From the earliest days of nursing school, when we were taught never to become "too involved" with our patients, we nurses find ourselves balancing precariously on the gossamer thread that separates caring for people and caring about them.
OK, so I'm a little jaded after having been a med/surg nurse for awhile and seen a lot of noncompliant medical patients, addicts and alcoholics returning for their umpteenth detox, and the usual assortment of frail, sickly, demented elderly patients whose families won't give up no matter how poor their loved one's quality of life.
And then there are patients like this one.
Twenty-nine-year-old female with four children, a husband who just got deported to Mexico, and an advanced case of cervical cancer with distant metastases to the bones, liver, pelvic organs, stomach, and now possibly the brain. She is hospitalized now for acute renal failure with a BUN in the 200s and creatinine nearing 20. She is still a full code, but in her few lucid moments she must know that her prognosis is terminal; all the operative options have been done, and she's had all the radiation and chemo her failing organs can handle. Essentially she is out of options and has a month to live if she can get dialysis, but only a few days if not.
She lies in bed with her eyes closed, the butterfly-yellow prayer shawl given her by the parish nurse spread over her wasted flesh. She does not complaining about pain or anything else. She also does not eat, drink, get up and walk around, or ask for anything. Her mother, who is my age or a couple of years older, is in almost constant attendance while her children, who range in age from 1 1/2 to 10, play on the other bed and dance around the room, seemingly oblivious to the fact that she is leaving them very soon, no matter what anyone does to try to save her. They do not know that even our strongest weapons are powerless against the enemy, that the battle was lost long before it began in earnest.
This suffering soul is the patient who gets to me, the one whose silent anguish makes me feel petty for ever thinking I was in pain or going through hard times. She has so many things to think about, so many decisions to make, and so little time. Why can't her husband be here, the one who should make her last days a little easier and give their children a stable home when she takes her final journey? Why must these children be split up at a time when they need each other the most---the two eldest to their grandmother's, while the two youngest must go to foster care? And why, oh why, is this girl dying in a hospital bed when she should be raising her babies, finding out what she wants from life, and looking forward to the future with eyes undimmed by pain?
This is the patient who will haunt my dreams, tonight and for nights to come. There should be answers for her. I am outraged because there are none. And as I work with her, I scream silently at the unfairness of it all.
This is the patient who breaks my heart. Who is yours?
TY Deb. I was trying to tell my husband about this last night.....the dear man hasn't a clue as to how these things kill your soul, but he listened and sympathized. What he can't do---what NO ONE who isn't in the medical field can do---is empathize, which is why I come here..........I'm the only member of my family in this field, and there is no other outlet for the expression of emotions that have no place else to go. Thank God for allnurses!
I totally agree. Folks in the "outside world" don't want to know what actually happens in the hospital and definately don't want to know any details.
My hardest patient that still haunts me after 15 years: Diabetic in kidney failure and was semi comatose at time of admission. Pt. developed gangrene and the family insisted that she have bilateral leg amputation. The family contintued to insists that pt. continue with her dialysis, even though she was end stage renal failure. Pt. coded several times during the dialysis treatments and family insisted on a full code being performed on the pt. They wanted "everything done".
Finally, after 3 days of full codes, the attending dr. decided to do a "slow code", when she went into full arrest. The pt. was allowed to have a very pain free death.
I had a nine month old baby that was a shaken baby with bilat broken femurs. she was in a pentobarb coma. Her head injury was improving but she developed severe ARDS. We could do nothing for her. Even the police said that this particular family would probably responded to intervention(MRDD mom, overwhelmed dad). They brought the dad in in cuffs and he was crying uncontrollably(he was the accused abuser) to see her before she died. I placed her in grandpa's arms and the baby died. It was devastating. The family even left me a stuffed animal that was left in her bed, still have it.
The second was an 8 month old SIDS baby. I remember that the docs thought she was braindead. She had been stable when the family left but as soon as the family had come back from rounding up the rest of the family, her heart dropped to the 80s and as soon as the family said goodbye, she died.
