What patient/patients have left the biggest impression on you re: just being so sadly unfair? Probably lots of them, but just thought it might be interesting... :)
One of mine was an 8 y/o kid who had been w/her family in the military. She had had flu-like symptoms, and was taken to the doc. He said yeah- flu...keep an eye on her, rest, etc. The kid got worse. Then unresponsive. The family took her to the ER on base, where it was found she had a blood sugar >800mg/dl. Her brain was caramelized. She never completely woke up (as of when I went to work elsewhere, about 3 months after she got to us). She could whimper and move the little finger on her right hand. A whole life gone, but still technically there. It was so sad.
There were a lot at that facility that were memorable, even 25 years later. I sometimes wonder what they would have been like if they'd never ended up with head injuries/brain damage.
I'm a NICU nurse and the thing that gets to me the most are the Cool Cap babies. The Cool Cap is a head cooling device we use if an infant qualifies for it after suffering a hypoxic event at birth. It's hard to qualify, you pretty much have to be a full term kid with a lot of problems.
It just kills me, because hours earlier, this mom was in labor, taking pictures, sucking ice chips, going about her business. Days earlier, she was packing her bag for the moment she went into labor, making sure everything was ready for the baby. She probably had her baby shower a couple weeks before the birth. She has made it through the first trimester and illness, she made it past 24 weeks and viability, she made it through everything, pretty normal. Then wham...something crazy happens during her labor or during birth and all of a sudden her kid is the most critical kid in the nursery, when hours earlier she was laughing through labor. It's just so cruel to me, because although we have seen some great outcomes with the cool cap, that isn't always the story.
I know that anything that brings a baby to the NICU is tragic. I know that preemies are delivered unexpectedly every day. I know all this, but to me the cool cap kiddos are the ones that shake me to my soul.
Mr G, a triathlete admitted for rehab post stroke. He was having a difficult time accepting the life changing events and he was angry. He wanted to get back out there and participate in the Iron Man competition according to his wife. He stands out in my mind because his spirit was not broken. I have never seen a patient work as hard at rehab as Mr. G had. The look on his face was pure determination.
At the end of his rehab, he was discharged, and the staff were so happy for him. I wheeled him out and I can still see his smiling face, whispering thank you, and waving to us. We cheered him on and wished him the best.
Two weeks later, we learned that he had passed unexpectedly. The staff was united in their grief as we remembered Mr. G. He was 48.
I've only been in healthcare for 5 years and have so many patients who have touched my heart.
1) A young 20 something with a little boy. I remember she was teaching him how to ride horses when she arrived at our hospital. Had spinal cord tumor that responded to radiation. She had hemiparesis and was so proud to be able to brush her hair with that hand and walk around with her wheelchair. The tumor dissipated but then showed up on her brainstem 3 months later. She died very quickly. I still have her email in my inbox telling me how happy she was to be home with her son getting back to a normal life...
2) Another young mom found out she had cancer after coding during child birth and ending up on ECMO...Paralyzed on one side of her body, too weak to move but loved snuggling with her baby...she died after a VERY long year back and forth at the hospital.
3) Recently had a young 40 something oncology patient on hospice in the ED for SVT. The family was realistic and just wanted to get the patient home so they wouldn't have to die in the ER. The patient had no pressure and was very much end of life in multisystem organ failure...we called an ambulance to transport back home, but ended up dying in the ER surrounded by family, with the spouse on the ground sobbing at the bedside.
oh, god, so many... the sweet 52-year old man whose whole little town donated money so he could come to us for a heart transplant, and had the heart transplant, and never got out of the icu in 7 weeks because we could never resolve his relentless rejection...
the fifteen year old with cardiomyopathy who came to us to await transplant who went into vt all the time and would scream "hit me harder! hit me harder!" so he didn't have to endure the electric shock..again and again, so we started letting him pass out first because the precordial thump wasn't as reliable...
the lovely man with an awful heart who went into vf so often, three or four times a shift, that we would station new nurses in his room with the experienced ones so everyone got a chance to use the paddles...he died when his iv antiarrhythmic gtt ran dry in the ambulance when he was being transferred to his home hospital...
the guy whose surgeon had no idea how to do his surgery and ended up brain-dead with fecal material coming out his chest tubes...finally the anesthesia department and the nurses let his surgeon run his next code, and of course she was completely unable to do it, so he died...
