A co-worker ended their life after our shift the other day. Didn't go home and shower. Didn't change out of scrubs. Don't know if it was planned or spontaneous but I do know we got the last living moments. And I don't know how I feel about that.

Our broken team is shattered. I don't know contributing factors. I do know that nobody can deny how fully draining these last few years, months and weeks have been on our ICU. In hospitals around the globe...

I. LOVE. YOU.

The way my dying patients wife spoke those words took my breath away. The pause between each word. The emphasis on each word as though willing him to feel the power, the pain, and the emotion.

It was as if it was a plea and a fact at the same time. It's been weeks for him in our ICU. Weeks of ventilating, making gains and losing ground. Weeks of family updates and he's not doing well today but then a bit better tomorrow. Weeks of slowly failing organs. Weeks of sedation and life support.

My pt *Tim was admitted with Covid. A relatively healthy guy. Exercises more than I do if you don't count the steps I put in at work.

It's rare that Covid patients are already intubated before coming to the ICU, which can be both a blessing and a curse... ICU + covid = Not a great combo.
But it does give us a chance to get to know our patients.

Tim was doing ok with self proning, he watched his oxygen levels and flipped himself over for "tummy time" to get them up again when they were low.

He's been here for weeks so he knows the drill.

Expect the worst, hope for the best...

It's been many weeks now since we admitted the 'Lords prayer' Covid patient. He came to us awake and talking but deteriorated quickly overnight. After calling his wife and praying with him I held his hand while he was intubated. Each shift back to work I would casually wander to his bedside to see how he was doing. Each shift a different plan of care to accommodate his failing lungs and subsequently his failing organs.
Sometimes he would be on his stomach with arms positioned like a swimmer.

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...

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.

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.

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...

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

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 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.

I pulled into the hospital parking lot for night shift with an uneasy feeling in my stomach. I'd heard on the radio about a bad trauma when I was on my way in to work. Somehow I knew it was going to be a rough one... After dropping my lunch bag off in the lounge I called to check in at home. My dad is visiting and having a movie night with my kids. Tomorrow is football & he travels 2 hours every week to spend it with us.

You guys. I'm caring for a widowed old fella today and he says his lady friend from up the street has been visiting. He thinks she likes him but he says "I'm not sure I can collect the muster if you know what I mean".
Said he hasn't had a first date in 58 years... SHE'S HERE!

She's holding his hand and he just keeps staring at it. Sometimes he reaches over and pats it.

😍

I stayed for hours after my shift yesterday to be with a little girl whose daddy was dying. We coloured and sang and wandered the secret passageways of the hospital. She confided in me that she is in fact Hermione Granger, a good wizard. I made her a special wand... She said she only uses her magic for good. She cast spells that all the sick people would get better. She cast a best friend spell on us. She stole my heart & everyone who met her.

I have never met such a special little girl & I started to believe she did hold magical powers

Today in my role as nurse I wore many hats. Let me tell you a story about how the day went... #NurseLife
#medtwitter
Came in this am to discover my pt from yesterday had imaging overnight that revealed catastrophic injuries, along with her sepsis and multi-system organ failure Within 1/2 hr her fiance approached me about calling in a chaplain, which I assume is to do final prayers. He informs me that he wants to marry her. Today.

I'm not sure b/c pt is sedated and fully ventilated, with no hope of waking up.