Com'on, you got one...What is your heart wrenching moment?

[CrunchBerries]

Mine was....

I was a very young, too young DON at a care home. I was working late one night doing paperwork. I heard odd noises coming from outside my office. I went out to investigate and I saw Marjean, one of my fav's sitting under a tree rocking back and forth.

I asked what was wrong, she kept rocking telling me she was just gang raped on the pool table of the game room.

Marjean was a hard core, paranoid schizophrenic. It never happened, while we had a game room we had no pool table and, we had cameras in that room. Naw, it didn't happen but SHE totally believed it did, it was one of her hallucinations.

While it did not *really* happen, it did happen in her reality and she was going through the same emotions as a true rape victim would experience.

I finally got it, I finally understood. Hallucination or not, it was still real for her. I just sat with her under the tree rocking back and forth.

We ALL have one or more of those moments, what is yours?

[FlyingScot, RN]

CrunchBerries said:

Actually, I do.

Okay you asked for it. Unfortunately I have so many stories that no matter how often I bleach my brain I cannot get the stains out. I'll share a few here in bits and pieces.

As part of the flight team for a large free-standing pediatric center we responded to traumas in our own ED as well. I got called for a "Level one with Attending" which is the worst of the worst.

This time it was a two year old little girl who had been backed over by her neighbor as she was riding her ride-on toy down the sidewalk. The rear tire ran directly over her head. I don't think I need to go into any detail about what that did to her.

She arrived as a trauma arrest but it was quickly determined that any further efforts were futile. Her mother had not arrived as she was at work.

I had the time so I did her post mortem care and tried to make her as presentable as possible. I washed the blood off her beautiful little face and out of her whispy blonde hair. That was the easy part. The weight of the vehicle had herniated her brain out both of her ears and her nose. I absolutely could not let her mother see this so I literally had to push this baby's brain back into her skull and wedge cotton balls in her nares and ears to keep it from coming back out.

When her mother arrived she was brought into the dimly lit trauma room and saw her baby lying quiet and still on the cot. As any mommy would do she ran to her child, scooped her up in her arms and collapsed to the floor holding the tiny limp body. As she rocked her back and forth the tears streaming down her face, her eyes wild and pleading she begged me to "do something" to bring her child back. I had no words. She then looked up and begged God for another chance because she didn't mean to yell at her little girl for not eating her Cheerios that morning. She didn't mean for her last words to her baby to be angry. She just wanted one more chance to hold her and tell her how much she loved her when she could hear it.

A little part of me died that day.

[Twinmom06, ASN, APN]

so mine just happened this 4th of July that just went by. My patient (we'll call her Sam - not her real name) was a lovely woman, newly retired and determined to travel with her husband and enjoy life. Healthy as a horse untill 4 days before she came to the hospital. She initially went to her local hospital with "flu like symptoms" - tired, SOB etc...found to have a Hgb in the 5's - and a CT scan showed a large mass. She came to us and found to have Stage IV metastatic breast CA - after having a normal mammo just a year ago! Anyway her kidney function was getting worse as was her SOB. Took her to nuke med for a VQ scan since her kidney function couldn't handle a PE study with contrast, and 20 minutes after I sent her down with transport, I get a phone call from Radiology - "something's wrong with your patient" - by the time I ran down from my floor she was pulseless and only agonal breathing. Started the code and got her back and intubated, and coded her again in the ICU. I had to go to the waiting room and get her devoted husband (you know the kind that only leaves to shower and come back) - and walk him back to her room just as they called the 2nd code. I went back to my floor to pack up her stuff and bring it down to the ICU and walked back into the ICU just as they printed her asystole strip - she was gone. The doctor was just holding him and crying with him. I've never been so heartbroken in my life.

[NOADLS]

It was around 2AM on a very quiet night. Laptop on hand and on level 500 of candycrush (this was back when level 500 was the last level). I had the game winner set up with 2 moves left. As I am about to click the winner into place, I hear screaming coming from the direction of the lounge one of the CNA's normally sits at and could have sworn it was her. As I approach her, I see her vomiting violently with bloodshot eyes. I never thought I would have seen the day where I would have to use my training. I started chanting "the power of Christ compels" repeatedly and after another bout or two or vomiting, the demons were exorcised. The CNA thanked me for my quick intervention and off I went back to play candycrush. I noticed that my laptop wasn't emitting its running sound and as I approach the screen, it was black. I then notice the charger lying on the floor. The world came crashing down on me as I realized it would have to be another day before I beat level 500 of candycrush.

[OrganizedChaos, LVN]

FlyingScot said:

Okay you asked for it. Unfortunately I have so many stories that no matter how often I bleach my brain I cannot get the stains out. I'll share a few here in bits and pieces.

