Thursday, November 6, 2008
Too Much Too Soon?
Wow, I had now idea how different working in the ICU would be from working the small Med/Surg unit in Maryville. Today was a prime example. The patient that coded on Tuesday, is still in the ICU on the vent, well today the Neurologist came in to test brain function. Needless to say, there was only a very small of deep brain stem function left. This is basically the part of the brain the controls the primitive controls of the body including blood pressure, heart rate, and temperature. All of these things are even fluctuating a lot too. I was in the room when the Neurologist told the family his findings. He started talking about "brain death" and "decisions" that needed to be made and "withdrawing care" Once he started talking I was like..Holy Shit, and started feeling like I couldn't breathe and someone put about 7 winter coats on me. I felt that feeling in the pit of my stomach, and knew I was about ready to burst. I had no idea the amount of tears the my eye-sockets could hold without the tears trickling down my cheek, but they must have held about a gallon, because I was able to hold it together until I got out of the room. Then it started, the gut wrenching crying. You know the type, the tears literally come from the bottom of your stomach, and you start learching because you are crying so hard that you cant catch your breath, and to add insult to injury, the nurse I was orientating with looked strait at me and said "Oh my God, are you okay" Well that comment didn't help at all, I just shook my head, and pointed to the bathroom. And always being Classy Cassi, I sat on the toilet and bawled for about 5 minutes, and then finally pulled myself together, washed my face, and went back onto the unit. I think even the people in coma's could tell that I had just bawled my head off.
I really thought that I would be able to control all my emotions and feelings, but all the talk about withdrawing cares, I was right back in the NICU at Children's. I could literally hear the doctors telling us about Elli, and her "quality of life" and our "decision". I felt so bad for that family, but moreover, I felt bad for Brian and I. It all just hit me at once, and out of the blue. I guess that it might just be too much too soon. I already decided I don't want to be in the room if the family does make a decision tomorrow when I work. They will extubate him and let him slip away, and that thought of Elli has already crossed my mind. I thought about it all the way home from work. I remember the look on her tiny face as she looked up at me and took her last breaths lying in my arms, and it is like I am right back there in that rocking chair with Brian's arm around my back and his hand on Elli's head telling her it was okay to go. I said that I never wanted to see that sight again, gasping for breaths, and to see my patient doing it even while he is on the ventilator just made it all come flooding back. I have seen people pass away in the past, but it was nothing like seeing Elli quickly slip away from me, to never have the life that she was supposed to have as Brian and I's beautiful daughter. So needless to say, I will hopefully be taking a different patient tomorrow. The "coolness" of ICU has so worn off, and now it is hitting a little too close to home. Oh and about the nurse I am orientation with, she is so nice, and knows about Elli, we were just really busy trying to discharge another patient and didn't realize that I had started to well up in the room and was shocked to see me in that state. She started crying and so did the other nurse working with us. So there I go again, making people cry, I should really work on that.
Wow Elli- This has been such a hard day, so many emotions and feeling creeping up on me that I thought I had control of, but in reality, I have control of nothing. I miss you so much, it's crazy sometimes how much I think of you. I picture you in my arms and those last hours we spent together. I cant believe we were able to make the decision to "let you go" and I forever hope it was what was best for you Elli. Just know that Daddy and I were only trying to do what we thought was the right thing to do. I never thought that I would have to make a decision that I would have to think about every day. People ask all the time, I don't know how you could do that or I could have never have made that decision. The truth is Elli, that we really had no choice, it was already made for us. We just had to follow through, and we deal with it because we have to. Of course we don't want to deal with it, but we have no choice sweetie. We no longer get to have you in our arms, but Daddy and I have you forever in our hearts, I just wish that that was as good a substitute to rocking you to sleep each night, but in reality it's not. I hate that this is how this whole situation had to turn out, but it is and there is nothing that we could have done to prevent it or change it, it is just what it was, You, Me and Daddy for 20 amazing days. We miss you daily and think of you constantly Elli. We love you forever and are so thankful for the days you were here and are so glad that you are no longer struggling and in pain. Good night sweetie, be with me tomorrow and the days following while I am at work to give me strength to be there for not only my patients but their families. All our love. Breathe Easy-