the orange lady, who was a boarder in the rooming house where the landlady served everyone a nice wild mushroom stew , and the only one that didn't die of fulminant liver failure (hence the orange) was the guy who wasn't home for dinner...
the orange man, who was a second case in the or and got three units of blood in the wrong type left in the warmer from the first case, and nobody checked...he came to the icu and immediately had the coca-cola urine, but not for long... he died in about a week...
the oyster guy, who aspirated an oyster on his way home from thanksgiving dinner in the car and drove off the road and killed his wife...he died a week later...
the fourteen year old athlete who was screwing around with a buddy with his buddy's dad's gun and it went off and pierced the end of his nose, looked just like a little zit, but he was an organ donor, and his coach came and stood at his bedside and cried and cried and cried...
the guy with wildly metastasized prostate cancer who "by accident" took a slug of weed killer in his garage, and died of cardiac arrhythmias two days later, but knowing his wife would have the insurance because it was an "accident" ...
the 32 year old woman who got blown off by her pcp when she complained of hematuria and it was six months before somebody scoped her... dead eight weeks later of bladder cancer, ugly death...
the sweet man whose wife talked him into getting a penile implant for sex, but he got a bad mrsa infection and died in the icu twelve weeks later and never even got to use it...
the early days of the aids epidemic, when so many of these boys never knew from one shift to the next whether the nurse would let his lover in one last time or fix him with an evil glare and say, "family only," when almost none of them had family that would ever speak to them again...and they all died on vents because we had nothing that would treat their pneumocystis pneumonia, and they knew it when they came to us...
it's a miracle we have, well, miracles to give us something better to remember when these ghosts are conjured up by a thread like this....
I was working neuro during the mid-late 80s, across the connecting hall with the pulmonary floor. We got the AIDS overflow. It was SO sad how nearly all of those guys had nobody. Family denied they even existed, and SOs were either too afraid or ashamed to show up. Those guys were there for weeks. Amphotercin adding to their misery. This was when it was still ok to smoke in hospitals and those of us who smoked would go and ask the guys if they wanted company during our breaks. They were so thankful to just have someone not judge them, and be willing to even be in the same room.
Too many sad stories about a lot of them. The guy whose wife got a transfusion during childbirth- she and the baby had already died of AIDS...he followed soon after. The guy whose doc wouldn't write the DNR (and was usually really good - must have just been fried by the deaths). We got the guy flat with the backboard, and oral airway when the charge nurse came down the hall at warp speed and said "we're done. Let him go". The family was standing there (and didn't want any coding- this was before the family had the input they do now). They were the only family I remember "being there".... I still have a wicker basket they'd sent full of candy for the nurses. Another guy came up from ICU, and we were getting him settled. His receptive language was intact, but expressive was not good. The other nurse and I had him situated with the call light, urinal, and TV remote and were leaving the room. He started yelling "oh no....oh no....oh no....", and we immediately went back in. He'd wet the bed. We got him to the chair to change the sheets, and he kept saying "I'm so bad" over and over. The other nurse and I did what we could to tell him we understood he did the best he could- he didn't have time, etc. I still tear up over that one. :heartbeat
In adolescent psych...the saddest situation (and there were several contenders) was timing contractions on a 12 y/o. It was her dad's baby. Her nurse was dealing with the transfer to the medical hospital, so I sat with the kid, trying to get her to just nod when the contractions started so I would have an idea of what was going on. I finally got her to look up and nod when she felt something. The "good" in this is that the siblings (girls) were removed from the home, and the dad charged (don't know what happened to him).
Some kids didn't want to leave (this was also back when we kept them for months- WAY different insurance set ups). They were treated well, and came to trust the staff, who were wonderful to work with. We got as many as possible sent to residential treatment to keep them from going back home. :heartbeat
thats a tough one. Had he been one more year older he would have been able to make his own decision.
A bit off topic....how is it a female can decide to get BC or an abortion without parental knowledge or consent, but this boy could not decide to save his own life??????
For me....a 90 yo LOL. Sweet, and would always say, "don't bother" or "I don't want to trouble you". I would always tell her that she was the reason we were here! Even when I didn't work her hall, I would stop in for a short chat.