As part of the flight team for a large free-standing pediatric center we responded to traumas in our own ED as well. I got called for a "Level one with Attending" which is the worst of the worst.

This time it was a two year old little girl who had been backed over by her neighbor as she was riding her ride-on toy down the sidewalk. The rear tire ran directly over her head. I don't think I need to go into any detail about what that did to her.

She arrived as a trauma arrest but it was quickly determined that any further efforts were futile. Her mother had not arrived as she was at work.

I had the time so I did her post mortem care and tried to make her as presentable as possible. I washed the blood off her beautiful little face and out of her whispy blonde hair. That was the easy part. The weight of the vehicle had herniated her brain out both of her ears and her nose. I absolutely could not let her mother see this so I literally had to push this baby's brain back into her skull and wedge cotton balls in her nares and ears to keep it from coming back out.

When her mother arrived she was brought into the dimly lit trauma room and saw her baby lying quiet and still on the cot. As any mommy would do she ran to her child, scooped her up in her arms and collapsed to the floor holding the tiny limp body. As she rocked her back and forth the tears streaming down her face, her eyes wild and pleading she begged me to "do something" to bring her child back. I had no words. She then looked up and begged God for another chance because she didn't mean to yell at her little girl for not eating her Cheerios that morning. She didn't mean for her last words to her baby to be angry. She just wanted one more chance to hold her and tell her how much she loved her when she could hear it.

A little part of me died that day.

I should've skipped that one. I'm bawling like a baby now. I'm gonna hug my son extra tight tomorrow. ?

[OrganizedChaos, LVN]

NOADLS said:

It was around 2AM on a very quiet night. Laptop on hand and on level 500 of candycrush (this was back when level 500 was the last level). I had the game winner set up with 2 moves left. As I am about to click the winner into place, I hear screaming coming from the direction of the lounge one of the CNA's normally sits at and could have sworn it was her. As I approach her, I see her vomiting violently with bloodshot eyes. I never thought I would have seen the day where I would have to use my training. I started chanting "the power of Christ compels" repeatedly and after another bout or two or vomiting, the demons were exorcised. The CNA thanked me for my quick intervention and off I went back to play candycrush. I noticed that my laptop wasn't emitting its running sound and as I approach the screen, it was black. I then notice the charger lying on the floor. The world came crashing down on me as I realized it would have to be another day before I beat level 500 of candycrush.

Lol. What would we do without you NOADLS?

[KeepItRealRN, BSN, RN]

This:

A Life Changing Experience

[canigraduate]

Y'all are killing me.

My worst one was an osteomyelitis patient who was my age.

He had already lost one leg to the disease and it had recurred in his other. He decided that he didn't want any further lifesaving treatment. He had come into our hospital for pain control until he could be placed in hospice.

I worked with him for weeks. He was a difficult and complicated patient and many of the nurses couldn't handle watching him deteriorate. We smeared lidocaine all over his involved leg, gave him ketamine and enough oxy IR and one of the long-acting narcs (I can't remember which anymore) to kill a small village. It literally took me almost ten minutes to scan and pop all 40 of his pain pills in the morning, along with his anxiolytics and muscle relaxers. The smell of his rotting flesh overcame many of the nurses, even though we had a charcoal air filter and several deodorizers in the room. The feel of rotten meat under your hands... it's hard to describe.

So, having an excellent poker face, I was assigned to "Tony" every shift. We would joke and flirt a little and I would try to take his mind off his excruciating pain. It was such an effort for him to even have the lidocaine gel applied that he would get tachy, diaphoretic, and nearly pass out. There were literally two spots on his foot that he could even bear to have touched to support his leg.

He would give me candy that his family brought in to try and tempt him to eat. He would tear up and tell me that he loved it when I was on because I treated him like a person.

One morning, he asked his family to step out. He was very quiet and thoughtful. He asked me if I could combine his med passes and "end it." I was floored. He begged me for an hour to find a way to help him end his life. We talked about hospice, about end-of-life sedation, about the laws in effect that prevented me from helping him to die. I was pretty shaken up.

I also had a very dignified elderly gentleman as a patient who came in with a bad attack of cellulitis in both legs. He had been having severe chronic pain and his health had been deteriorating significantly over the past year. He had been my patient for a few shifts running and we had developed a good rapport. The very same day, he talked about not wanting to be a burden on his family and tried to refuse his blood thinners, in the hope that he would have a stroke or MI and end his life.

I told him that he risked having a stroke and being paralyzed and that it was better for him to continue with his meds. He agreed. Then, he dropped the boom on me. He wanted me to circumvent the doctor and kill him, too.

I don't even remember what I said, I just knew I had to get out of that room. I'm pretty sure we had the same discussion about hospice, palliative care, and the current laws that prevented assisted suicide as I had just had with Tony.

