I hate rules. The rules I hate the most are hospital rules. I am a frakkin professional charged with the responsibility of the lives of others and some "suit" wants to decide how many visitors can see my patient cause I can't determine what is safe and/or reasonable. Thanks for acknowledging your respect for my ability.
Johnson (all my stories will feature "Johnson" as a patient to preserve privacy.. also these narratives are not verifiably true - in fact I deliberately change change things to protect identity and privacy. The spirit is true) was in pretty poor shape. The situation had gone down hill in the last 3 hours and now Johnson was beginning to get tired from the labor of breathing through all that fluid in his lungs. Johnson could occasionally talk in short winded bursts like a sprinter after a thousand yards.
It was time to intubate. This is the best time - before Johnson was so far gone that the stress caused other changes. We knew that it was impossible to keep Johnson from the ventilator. It was a matter of when.
Doctor Blue joined me at the bedside with the significant other. "We need to stick a tube down Johnson's throat to help with the breathing," Blue said in the doctorly way, as if this was as common as getting a shot of antibiotics.
Johnson looked scared. "Will it hurt?"
"We will put you to sleep while the tube goes in but you should only be out for about 15 minutes or so," came the standard reply. We have done this a thousand times.
"Will I be OK?" the question was delivered with some poise. Johnson could only manage about three words in a single gasp.
"I am going to slide a little tube in and it will breath for you so you can rest." said Blue. We could be car salesmen. No answer was given but one was received.
"Can I see" huff... "my family before" huff.... "you do this."
Dr Blue looked at me. I nodded yes. He nodded no. An impasse. "We need to get this done soon," the doctor replied. Not one to be so quickly beaten I added, "But we can get your family in here for a minute. How many are outside."
The Significant Other said, "Around fifty or sixty." Crap on a spoon.
Johnson looked at Dr Blue. "You do what has to be done doctor. I trust you." (the kiss of doom).
The doctor walked out. He wasn't pleased with me. This should be a simple thing and the family could come visit in the ICU. Two at a time, when they allowed visitors which wasn't often.
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When I came through the ER with a sixty person soul train the charge nurse nearly came out of her skin. "Two at a time in the room, PERIOD!"
Charge nurses are like that... Their job is to see that the whole ER runs as smoothly as possible. They hate nurses like me who could care less. I care about what is best for my patient. The two goals are not always compatible.
I looked toward her, "It's OK. I am leading this bunch and we won't be but five minutes." I swear she could have shot beams like the Deathstar at that moment.
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From the littlest Johnson to the Largest Johnson and everywhere in between they marched up to tell Johnson they loved him and wanted him to get better. Johnson children and Johnson siblings cried and kissed. Johnson parents graped hands and stood as the rock for all the other Johnsons to cling to...
I stood aside. This wasn't a moment for nurses, it was a moment for loving.
Questions came. Fears were soothed. My titanic frame giving authority to my words and my confidence.
All the Johnson shapes were ushered from the room. While they smiled and cried and patted or kissed, I had been getting everything ready. Little time had been wasted, maybe three minutes.
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Dr Blue laid Johnson back, "We are getting ready to start. Pretty soon you'll get sleepy and when you wake up we will have the ventilator breathing for you."
Johnson was already feeling the happy juice and said, "I know that you'll help me doctor. I don't want to die. You just get me through this."
In ER terms that is like someone pushing the great red "ABORT" button. Immediately all of us looked to each other. Twelve double quarter pounders with cheese hit rock bottom in our guts.
But we are professionals and don't buy into primitive superstitions. "Forward Hooo"
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Johnson never woke up. His last words, as far as I know his last thoughts were "don't let me die" to a roomful of strangers.
All the little Johnson's, all the old Johnson's, all the tall Johnson's and all the funny shaped Johnson's got to say goodbye. Johnson was surrounded by so much love in those final moments that I was afraid that a "love-healing miracle" would render our services as unnecessary.
I received notes and cards for weeks afterwards. I was even invited to attend the funeral.
The charge nurse wrote me up for violating hospital policy.
It was a fair trade.
NOTE:Unfortunately, all my stories have the inherent value of me in them, otherwise they would be your stories. Like all humans, I tend to minimize my mistakes. In reading the stories, it may seem like I don't make mistakes or think myself to be totally awesome!. Trust me, I do make mistakes and I have to live with them. There is no rationalizing to the dead body in front of you that was discharged 6 hours earlier. You will forever hear your voice telling the patient and their family that everything would be "just fine." Well, it isn't. A dead body lays on the gurney and grieving loved ones stand all around you. "I did my best," just doesn't cut it with the family and it doesn't cut it with that part of you that has to go to sleep every night. So, while most of these stories may make me look superhumanly cool they are only one side of the coin. The side I can share.
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