Wednesday, August 3, 2011

Welcome to the ICU... the end

It is now day three of my week. I haven't slept much and the last 48 hours have taken a lot out of me.
I wake up to a text message from a fellow night-shift co-worker who was working a day shift. 
Things were not going well... my patient was not doing well.
They were about to transition him to comfort care.

I read those words and my heart sank. It hit me like the weight of an elephant on my chest.
I stepped out to my balcony and began to pray.

"Lord please give us a miracle. Be with his family now. Be with my patient... please Lord."
Tears begin to fall and I feel a deep sense of loss. 
I have never been impacted by a patient this way. It is hard to explain.
As a nurse your job is to heal people... in any way you can...
but this time I had no answers... this time I had no control and I felt helpless.

I go to work and he is still alive. 
Things are worse now... I have never seen lab values like this. 
I have never had a patient as sick as this. 

There are no answers... 
Just sickness...

I began my shift with his minister at the bedside. Reading him the Psalms...

"The LORD is my shepherd, I lack nothing.
 He makes me lie down in green pastures,
he leads me beside quiet waters,
 he refreshes my soul.
He guides me along the right paths
   for his name’s sake.
 Even though I walk
   through the darkest valley,
I will fear no evil,
   for you are with me;
your rod and your staff,
   they comfort me.

  You prepare a table before me
   in the presence of my enemies.
You anoint my head with oil;
   my cup overflows.
 Surely your goodness and love will follow me
   all the days of my life,
and I will dwell in the house of the LORD

I go through the motions... his family is there... his grandson asks me,
 "How long would he have lived if he didn't get the original surgery."
I take a deep breath.
"My dear only the Lord knows the answer to that."
He nods and grabs his grandfather's hand.
"I love you papa" and he leaves the room.

A while later his wife has a discussion with the ICU team.
It is time. He is not getting better... she wants him to be comfortable.
We give everyone time to say goodbye and I explain to the family what to expect.

And then... one by one... I proceed to remove the medications that are giving him life.
At the end he is left with sedation and pain medicine only.

His family joins in a circle of hands... praying and singing over the man that they have known for years to be grandpa, dad, brother, husband.

Within minutes the monitor shows nothing but a ragged line... he is gone.
He has passed.

I enter the room and find his wife...
"I am so sorry but it looks like he has passed. I will call the physician to come in and confirm."
She begins to cry harder.
"I am so so sorry for your loss." I place my hand on her shoulder.
She waves her hand as she covers her mouth and I step away to inform our ICU fellow that he is in asystole. 

After some time... after his family have said their goodbyes... they leave in a state of shock.
I am left with this man that I have to clean and take the morgue.
My patient.
A man that I have cared for and fought for. 
A man that I don't really know... but a man that I desperately wanted to live.
In that moment I feel lost.
I feel like a failure.
I am confused and frustrated.. but most of all I am devastated.
We are supposed to save people. 
We are supposed to heal them...

but sometimes the Lord calls us home... sometimes medicine is not enough. 
Sometimes we don't have answers...
and sometimes it just isn't our fault...
it is just their time.

As I prepare my patient's body for the morgue... I grieve...
I grieve for his family... I grieve for the loss of life.
And in that moment I realize that I have experienced the truth depth of nursing...
 in a way that I never have before.
I begin to feel the tears of the ugly cry and I have no reserve to hold back. 
My charge nurse encourages me and thanks me for caring so much for this man.
With help from co-workers I get my patient in the body bag and begin the trip up to the morgue.
I am silent and somber and as I walk the empty halls of the hospital all I can think is, 
"Welcome to the ICU dear... 
Welcome to the ICU."


  1. I'm so sorry Andi. What a hard job you have. You were a fantastic nurse, not only to that man, but to his whole family. Hugs and love to you!

  2. Andi you are absolutely right, medicine can't overpower God's will unfortunately. I know you did the best you could and it sounds like you are more than a stellar nurse. Love you and praying for you