Saturday, October 6, 2007

Wake Me Up When September Ends

Holy smokes, I saw somebody die today.

I was working at my dialysis job and things happened so fast that I can't remember what made me realize something was wrong. Next thing I knew a few of us were standing around a patient shaking him, calling his name and getting no response. His eyes were wide open, mouth gaping open and he was having agonal respirations. I felt his neck for a pulse and felt nothing.

The nurse brought the crash cart and had the foresight to tell someone to put privacy screens around the chair so the other patients couldn't see what was going on. The clinic I work in has three rows of five chairs about two feet apart. Everyone can see everything that's going on.

The downside of working in dialysis is that death is frequent. It's different from other specialities because we have long-term relationships with our patients. We see them three times a week for years, sometimes decades. When someone dies it's a terrible loss for us and we grieve every time. In the hospital, especially in the ER, there isn't time to get to know someone, and if you do become acquainted with them, it's for a shorter time. That's not to say it's not difficult. Death is always sad for health care workers. For dialysis professionals it's different. These people are like our family.

We're not the only ones affected. The other patients are affected too. Whenever someone dies a wave of fear goes through the clinic. Patients with end-stage renal disease are very, very ill and usually in a long, downhill slide. They never know when they'll reach the bottom. It's especially bad if a youngish patient in seemingly fair health dies without warning. They are terrified that they might be next. Having a patient die in the chair next to them is even more horrific.

This is the first time someone has coded while I was in the clinic. I cannot imagine what the other patients were going through while this guy was coding. I applaud the nurse for putting up the privacy screen. Even though it didn't completely block the sights, and none of the sounds, anything to soften the effect was worthwhile.

When it was over my adrenaline was pumping. I understand now why people are drawn to working trauma care. It was an unbelievable high. That's something I didn't know about myself.

Later on I learned that they managed to revive the patient in the ER, but he coded twice more. Even though he was alive last I heard, I don't think he'll survive for long, and if he does he'll probably be on life support until someone makes the decision to withdraw it.

It's funny that after more than a year of nursing school, I'm just now really getting into the thick of it. For all the times I wondered if a career in nursing was the best choice for me, on days like today I have no doubt. I definitely made the right decision.

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