Shock

Sometimes I wonder about this job of nursing in critical care. Part of me loves the action and yet nights like the past two make me count the days till I am through and at the same time thirst for more knowledge and skill and want to keep working in critical care.

A man disfigured from a fall with purple skin taut around his eyes. He could not see yet he begged to get up. Nose packed with dried bloody cotton…forehead swelling. I wonder what he looked like before. Blood pressure low, but the man...awake and moving. Something was wrong ...but what? Blood pressure falling and the man wants up...he is getting cold and clammy. Doesn't he understand that sitting up will just make his BP drop? Calling doctor and it takes forever to hear back. She laughs a bit and seems flustered. Doesn't she understand the gravity of the situation? Blood pressure plummeting. Yes he runs low normally, but something amiss. Why are all the other nurses busy? Finally some Dopamine after imploring and here comes the nurse who is following me...she helps...past time for me to leave, but how can I? Patient is anxious and aggravating everyone, yet he knows where he is at. I ask him...he says his mouth is dry so I give him a swab with water on it...no more cause he's NPO. Filling out admission paper work half way and trying to give report. Blood pressure dropping, but the other nurse doesn't seem concerned. Is it right...that BP? He is getting quiet ...that's not good...his heart rate is dropping...oh NO!!!!! Running into room and shouting down the hall, I go for help. Crash cart and CPR....calling doctor and pushing meds...calling his friends (for he has no relatives)...this is not good. NG tube down and bright red blood...breathing for patient and pumping his chest. Bells ringing, people shouting. Tension. Tears and shaking. Where is that doctor? Running down hall to meet with his friends. It's over, the end...the man with the purple bug eyes. Maybe a cousin or two out east...he was supposed to get better not worse! With tears in her eyes, his friend proclaims "He just said last week he wasn't ready to die!". And now here he lies. He was fighting...fighting for his life those last few minutes.

Shock...trembling, with dry tears....Shock is right...my state and his. People say there is nothing I could have done differently, but it feels wrong. Doctors and others failed him, but so did I. He was going into shock from loss of blood...still bleeding inside...I wish I would have told the doctor THIS IS Serious. I mean she knew it was, but....well...I could have been more firm and told her he needed surgery.

Finishing his admission paperwork I push forward…a bit irrational now that he is gone. Sad. Heart breaking. Tears flowing now. This cute little man...now gone. Why?