I am ashamed to say that I stood in the shower recently before work and other than offering up the usual prayers for a smooth day I actually made a very specific petition for divine intervention. The day before I had helped a coworker with a very unstable patient. I had watched him run his legs off trying to keep this patient alive, and I just wasn’t up for taking the reigns on that one in his absence. I was tired, and the thought of the serious mental concentration that would be required to combat the patient’s labile blood pressure and respiratory distress for thirteen hours wasn’t something that made me want to turn cartwheels. In fact, I wanted no part of it this particular day.
I work in critical care so I’m used to critically ill patients, and yes, that’s just part of it. But I think any nurse will tell you that some days your brain just wants a breather. The thing is we don’t talk about it out loud that much, but the profession we have chosen comes with a mountain of responsibility. Yes, it comes with loads of rewards, but it’s also a bit frightening when you think about it. So typically we don’t. We just do our thing. It’s our job, right? But what exactly does that entail?
Let me tell you a story. I remember once having a patient on the ventilator. He was receiving a large fluid bolus, and though I was close by things happened pretty quickly. I looked up from my seat outside his window and noted the oxygen monitor on his finger suddenly not picking up properly. When I entered the darkened room I was confronted with a huge purple hand. His circulation was compromised and I couldn’t feel or even doppler a pulse. A nearby physican even got excited when I called him to the bedside, and he started contacting the orthopedic doctor on call. It looked like Compartment Syndrome and perhaps a surgical intervention was going to be necessary to save this patient’s limb. Intubated patients can’t tell you it hurts. I wondered was it broken, or just an infiltration gone bad, and should I have caught this sooner?
It happened so quickly, and the crazy thing was that for critical care this patient was incredibly stable. Everything was smooth sailing, but all it took was a moment for things to turn south. The patient was fairly young, and all I kept thinking was, this guy may lose his hand, and it will be my fault.
That’s the truth about nursing that most of us don’t talk about. We don’t talk about it because if we did it might frighten us from the bedside altogether. Simple things, the tasks we take for granted as being second nature, those small things are even big things. A simple med pass can end in a serious allergic reaction, or God-forbid, a deadly medication error. A walk in the hall can become a sentinel event if nonskid socks aren’t worn, or something as easy to do as forgetting to put the call light within reach can lead to a head injury. The everyday nursing task of giving IV fluids can turn into an amputation.
For my patient that day the problem resolved as quickly as it had occurred. After the fluids were stopped, IV removed, and the arm elevated the circulation was restored. No tissue damage incurred, and what could have been a terrible occurrence never resulted in more than a mild, visible swelling by the end of my shift. But it was a reminder of the truth. As a nurse you can never let your guard down for even a moment.
I think of all the shifts over the years where I skipped lunch. Not because I wasn’t hungry; I was, but because I just didn’t feel like I could leave my patient’s side. It didn’t feel safe. There’s not always someone to watch your patient assignment for you. They have their own.
The truth of nursing is that it’s more than just a job. When you walk into the room and accept your assignment you are accepting responsibility for another person’s life. Sure, you’re not a man on an island with no help in sight, but as your patient, the person in the bed is your ultimate responsibility. So if you’re not feeling well, tired from being up with a teething baby, or distracted by personal problems at home, it doesn’t matter. Your responsibility is the same despite your capabilities that day. There becomes no such thing as simple oversight when life and death are on the line. Not being melodramatic. Just keeping it real.
Your mind must work on overtime, thinking not just of the task at hand, but anticipating unforeseen complications or possible outcomes of the intervention you’re considering performing. In critical or emergent situations your mind is not allowed to stop thinking this way. It must continue thinking through every possible scenario and snafu until it’s relieved by another fresh mind half a day later. Whew.
Some days all your patients are golden. Everything runs smoothly and patient presentation is practically perfect in every way. On those days it seems like your job is pretty easy, except for the fact that you always know deep down. You know that you can never fully relax or let down your guard because it could change in a second. It only takes a moment for a heart to stop beating.
So the weight of that responsibility can be pretty heavy some days. The truth can be taxing, and maybe you want a break for your brain. To my fellow nurses I would say, there’s nothing wrong with that. Sometimes it’s okay to speak the truth. It’s a relief even.
Dave Parsons says
A few months after retiring from Disney I decided I wanted to work with my tools again as I had been in management for a good many of my final years at the Mouse House & we couldn’t work with tools unless an emergency happened! That was part of the contract negotiated with the unions! I just wanted to gather my tools, work by the hour and not have to direct anyone! Just go and do what was assigned to me! I landed a job at a big nursing home near Orlando and got a first hand look at what the nurses and their aides went through on a daily basis! After observing this first hand I had a great admiration and heart full of thanks for people who care for those of us that end up in situations where constant care is needed! All I can say is thanks for being there as a nurse! Also, after having been there as one who has needed health care professionals I can appreciate the care of those who are dedicated to our well being and especially those who have God in their lives! Now that is an awesome combination!
brieann.rn@gmail.com says
Thank you!