I had a special rotation day in the ICU yesterday. Started at 1400. The first patient I saw was DNR/DNI w/ Aids and pneumocystis carinii pneumonia. He was on 100% 02 trach and his sat's were in the 50's. By 1530 his sat's weren't registering and the nurse knew time was near. He had no family w/ him( we called them @ 1400and told them to come in as the end was near but no one came) so we sat with him. He started Cheyene-Stokes and that only lasted about 10 minutes...and he passed. He passed looking right at me. I just told him it was OK to go now- I didn't know what else to say.
At 1615 another patient coded that was DNR/DNI. He had ARDS. All we could do was sit with him again.
. Again, no family/friends. His death was a lot more painful to watch. I think also because the other patient had JUST passed- it was like I was in a nightmare trance.
At 1720 my instructor found out that I had been w/ 2 deaths and so she pulled me to follow respiratory therapy ( this is Med/Surg 1 rotation). As soon as I was with RT- we got an ER call for an emergency intubation. The patient was only in his 30's but had fallen 6 stories. They didn't allow me in the room but I was right outside and things didn't turn out. They worked on him for 40 minutes. I went to the waiting room and sat w/ his wife.
After that my instructor pulled me back to our floor ( ortho) and told me I could go home if I wanted to because it had been such a traumatic day. I told her I would stay but I guess she decided it was best for me to leave because about 10 minutes later she came back and said no I really think you should go home. You have a lot to digest.
I came home and I think I was in shock because I wasn't feeling *anything*. I thought I would be crying or something but I wasn't. I was OK all night but had a horrible nightmare that I kept trying to save people and couldn't. Then that turned into a patient who coded and they called it- but as I was doing postmortem care she came back to life and I was screaming that I could have saved the others if they had let me stay.
Woke up in TEARS.
I talked to my instructor today- she said it gets easier. She said she has never had a student witness a death in her 3 yrs. teaching- let alone 3 in one day. She told me I handled it well - I guess I did. I don't know. It's hard to shake the feeling that there was nothing I could DO.