The things you never forget...

[nerdtonurse?]

There are things I've seen that I know I'll never forget. Anyone else want to share?

• The first time I had my steth on someone and listened to their heart stop
  
• The first time I looked at a CT report and realized my patient had advanced and probably terminal cancer...and they didn't know it yet.
  
• Calling a family trying to get an authorization for surgery on an elderly alzheimer's pt, and having the grown child say the patient had been physically and sexually abusive as to them children, and they refused to authorize it, saying they hoped he died...and the other 3 kids (in their 40's) I called all said the same thing.
  
• Maggots
  
• Having to code someone with a living will stating no code blue, but the doctor wimped out on the DNR order because the family couldn't agree

[Cindy_A]

I used to work in a small rural hospital. A 3 year old boy was brought in because he had passed out at home while playing with his brother. Despite their best efforts, the little boy didn't make it. The parents were beside themselves with grief.

Seeing that perfect little boy lying there dead was so sad.......

[casi, ASN, RN]

Not a nurse yet, but a few things that stick with me as a CNA

The first patient I had stop breathing in my arms.

A father hugging me and sobbing after his daughter who was my age died.

On the happy note,

A dementia patient thank me for being his "watching angel"

[Babs0512]

I'll never forget the man having an active MI, ST elevation and all, in the process of a divorce, refusing retavace. Stated to me "I want to die, I have the right to refuse treatment." the "I want to die" part in a 38 y/o man was the part I had trouble with. So talked it over with the doc, and we agreed on a psyc eval done. Evaluation said "He's in his right mind - we have to let him go". We educated him on the fact that he will probably return to us DEAD, but he wanted to leave. Signed AMA paperwork. His estranged wife talked him into coming back a few hours later. He said "I want the clot busting meds now" Told him too much time had gone by, no active ST elevation, damage has been done. We admitted him and put him on Heparin and Ntg gtt. I thought, he went about it the wrong way, getting his estranged wife's attention.

I also remember the teenage who OD on Klonopin, ASA, Paxil. Was stuporus when she arrived and difficult to keep awake. I said "What were you thinking!" She said "My parents wouldn't let me go to this party, so I thought I would show them!" I said "My son killed himself last year - YOU HAVE NO IDEA WHAT THIS DOES TO A FAMILY!" It's something your parents will NEVER get over - is it worth that over a PARTY????" She started crying and said "No....I guess not". So I gave her some Charcol to drink, she refused, I said, "we can do this the easy way, by you just drinking this down, or the hard way, I stick a tube up your nose and into your stomach. What's it gonna be? She looked at me and said, "If you take a swig, I'll drink it!" Without thinking I took a swig, smiled my black teeth smile and handed it to her. She said "Wow", but she drank it down. My co-worker said "I can't believe you did that, that was great" - I said "I didn't think about it, DON'T tell infection controll!!!" We both laughed. Truthfully, it didn't taste that bad, it was really sweet.

Never had a lick of trouble from her after that, she trusted me.

We had a young girl, in her 20's, come running in to the ER one day, carrying a blanket wrapped bundle, screaming "help my baby, I think he's dying" Three of us ran over, I picked up the bundle, it was a dog. This was a weekend, no management around, the girl, obviously distraught, kept screaming for us to do something. We took her and the "baby" into a room and shut the door. As we did so, the puppy took it's last breath. The puppy also soiled the blanket, it had been hit by a car. So we wrapped it in a new blanket and gave it to the girl, who's boyfriend had arrived by this time. She cried and cried, has us crying. All we could think about was management or infection control finding out. So we made a pack to deny everything. One of the three of us stayed with this girl cradeling her puppy, until her parents arrived. We had to ask them to leave through the ambulance bay as it would look strange walking and crying through the waiting room with a "baby" in it's mothers arms, and the mother crying inconsolubly. We never knew how our manager found out, but Monday morning one at a time, all three of us were called into his office seperately, asking if we had a dog in here over the weekend. We all denied it. So he dropped it.

About a month later, a thank you card comes to the ER "Thanking" us for taking care of "Jane" and her deceased dog - and a photo of "Jane" with her new puppy. Our manager and infection control came down and showed us the card, and we all played "dumb". They let it go.

:chuckle

[OregonGal]

It was humbling to say the least. Here before me was the control center for the most complex 'machine' on earth. I was gazing upon the organ that allowed this man to laugh, cry, love, speak, breath, etc .....It just reinforced for me the magnificent beings that we all are and that we are incredibly resilient yet fragile at the same time.

Well said, and what an honor.

[robinbird]

Our tele tech was watching the monitors. She announced on the overhead system, "check [Room 415] now!"

I ran by the monitor bank on the way to the room and yelled, "What do we have?"

"V-fib!" She yelled back.

Someone else was pulling the crash cart to the room. We yanked the board off the cart, rolled the patient put the the board under him and the zoll patches on his back and front, ready to defibrillate. We confirmed, no pulse, v-fib. Then another nurse began CPR, did two compressions and the patient opened his eyes and said, "Hey, what are you doing?"

The nurse stopped and looked at the patient and the patient looked back at him. The nurse said, "You didn't have a heart beat, and apparantly now you do." :heartbeat

10 minutes later the patient was sitting up in bed talking as if nothing happened. Will neve forget it.

[Indy, LPN, LVN]

I don't forget the songs that somehow wound up being associated with several of my now deceased patients. Unfortunately that trend can't continue or I'll be 90 and unable to listen to music without bawling.

The look of a freshly deceased (especially if unexpected) person's face, before they have the chance to relax and look peaceful.

