So, I really didn't want to come to work today. I was having a nervous breakdown over a missing/broken tooth. I had no sleep, practically. I requested to be canceled and (read this dramatically) my request was denied. I'd had a gross assignment for a few days already and was tired of feeling coated in crap (both literally and figuratively) when I came home. My patients were both kind of emotionally exhausting - both were on all kinds of life support while the families insisted there was still a point zero one chance of full recovery so, keep going!
Today, I came in to find out that in both cases, the families decided to withdraw care. This means - remove the breathing tube, stop life support, keep them comfortable, maybe send them home on hospice care if they do well enough off life support. Not immediately - one of them, the family wasn't sure when and is still talking about it (in those cases we will be gracious and give the family time). The other family - the parents of a very young woman - wanted to come later in the week and take pictures with her, so they can say goodbye before withdrawing care.
This woman was hard to make "look nice" from the moment I had her. She had continuous E.E.G. Monitoring for 4 days, which is where they paste electrodes to her scalp to monitor for seizures. When the parents decided to withdraw care, they discontinued this. She had to have her tube re-taped multiple times daily because of secretions, etc, etc (trying to not make this too gross for some of you!). Sidebar here: In the ICU, making your patients look nice is often secondary only to keeping them alive. My preceptor used to always say, "it doesn't matter what happens, make them look nice anyway" and I'd roll my eyes. It's funny how I am now totally converted to that viewpoint. I've learned all kinds of tricks, but it's totally true - in the ICU, as long as you're not having a very hard time keeping the patient alive, they'd better look good. You end up kind of judgy of people who are not brand-new and learning the ropes but their patients always look like crap.
We bathe patients at night here. I just spent over an hour combing through her hair to get that EEG glue out with nothing more than an icu comb and hospital soap, and my hands. It was oddly soothing, even she calmed down while I was doing her hair. I wanted her hair to look nice for her pictures for her family. I still need respiratory to re-tape her tube again so that looks nice, too, but her hair looks a million times better than when it came in, and I feel such a sense of pride for that.
I got time to process shit. I really no longer care about my tooth or any number of other crises I have going on. This afternoon, a mother and father will come to our icu to take their last pictures while their daughter is still alive. I hope I made that experience just a little easier for them. And this reminded me that I love helping families through loss. I used to want to do hospice. I don't want to now, but sometimes it's good to have a really satisfying night. It's kind of an emotionally powerful experience giving someone their possible last good bath.
I'm really glad I came to work, and even glad I didn't get canceled. I am so stoked with the way my workweek unexpectedly ended.
(now back to your regularly scheduled funny shit)
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