It's been almost ten years since I cared for these infants, and they still get to me.
i had a nine month old baby that was a shaken baby with bilat broken femurs. she was in a pentobarb coma. Her head injury was improving but she developed severe ARDS. We could do nothing for her. Even the police said that this particular family would probably responded to intervention(MRDD mom, overwhelmed dad). They brought the dad in in cuffs and he was crying uncontrollably(he was the accused abuser) to see her before she died. I placed her in grandpa's arms and the baby died. It was devastating. The family even left me a stuffed animal that was left in her bed, still have it.
The second was an 8 month old SIDS baby. I remember that the docs thought she was braindead. She had been stable when the family left but as soon as the family had come back from rounding up the rest of the family, her heart dropped to the 80s and as soon as the family said goodbye, she died.
It's been almost ten years since I cared for these infants, and they still get to me.
As a student n LnD i see lots of pts who r just frequent fliers who come in at the drop of the hat usually with the same complaints (3rd or 4th baby w/ back pain ect.) My role is to help the pt into bed and apply fetal monitors. This on pt i will never forget. I was in the room with a tech searching for heart tones. The lady told me her due date which made her 38 weeks and a few days(basically full term). As we talked with her(while still search for heart tones) she told us she had not felt the baby move in 3 days. The tech and i looked at each other and decided to go out of the room to the nurses station to get the nurse who was already at the door. We told here there were no heart tones. Long story short at time for me to leave for the day they told her the baby was gone. I can still remember hearing her scream and cry. This was her first pregnancy and she taught the baby was running out of room and thats why it was not moving as much. I felt sooooo horrible that day. i cried all the way home.
I am single and have never been pregnant. I can only imagine how a woman must worry as she goes through her pregnancy not knowing what may go wrong. I now feel that I would worry my self to death if i ever become pregnant :redbeathe
OK, so I'm a little jaded after having been a med/surg nurse for awhile and seen a lot of noncompliant medical patients, addicts and alcoholics returning for their umpteenth detox, and the usual assortment of frail, sickly, demented elderly patients whose families won't give up no matter how poor their loved one's quality of life.
And then there are patients like this one.
Twenty-nine-year-old female with four children, a husband who just got deported to Mexico, and an advanced case of cervical cancer with distant metastases to the bones, liver, pelvic organs, stomach, and now possibly the brain. She is hospitalized now for acute renal failure with a BUN in the 200s and creatinine nearing 20. She is still a full code, but in her few lucid moments she must know that her prognosis is terminal; all the operative options have been done, and she's had all the radiation and chemo her failing organs can handle. Essentially she is out of options and has a month to live if she can get dialysis, but only a few days if not.
She lies in bed with her eyes closed, the butterfly-yellow prayer shawl given her by the parish nurse spread over her wasted flesh. She does not complaining about pain or anything else. She also does not eat, drink, get up and walk around, or ask for anything. Her mother, who is my age or a couple of years older, is in almost constant attendance while her children, who range in age from 1 1/2 to 10, play on the other bed and dance around the room, seemingly oblivious to the fact that she is leaving them very soon, no matter what anyone does to try to save her. They do not know that even our strongest weapons are powerless against the enemy, that the battle was lost long before it began in earnest.
This suffering soul is the patient who gets to me, the one whose silent anguish makes me feel petty for ever thinking I was in pain or going through hard times. She has so many things to think about, so many decisions to make, and so little time. Why can't her husband be here, the one who should make her last days a little easier and give their children a stable home when she takes her final journey? Why must these children be split up at a time when they need each other the most---the two eldest to their grandmother's, while the two youngest must go to foster care? And why, oh why, is this girl dying in a hospital bed when she should be raising her babies, finding out what she wants from life, and looking forward to the future with eyes undimmed by pain?
