsuccessful? Absolutely! Do I cry after every death? No. Do I feel as if I failed everytime? No. And as for the patient in my story, let me be clear in saying that I wasn't upset that he passed away because in my opinion he had suffered enough. However, nothing will ever take away the disappointment that you SHOULD feel after coding someone for 45minutes. We (ICU teams) work very hard. I worked very hard that day and I think my tears were a clear indication that the death and dying I experience at work has not left me jaded and insensitive. I went on to care for other patient's that day and the following. I have never let one code, successful or not impact my care for other patients. I AM a professional and will always do whats right for my patient.

I didn't get into nursing with the INTENTION of becoming emotionally invested with my patients. I got into nursing because I love helping people. The blood, sweat and tears is an unfortunate thing that comes with the job. And for the record, every nurse, no matter what their background is will have that one patient that they felt they couldn't save. It doesn't make you unprofessional to think of that patient from time to time. In my opinion, it makes you work harder to make sure every move you make has the patients best interest at heart.

I leave you with this,

"Your level of control and outward response may change, but if you ever get to a day where your heart doesn't break for the breaking hearts of others, it's time to find another line of work." -Unknown.

[CBlover, BSN, RN]

I am not an ICU nurse, so I haven't experienced nearly all you have with critically ill pt's, but I have experienced high stress, tense, life vs. death situations with pt's and I cannot say that I was ever "emotionally vested." That is taking it a bit far for me. You've been doing this for 3 years though so apparently it hasn't burnt you too much yet. I actually love adrenaline rush type situations, but at the same time they always involve someone's life. That part can get emotional -- absolutely.