Her situation killed me....she was so sweet, A&O (unlike most of our residents), yet she couldn't move her limbs any more and it was painful when someone else moved them. Her skin was falling off and she was always being treated for a new wound somewhere on her body. This poor woman was less than 100 lbs and all she could do was wait to die.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
oh, god, so many... the sweet 52-year old man whose whole little town donated money so he could come to us for a heart transplant, and had the heart transplant, and never got out of the icu in 7 weeks because we could never resolve his relentless rejection...
the fifteen year old with cardiomyopathy who came to us to await transplant who went into vt all the time and would scream "hit me harder! hit me harder!" so he didn't have to endure the electric shock..again and again, so we started letting him pass out first because the precordial thump wasn't as reliable...
the lovely man with an awful heart who went into vf so often, three or four times a shift, that we would station new nurses in his room with the experienced ones so everyone got a chance to use the paddles...he died when his iv antiarrhythmic gtt ran dry in the ambulance when he was being transferred to his home hospital...
the guy whose surgeon had no idea how to do his surgery and ended up brain-dead with fecal material coming out his chest tubes...finally the anesthesia department and the nurses let his surgeon run his next code, and of course she was completely unable to do it, so he died...
the orange lady, who was a boarder in the rooming house where the landlady served everyone a nice wild mushroom stew , and the only one that didn't die of fulminant liver failure (hence the orange) was the guy who wasn't home for dinner...
the orange man, who was a second case in the or and got three units of blood in the wrong type left in the warmer from the first case, and nobody checked...he came to the icu and immediately had the coca-cola urine, but not for long... he died in about a week...
the oyster guy, who aspirated an oyster on his way home from thanksgiving dinner in the car and drove off the road and killed his wife...he died a week later...
the fourteen year old athlete who was screwing around with a buddy with his buddy's dad's gun and it went off and pierced the end of his nose, looked just like a little zit, but he was an organ donor, and his coach came and stood at his bedside and cried and cried and cried...
the guy with wildly metastasized prostate cancer who "by accident" took a slug of weed killer in his garage, and died of cardiac arrhythmias two days later, but knowing his wife would have the insurance because it was an "accident" ...
the 32 year old woman who got blown off by her pcp when she complained of hematuria and it was six months before somebody scoped her... dead eight weeks later of bladder cancer, ugly death...
the sweet man whose wife talked him into getting a penile implant for sex, but he got a bad mrsa infection and died in the icu twelve weeks later and never even got to use it...
the early days of the aids epidemic, when so many of these boys never knew from one shift to the next whether the nurse would let his lover in one last time or fix him with an evil glare and say, "family only," when almost none of them had family that would ever speak to them again...and they all died on vents because we had nothing that would treat their pneumocystis pneumonia, and they knew it when they came to us...
it's a miracle we have, well, miracles to give us something better to remember when these ghosts are conjured up by a thread like this....
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
GrnTea.....you, like me have seen much.
I remember a little boy at a birthday party eating marshmallows. Someone slapped him on the back and he aspirated them.....by the time he arrived to the hospital he was gone. The marshmallow turned into a thick tenacious plug that could not be suctioned in time. My children were almost teenagers before they were allowed to have marshmallows.
I remember seeing a dear friend and co-workers running up the ED sally-port covered in blood with her grand-baby in her arms....he stood up under a table saw.
I remember a set of twins, the most beautiful children I have ever seen. Curly silken hair a golden shade of red with the clearest blue eyes......and the sorrow in the families eyes when we could not resuscitate one who punctured his heart running in the kitchen with his brother fell onto a knife in the dishwasher as their mother was yelling for them to knock it off.
The ligature marks on an 8 month old baby girl left alone in her playpen so her parents could go to the bar downstairs and tie one on........the one and only time I ever touched a family member in anger........
The anger and hate of a mother I refused to allow to see her son, under some pretext it was a coroners case(lie).....who had been incinerated and turned into a piece of petrified charcoal when he struck the side of a van on a motorcycle at a high rate of speed still crouched in the position he was in when he struck the van knees bent hand pulled back in an open throttle position. She never did see him, she decided later not to see him on her families advice......but she never forgave me.
Realizing my own mortality when I was armed robbed for narcotics at an inner city ED.
