What a day!

Today was one of those days...

I work at a small rural hospital...we're 28 beds including ob, med surg and ICU. Today I had a patient with a GI bleed. I had admitted this patient on saturday evening and was surprised to find her still at the hospital when I got to work this morning. (I had hoped they would have shipped her out already). She had bloody emesis at home and black stools. We had her on Q6H hgb's, IV Zantac and were infusing PRBCs and had done FFP. Her admit hgb was 8.6, recheck after 2 units was 7.6, recheck 6 hrs later was 9.5....then 9.2...then for some reason lab had accidentally missed the midnight draw. The night nurse didnt catch it and her hgb this am was 7.2. I just finished transfusing the 1st unit and my student took the pt to the bathroom. She became diaphoretic, pale and skin was cool. She had a 1000cc of bright red bloody emesis with several golf ball size clots...then it started coming from the other end too...black stool along with bright blood. Got her back to bed...called the charge nurse and a rapid response....got her bolused plus a 2nd unit of blood going...called aircare and prayed to God they would make it there quickly...she was losing blood faster than I could put it in. We got her out the door by helicopter within 30 minutes....those last few minutes before she left I felt horrible...there was absolutely nothing more that I could do...the patient was crying and scared and i just looked at her, held her hand and thought in my head "what else can I do?" She prayed and her pastor showed up along with her son just before the chopper landed and he said a prayer. All she could do was cry once her son and pastor left and she told me "I will win either way...If i die I'll be with God...If I live I'll win and get to still be with my family." That poor student of mine too....it was her first day of clinicals....but one she will never forget!

These are the days I love being a nurse but it breaks my heart at the same time...I'm not sure if she made it or not...it takes about 15-20 minutes by air to get to a bigger hospital where they could do more for her. Her vitals were starting to fade when we got her loaded up....