Once I made it out of the room, my famous poker face cracked wide open. I had to "code walk" to the break room. I was done. I bawled for a good ten minutes and had to get the charge to cover me until I could function again. I kept having to duck off in an empty room and take deep breaths to calm down for the rest of the day.

Tony lived long enough to make it to hospice, where he died a few short weeks later. My dignified gentleman came back in with a GI bleed, caused by the very blood thinners I had asked him to keep taking. He passed within twenty four hours of admission from massive blood loss. I guess I helped him die, after all.

[rowrowyourboat]

I am not yet a nurse but these stories just tugged at my heart like crazy. Sigh!

[CelticGoddess, BSN, RN]

I have two:

When I was doing my OB rotation I went to the OR to observe a c-section. The baby was delivered and I was helping with the baby. His 1min apgar was 3. I had to bag him until the respiratory therapist could get in to assess. The baby had a5min apgar of 5. Respiratory came and took over. I knew then I would never be able to do NICU. I cried.

I work palliative now. (Onc-Palliative, actually). We become close to our "regulars" (Our sickle cellers and our patients who are there for chemo or neutropenic fever). One of our regulars was getting chemo and she had been fine one day but the next she was declining. She was helped up to the bathroom, where she proceeded to pass out due to blood loss. She had a massive lower GI bleed. We were afraid she wouldn't make it to the unit. He Hgb dropped to 3.8 She survived. I will NEVER forget her face, it turned grey and down she went.

[JaxJax5423]

I had an infant , maybe 6 months that I was administering chemo to. I was crunched reading her history. In just her few short months on this world cancer was spread throughout her delicate body. I was torn up. I went in to assess and I was standing over her and she reached her little arm up and grabbed my hand and gave me the sweetest smile. I melted and I will never forget that sweet girl. That's just one of many!

[Ruby Vee, BSN]

Years ago, when I worked in CCU and my ex-husband worked on the renal transplant floor just outside the double doors of the CCU, a 30ish woman with Type I diabetes and a new renal transplant coded. She'd been talking to the nurse and said she "just didn't feel right." The nurse went to take her blood pressure and couldn't find one. The code was called, very good CPR was initiated and I as the designated "Code Nurse" for the day ran to the code.

With CPR, the patient was awake and attempting to communicate with us. I remember her mouthing "Get my husband" around her ETT. She had a rhythm on the monitor, but without CPR she rapidly lost consciousness. We called it "EMD" in those days. Electro-mechanical dissociation. Now we call it PEA.

The husband was home with the kids, and my ex called him to come in. I remember he was about an hour away. We rotated off CPR for that hour, while we discussed what to do. No one had any ideas. She was awake and communicating while we were doing CPR but immediately lost consciousness if we stopped. I wanted to give Valium, but the patient mouthed "No. Please. I want to be awake when my husband gets here." So we continued CPR until he got there. I will never forget crying while I did compressions, and taking turns holding her hand and speaking softly to her when I wasn't doing compressions. And as we did CPR, the wife told her husband that she loved him, he should tell the kids how much she loved them, and she was "going to Jesus now."

It turned out that she'd had a global infarct. She'd been getting demerol for "incisional pain", but no chest pain was noted -- probably because she was diabetic. Over 30 years later, I'm still getting chills when I think about it.

[Here.I.Stand, BSN, RN]

Weird, I typed a reply to this yesterday a.m. and don't see it...I must not have hit "post." Thank you all for sharing. FlyingScot...thank you...the other day I yelled at my 8 yr old before dropping her at gymnastics. I don't even remember what I was angry about. I work in trauma too (ICU), and see all the time how physics can destroy life... but I became angry and behaved badly to her before saying goodbye. Almost as soon as she was inside, I began to cry, thinking what if something happens to her or me during the next four hours? This would be the last memory either of us would have of the other. Your story was a much-needed reminder to never say good-bye angry. NOADLS...that was some ingenious comic relief!!

Anyway, on to that post that I didn't make this morning. The big one that stands out for me was a 20-something woman who'd OD'd on Percocet. She had essentially an emergent liver transplant (she'd gone from healthy to liver recipient within a week or two, can't remember exactly) and had been on CRRT. However, all signs were pointing to some pretty severe cerebral edema despite all of our efforts, and prognosis was poor. I had left the floor to pump for my baby, and came back to the room; I still had my breastpump over my shoulder because staff would use the unsightly cabinet space under the sink to put our things in. The chief neurosurg resident was in the room with this woman's dad, and before I was even able to gather what was being said, her father whirled around and threw himself sobbing into my arms. The resident who had been facing me mouthed the words "brain dead." After the resident left, the first thing this poor man said was, "What am I going to tell her little girl?" She was the single mom of an elementary aged daughter.

Pre-op organ donors can be heartwrenching. We had one mom of an 18 y/o son request the staff sing his babyhood lullaby on the way to the OR.