This is the patient who will haunt my dreams, tonight and for nights to come. There should be answers for her. I am outraged because there are none. And as I work with her, I scream silently at the unfairness of it all. :stone
This is the patient who breaks my heart. Who is yours?
Thank you for that. You said it subliminaly in your post...just let us (me and u and all of us) recognize how blessed, lucky we are. Let us work with integrity and do everything we can has nurses. Aren't we blessed to have a career that opens our eyes/mind/soul..... I wish to her a peaceful eternity...
Marla, I have several patients who I will never forget. First, I'm so sorry that this is happening to this young mother, and I'm so glad you're there for her and her family at this tragic time.
My heartbreaking story didn't happen while a was a nurse or even in a hospital, yet it has had the most profound impact on my practice: I cannot be an effective nurse to children.
I'm even finding it difficult to write about, so I'll be brief.
[Edited. I'm sorry. I read it over again, and I decided to delete it. It's over 20 years, but it still makes me cry to think about it.]
What he can't do---what NO ONE who isn't in the medical field can do---is empathize, which is why I come here..........I'm the only member of my family in this field, and there is no other outlet for the expression of emotions that have no place else to go. Thank God for allnurses!
Amen to that! So many heartbreaking stories. And we still stay in the profession. God bless all nurses.
Mine would be from last night. The toddler whose skull was crushed on every single side in a car crash - drunk driver rear ended mom and dad's car. The toddler was properly restrained in a car seat. They were just hit that hard.
Specializes in LTC, assisted living, med-surg, psych.
ERNurse752 said:
Mine would be from last night. The toddler whose skull was crushed on every single side in a car crash - drunk driver rear ended mom and dad's car. The toddler was properly restrained in a car seat. They were just hit that hard.
? That makes my heart hurt.........I am so sorry you had to see that. I'm sorry for ANYONE who has to see something like that.........I'd have nightmares for the rest of my life. Which is why I don't do L&D, peds, or ER---I can't deal with the kids.
Long ago, I lost my second child seven hours after birth (she was anencephalic), and ever since then I've been unable even to hear or read about child abuse, SIDS, accidents, drownings, or any other sort of tragedy involving children without getting literally sick to my stomach. I love my own, including my grandson, with every last fiber of my being, and I've always feared that if something were to happen to one of them, I wouldn't be able to take it. It's my weak spot......sometimes I think they are all alive and well mainly because God knows I couldn't handle another loss like that. I pray I never have to find out whether I can or not.
These stories all bring tears to my eyes. It's just not fair. As long as I live, I will never forget the baby that was brought into the ER when I worked in admitting that was blue and stiff. The mom's wails still make me shiver thinking about it, and it's been almost 10 years ago.
The most recent one was a mom, same age as me, with a little girl who was 4. She'd had a congenital heart defect repaired as a child. She was in liver failure, being worked up for a transplant, when they discovered she had severe right sided failure (which, of course, caused her liver failure from portal HTN) and had a triple valve replacement/repair. Went into renal failure, respiratory failure, was finally getting well enough to go to rehab and was transferred to the rehab facility at our hospital. Didn't even get her admission paper work done and she was in bad enough shape that she had to come over to the acute side for mechanical ventilation. Never got well enough to get worked up for the liver transplant. I'd been off work for a week and saw her obitutary in the paper. I couldn't stop crying.
I've cried a river over the years, too, including 2 nights ago. I love NICU, but it's so very hard when we lose a baby, particularly having a mother there sobbing and wailing. My most memorable one I took care of over a week-end of three 12 hour shifts. I went home crying everyday because we were only prolonging the baby's death. I was sobbing in the car on the interstate and literally had an open vision of Jesus holding the baby. I realized we do what we can. Doctors may play God, but ultimately they aren't.
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Neilsbiggestfan
19 Posts
43 yr. old male in LTC who had been paralyzed since 19 from a car wreck. He died from a seizure not long ago. Never got to live his life.