For code blues, there's always a moment, even if it's only two seconds long, when I open the cart and my hands shake, and that little thrill of sheer terror runs through me. Every time.

I'll never forget the first palliative care patient I had, who died of a broken back and the frequent flyer CHF'er with the PITA family who (along with her sister) spent the whole night trying to cheer me up. I still don't have a clue how not to be sad with palliative care patients.

My first postop on a vent, my gosh that was a busy night.

The first case of DIC I ever saw. I didn't know how bad it could be until I had to run that race.

Telling the LOL with the huge glasses on, in response to the all-night repeated question, "am I going to be okay?!" that "no hon, you're dying." It was scary to say but she ultimately benefited from the honesty and had a good, dignified end at her family's home. Now when people ask me if I'm sure they're going to live, I can say "I'd tell you if you weren't" and mean it, 'cause I didn't chicken out.

Before I was a nurse, a coworker died unexpectedly one morning at her home, and there was some drama between her daughter and her mother to the extent that the daughter called me at work to tell me the news, but didn't call her own grandmother. So I wound up being the goofus who answered the phone when the deceased's mom called me to find out what in blazes was going on. No one should have to find out that their only daughter passed away on the phone, with no one there to comfort her.

The look of that one patient that I'm still convinced is posessed by the devil, whenever he gets agitated. There is just no adequate way to describe the look in his eyes.

/ramble mode off...

[2shihtzus]

Indy.....you really told that pt "no hon, you're dying"??????

[ONCRN84]

I remember almost all of my inpatient hospice deaths.

The husband who cornered me at the end of the hallway and asked if he could take off his wife's O2 because they knew it was the only thing keeping her alive and she'd never wake up and it wasn't what she wanted. All of this through heart wrenching tears.

The 19 year old daughter of our spanish only speaking AML patient who had been with us for a long time, collapsing in my arms when she found out her mom refused the last ditch effort chemo and was going to go home to die. She weeped in my arms for 15 minutes in the middle of the hallway, and all I did was hold her and let her snot on my scrubs. I'd been a nurse on my own for 2 months. (this was the hardest one I've had in my short career).

My very first hospice death where the wife in the wheel chair wouldn't leave the husband's bedside. After he died, she called me down to her level, gave me a hug, cried, and winked at me. She didn't have to say a word, I knew what she meant.

The morning one of our "favorite" AML patients came into the ER having a massive MI and probable CVA. They were going to transfer him to the floor to die and as the day shift nurse was getting report, the ER nurse said "he's having an MI as I speak... nevermind. we're not bringing him up, he'll die in transit" so we all filed down to say goodbye. He died 10 minutes later.

My most recent one where my totally alert and oriented end stage lung CA patient decided to take off his bipap. Respiratory therapy told him that if he took it off, he would die. He said he understood. After I argued with him about waiting for his kids, I made him sit down, put it back on, and promise me he'd wait until his kids got there to say goodbye. He cried, I cried, and he agreed. I gave him some Ativan to calm him until his son got there. He woke up, saw his son, took off his bipap, and cried. He died an hour later.

Finding out one of our regulars committed suicide at home because they told him he was terminal and he wanted to go out on his own terms.

My sister's best friend who died from breast cancer on my floor. She was 33.

I could really go on and on with my horrible stories. I'm burned out on death and dying and cancer. I KNOW in my heart I have helped so many people and their families through this time, but I also know that my heart can't keep doing this. I'm interviewing for a public health nurse position in maternal child health.

[Nurseboy1]

I will never forget one of the worst varicel bleeds of my career. We struggled to intubate him around the bleeding, and contain his blood loss with an EGD and when that failed a minnesota tube, we had at least 5 nurses, 2 residents, 1 fellow, 2 RTs, and 2 anesthesologists along with the GI team. We worked on this man for 3 hrs. I ran the level one infuser to keep up with his blood losses. I gave that man 50 units of PRBCs, FFP and platelets. We transported to VIR to stop the bleeding but failed. We were sure he would die and told his wife. Overnight, however, the bleeding stopped and he slowly stabilized, we extubated him A&Ox3. He did survive to transplant.

[Burnt Out, ASN, RN]

I will never forget the 12 week gestation and 16 week gestation babies that I saw that died way before their time. So tiny and yet so perfect.

[Dalzac, LPN, LVN, RN]

I have 30 yrs of stuff. I think the most memorial one was my first code. It was the first time I had ever seen someone die . I even remember her name. And then the chf'er that lived a block away from the hospital and would try to walk the block and callapse half way there. I remember her name too. Now I do medical detox and am in recovery myself. I love it when I see past patients at meetings and doing the steps and staying clean. and I always remember their name.

[tvccrn, ASN, RN]

The time that I was on orientation in PICU and we got called down for a pediatric trauma. The boy was not wearing his seatbelt because the belt had been malfunctioning and wouldn't stay latched. Head-on into the tree and his mother had to be restrained at the scene. Turns out she was a first responder and answered the call, but they wouldn't let her near so she knew it had to be one of her kids.

In the ER, there was posturing and no other responses. CT showed herniation into the brainstem. Mom wanted everything possible done.

We get him up to the PICU and arrange all the tubes so teh family can be at the bedside. At 9 PM Mom asks if she can climb into bed with him, saying "I know he's gone. I knew it down in ER, but I need one more night with him."

We made room in the bed for her and she was there all night long. We worked around her, but she never once slept. Just laid there all night talking to him softly and running her hand through his hair.

At 10 the next morning, the family made the decision to withdraw care and he passed away at 10:10.

2 weeks later, my preceptor and I got a letter thanking us for giving her that last night with her "little boy".

Please forgive any mistakes, as I am in tears as I type this.