Our Father, who art in heaven. Hallowed be thy name...
He was admitted for monitoring but we know how it goes. With the high flow nasal oxygen and the mask his oxygen levels were still only in the 80s.
"Try to lay on your stomach for as long as you can tolerate, I'll be back."
He did not tolerate. It's hard with all the things on your face to lay like that. It's hard when your lungs betray you and don't do their job. It's hard when you see the news every day and know that the ventilator is the last resort.
He was tiring. It would soon be time...
All garbed up in PPE I go back in the room to talk to him before the team comes in. He knows it's getting worse. I ask if he wants to call his wife to talk to her before we rest him on the ventilator.
He asks if we can take the mask off to make the call.
We really can't afford to lose any gains with the double oxygen therapy but I also know this may be his last time to speak with her. He knows it too. I take the mask off and hold it close by so it's at least blowing on him while he tells his wife he loves her.
The team is busy intubating across the hall but I can't leave him to go help. He is uncomfortable as he tries to find a method of breathing that doesn't cause panic. I breathe with him as though it was lamaze... Slowly in through your nose, out through your mouth
I hold my finger up and tell him to pretend it's a candle that he can't blow out. Slow relaxed breathing. There now. That's it. Don't blow out the candle. It works until the coughing fit starts up again.
We've lost all grounds. Oxygen levels are now in the 70s... Team is coming
Through laboured breaths he tells me he is afraid. I tell him he's exactly where he needs to be, we will do everything we can to help him.
He holds my gloved hands and squeezes tight as he tries not to blow out the imaginary candle
I ask him if he wants to pray. He emphatically nods yes. Does he want to be alone to pray? No.
We sit there holding hands as I offer a silent prayer over the hum of the oxygen. Then he starts... Our Father, who art in heaven, hallowed be thy name...
I join in, thy kingdom come; thy will be done on earth as it is in heaven. I haven't said this prayer in many years but it comes back to me as though it was yesterday.
Give us this day our daily bread...
By the end I'm the only one reciting the prayer. He is too breathless. Too scared. Too tired.
Them team is in the room now. He looks only to me. I tell him he is going to sleep for a few days, I want to hear about the dreams he has when we see each other next.
He nods ever so slightly and gives the tiniest of smiles. He asks my name once more before the sedation is sent through his veins.
"I'm going to remember that, in this place and the next" he says just before he drifts off to sleep.
I send up another prayer, "Our father, who art in heaven, please let it be in this place, Amen"
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It started as a normal shift... I mean, whatever normal looks like for us these days. I was extra staff so I busied myself with little projects, helping with turns and baths and dropping off meds. I was present but not really invested in this shift
I check in on the new nurses. They are always my favourite. They have just as much to teach me as I do them. Today they want to know the quickest way to the blood bank in case of MTP (massive transfusion protocol). I take them to show them, it's better than giving directions.
Next I pop over to check on a new admission. It's like a game of Red Rover: people from inside the room are calling out the things they need to the people outside the room. It's a flurry of activity. It usually is with a new admission, especially an unstable bleeding trauma.
I just sat down to do my assessment after a busy start to the shift. It's been like that lately, hit the ground running. Staff are dropping like flies, resources thin. We've gone back to 'team nursing' where we travel in packs room to room to do patient care
Anyway, just sat down
The phone rings and it's my coworker in another bay asking me to come help with matted hair if I have time. I don't really but I also love the challenge & satisfaction of getting matted hair fresh and braided.
I grab some supplies and head over.
There's two nurses at the head of the bed working away. They almost seem angry with how they have a fistful of hair and are attacking it with the comb. But I know better, this project is an act of love. I get to work and start braiding.
The alarm goes off at 0535. And again at 0545. Can't trust myself to hit snooze when the first one goes off. Since the beginning of COVID I started taking a sleeping pill before dayshift. Otherwise it's just tossing and turning, wondering what the day will bring...
My dayshift routine is always the same: lunch made for upcoming days the night before. Shower in the evening, clothes laid out. Coffee maker ready for go time when my feet hit the floor. These days I leave 15 minutes earlier due to the staff screening line up...
Are you experiencing any fever, cough, diarrhea? Almost always I must sing the Pepto song: nausea heartburn indigestion upset stomach diarrhea. We all have a nervous laugh while they wait for me to answer. No.
In the past two weeks have you travelled outside of the country? No.
When my kids were little, aged 4 & 5, it was our first Christmas with me as single mom. I had just completed a hard semester of nursing school (they're all hard - I know!) and we were making the 7 hour car ride to visit family for the holidays...
It was one of my first times driving on the 401 (busiest hwy in North America), and my kids in the backseat fighting over the imaginary friend was not helping my stress levels. 🤯
I yelled at them to settle down.
To my surprise, they both fell asleep
My daughter, 5 years old at the time, woke up a while later, "Mommy I'm sorry we were being bad"
My heart shattered. I'd been trying so hard to hold it together since my summer divorce, to keep my grades up but mostly to be a good mom. This was all for them.
I went in to help boost my coworkers patient. "Careful", he said, "there's no bone flap on your side"
I assumed this was a trauma patient with an increased ICP, removing part of the skull to allow room for the brain to swell is common practice in our centre.
"Was this guy in the accident from last night?" I asked. Turns out he wasn't a trauma pt at all. He had TTP, (thrombocytopenia purpura) and had suffered a massive stroke.
As I was leaving, the plasmapheresis nurse was getting ready to head in for his PLEX treatment.
I helped check blood products for the plex then went back to caring for my own patient. It was a pt with ARDS, sedated and paralyzed... One of many this flu season. I wrote my assessment and wandered to see if I could help my coworkers.
"I don't know why she's here, she just had a sore throat," my patients son said to me.
We had just admitted his mother into our ICU, now so infectious it was putting her in septic shock and multi system organ failure.
This boy looked like my own son, a big stocky football player. Just old enough to be considered an adult but still so young to be making life or death decisions for his mother.
He was lost.
My heart was in pieces.
She was with us for weeks as we battled to sustain her life. It was a rollercoaster of emotion: one day able to talk and the next day would spiral and end up intubated, sedated and on multiple forms of life support.