I remember answering a code of a primip.....amniotic fluid embolism. Coding her through her c-section. Her subsequent 92 units of blood and blood products as she DIC'd. Of her opening her eyes several hours later when she mouthed the words "Where's my baby" and that christmas when she returned to show off her new arrival..:heartbeat
The 41 yr old wife and mother to 2 beautiful teenaged daughters who ended up with more than planned after an exp lap. She ended up having a total colectomy w/colostomy, TAH/BSO, splenectomy, and partial lobectomy. She had been going to her PCP for the past year and he had poo-pooed all her symptoms off. What was surprising was the surgeon who was near tears himself as he talked with us nurses at the station after the pt had been brought to us from PACU. His question was "how do I tell my pt now that after all this surgery I've just done you will have less than 6 months to live"?
I've taken care of hundreds of pancreatic cancer pts who look so great when they're discharged after their Whipple only to know that most likely they'll be back in the hospital soon or pass within the year.
Another sad one was my own nephew who had osteosarcoma and his dx wasn't found soon enough because he wasn't taken seriously. He had such a bright future ahead of him but spent his teenage years in the hospital on chemo, surgery, and soon after dealing with the lung metastases which he succombed to at 21 yrs.
wow....after the last few months of wondering what exactly i'm still doing in nursing- this makes me remember....
remember being an aide and sitting at the side of a 60 something y/o lady with end stage metastatic ovarian cancer...she was such a sweet lady...she never wanted to bother any of us...one day i asked her if she needed anything..she asked if i had just a minute..."of course i do"....and i sat and listened as she poured her soul out to me and told me this was god's punishment to her...i told her our god is not the punishing type...she said- "yes, and i deserve this...when i was young and smart and had all the answers..the government came to me and offered me a job- i worked on the bombs that were dropped on japan and killed all those innocent people....now god is punishing me for my part in it"......i will never forget her...she died 2 days later.
the 2 y/o boy that came to our icu after a mva...looked like a perfect sleeping angel- except the top of his head that was missing from the telephone pole that fell on top of the car....his mother donated his organs and saved the lives of 7 other children....i went home and held my children for a very long time that night.
there are so many....
one i will never forget is the man that came in as a code ice after having a huge mi at home on christmas eve...the family was a jerry springer episode and kept arguing over what to do- the wife and girlfriend knew about one another- but because he was still married- the wife made all the decisions.......he lived..barely...we sent him to a long term vent hospital...i think he finally passed 4 weeks later....
a light in all this was a gentleman in his mid 60's that came to the er complaining of abd pain..they sent him home with an enema and go- lightly and told him to see his md in the morning..the next morning- the wife found him in the fetal position on the bathroom floor with a temp of 105...perfed his bowel...came to us- had him on 9 gtt's, vented, wound vac x 3, tons of blood, crrt, you name it- he got it....after 5 weeks in the icu....he woke up and mouthed to me..."where am i?"...the best day ever was the day he walked back in that door- gave me a hug and thanked me for saving his life....
Her nurse was dealing with the transfer to the medical hospital, so I sat with the kid, trying to get her to just nod when the contractions started so I would have an idea of what was going on. I finally got her to look up and nod when she felt something. The "good" in this is that the siblings (girls) were removed from the home, and the dad charged (don't know what happened to him). 
.
Imafloat, BSN, RN
1 Article; 1,289 Posts
I'm a NICU nurse and the thing that gets to me the most are the Cool Cap babies. The Cool Cap is a head cooling device we use if an infant qualifies for it after suffering a hypoxic event at birth. It's hard to qualify, you pretty much have to be a full term kid with a lot of problems.
It just kills me, because hours earlier, this mom was in labor, taking pictures, sucking ice chips, going about her business. Days earlier, she was packing her bag for the moment she went into labor, making sure everything was ready for the baby. She probably had her baby shower a couple weeks before the birth. She has made it through the first trimester and illness, she made it past 24 weeks and viability, she made it through everything, pretty normal. Then wham...something crazy happens during her labor or during birth and all of a sudden her kid is the most critical kid in the nursery, when hours earlier she was laughing through labor. It's just so cruel to me, because although we have seen some great outcomes with the cool cap, that isn't always the story.
I know that anything that brings a baby to the NICU is tragic. I know that preemies are delivered unexpectedly every day. I know all this, but to me the cool cap kiddos are the ones that shake me to my soul.