The Transience of Life

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    Life is short lived...transient...fleeting. Embrace it and move on.

    In the 19 years that I was active as a volunteer EMS member of my local fire department (2 years NREMT-Basic + 17 years NREMT-Paramedic), I was often amazed at the difference between a "scene" on the day of getting a call, versus the same location a day or two later.

    I'd pull up on a horrific motor vehicle into tree...partial rollover...pinned screaming pt. You work to stabilize/extricate/transport the victim of the crash. Do the paperwork, and move on. Same with a shooting....stabilize, transport, "wash down" the ground to clean away the blood.....and move on.

    A day or two later, I'd be on my way home from work, and might drive by the same location. Sun shining, pretty green grass. Maybe a scrape on the bark of the tree, a little shattered glass or a discarded rubber glove on the ground, but nothing else to indicate that this is the location where a human life ended or was forever changed. Just another spot of ground...nothing more.

    Now, as an ICU nurse, I sometimes experience the same dichotomy ("here" vs "not-here"). A couple days ago, I was taking care of an elderly pt with a dissecting/ruptured AAA. While in the OR, the pt received 16 units of packed red blood cells, 18 units of platelets, 8 units of FFP, 6 liters of fluid, and 4 liters of fluid from the intraoperative "cell saver".

    Upon arrival to our ICU, the surgeon was very straightforward with the pt's family....the pt was not likely to survive.

    Over the next couple days, the pt ended up getting multiple units of PRBC and platelets, along with liters and liters of fluid (plus pressors and hemostatic agents). The pt's family (spouse and children) hoped for the best, while the medical staff could see (from blood work) that multiple organ systems were failing.

    The pt's family ended up withdrawing care....finally...after multiple "talks."

    The pt's body was still in the room yesterday (awaiting transport to our hospital morgue) when I came into work. The body was eventually removed, leaving an empty room.

    And the room remains....a bare, sterile room in our ICU. Ready for the next patient. The only sign of the deceased is the family contact information written on the dry-erase board.

    As with scraped tree bark, the family contact information is the only (short lived) sign of yet another human having passed from this world to the next. Wipe it off with a paper towel....set up the room for the next patient.

    Transient...Here vs not here.
    Last edit by Joe V on Jan 9, '15
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    About CrufflerJJ

    Joined: Sep '06; Posts: 1,643; Likes: 1,905
    RN - ICU; from US
    Specialty: 5 year(s) of experience in ICU

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  3. by   TheCommuter
    Thank you for writing this!
  4. by   CrufflerJJ
    Quote from TheCommuter
    Thank you for writing this!
    You're quite welcome!
  5. by   sueall
    Yes, thank you. An exceptionally well-written and thought-provoking post.
  6. by   VivaLasViejas
    Well-written and straight from the heart. Thank you!
  7. by   5thflrnrse
    Excellent! Really enjoyed this.
  8. by   aboucherrn
    I sometimes use the metaphor "assembly line", but you explained it much more eloquently. Great post!
  9. by   SE_BSN_RN
    All I have to say
  10. by   NutmeggeRN
    So true....
  11. by   Multicollinearity
    Well-written. I've thought similar thoughts when walking past where a patient died. Life going on as normal, but in my mind I'm back with the deceased patient, in another time.
  12. by   TopazLover
    Thank you for this well written piece.

    As a family member whose loved one was one became "not here" I really appreciated those nurses who fought for his life against all odds. They were there for him and for me. I hope that after I left he became a "not here"so they could do it over again. It is a talent and a gift to be able to let go of patients quickly.
  13. by   StrwbryblndRN
    Well written and thank you.
    I have thought this many times before.
    I like the way aknottedyarn put it.
    To repeat the process over and over is a talent. To be "not here" allows us to put
    the past aside and move on to next one pt who needs help.
  14. by   radicalsenseofhope
    What a lovely piece of writing. Well done. Very moving. My grandpa spent his last days on earth in an ICU after a heart attack. I was in my early 20s. Watching the nurses care for him was amazing. They treated him with so much respect and compassion. It was actually one of the first moments where I thought I might want to become a nurse. Thank you for being an ICU nurse and for all that you do. Also thank you for your time in emergency services. My husband is a paramedic. I know all too well how tough a job that is.