There but for the grace of....

[xtxrn]

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.

[anotherone, BSN, RN]

CF patients, really young and completely aware of their poor/terminal prognosis. very young (20s) AIDS patient excepcted to die within 6 months who had 4 kids and no one to care for them after pt died. during clinicals babies in the nicu whose parents never called or visited once while the kids (multiple patients) had been there months, a couple of young 20 some year old patients paralyzed after a gsw or mva. also in clinicals a toddler with massive burns all over..........

[xtxrn, ASN, RN]

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??????

Roe v Wade, along with argument that if a girl tells her family about said pregnancy her life at home would be compromised (especially if the kid is in an abusive home, trying to just make it out alive when she's of age).

[Nurseboy1]

I remember being a new ICU nurse not even a month off orientation when a horrible upper GI bleed was rushed over from the floor. He was awake and conscious when he got to us. He begged us not to let him die, but we couldn't stop the bleeding. I remember watching the light in his eyes go out as he exsanguinated in front of us.

I remeber taking care of a catholic priest at the end of his life. As he started to breath his last breaths the other priests in the room began to chant prayers in latin and to sing in latin. I know that I felt something in the room that night, some overwhelming peace as that priest left this earth.

I took care of a lady with esophageal cancer who had finally had enough. She had been through surgery, chemo, and radiation and her quality of life was getting worse. She asked me to call her family and that she wanted to let go. Her family came and she told each of them what they had meant to her and gave them her love. When they were done she told me it was time. I gave her morphine and ativan until she was drowsy and we took her off the vent and put her on a trach collar. As she began to die her mother and her daughters gathered around the bed held hands and began to sing old afro-american spirituals, and they sang them until she quietly took her last breath. When she passed her mother hugged me and with tears rolling she told me that they had sang her as far as they could, the angels would have to sing her the rest of the way to heaven.

[xtxrn, ASN, RN]

Good reminders, everyone. Y'all have made differences in so many lives - it's humbling isn't it, that we get to be with people in these ways....

[xtxrn, ASN, RN]

I took care of a 2 year old, who was submerged intentionally into scalding water (don't remember if it was the dad, mom's SO, or what). He had 2nd degree burns from his suprapubic area down to the back of his legs, and all points in between. Dressing changes were q shift, and consisted of "buttering" 4x4s with Silvadene, and securing them somehow. The little guy also had a Foley, to help with infection control.

He was SO good with the dressing changes (I'd premeditate him anyway- he seemed like a kid who had already learned that crying was pointless in getting someone to help him). Towards the end, he'd get sick of lying still (very age appropriate), but otherwise, he was eerily quiet. The kid didn't talk much either, for a 2 year old. I'd expect some words and short phrases. He seemed very poorly socialized.

As he got better, we'd put him in a high chair at the nurses' station. Initially, he seemed confused by the whole thing. But within a week he was directing traffic, chowing down on Cheerios, and even smiling. It was amazing to see the little buy sort of come alive :) He loved the attention (which was obviously lacking). He ended up in foster care.

That job was predictable based on the evening news. Sad. But the nurses I worked with would take those little abused kids, and give them all the TLC we could fit into a shift.

But it broke my heart to be doing burn dressings, in such a sensitive area, and have the little guy just lie there. That's not normal.

Fortunately, just about everyone who worked there sort of adopted him while he was there. By the time he left, he was yelling out at people who weren't doing what he wanted (normal), tossing toys all over the place- and laughing when staff went to 'fetch' stuff, etc. He was only 2 years old- and had a floor full of nurses, hospitalists, and ancillary staff wrapped around his finger :)

[xtxrn, ASN, RN]

A double-major college student got meningitis- it trashed her spinal cord from C2-3 (I think- it's been 24 years). She was vent dependent, and a quad. But her mind was totally intact. She had a wicked sense of humor, and could form words distinctively enough to communicate by us lip-reading her (she also had a ST gizmo that was ok, but relied on eye movements- and it wasn't as easy as just reading her lips).

One night, I was making my initial rounds (charge- 20+ bed coma-stim unit) and found the 3-11 charge nurse, and RT BAGGING the patient. I asked if there was something I should know . They said the cuff on her trach blew. GREAT. Nice to know they were on top of letting me know (neither planned to spend the night). So, I call the doc, expecting a transfer to the ED...we were a rehab place. She was the only vent. RT didn't know how to change a trach.

The doc said I needed to change out the entire trach. He'd wait on the phone (how helpful ). I got the right size, and went in to deal with it. There was NO ONE else to do it. I got it changed, but it wasn't smooth- the ridge over the cartilage was high; come to find out, the doc who told me to change it wouldn't change it himself the last time she needed it done (made me mad).

The look in her eyes- she knew none of us knew what we were doing- just what we expected to be doing. I felt so bad for her. After it was done, she was ok- and relaxed. But I felt horrible. She shouldn't have had to deal with that- though a trip in an ambulance w/the vent probably wouldn't have been safer. It was just so sad that she was so aware of it all.