Thursday, November 6, 2008
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-
Monday, November 3, 2008
Wow I guess it has been a while since I updated anything. So many people have been asking how work is going, and it is going so well. I love it, but think I am going to dread making the switch over to nights, for right now I am on orientation on days. Three days a week goes by so fast and I love having 4 days to spend with Brian.
As if I had not already announced, I am in the Intensive Care Unit. It is challenging, but I really enjoy having to learn new things every day. I cant believe how much I didn't learn in nursing school. The good news is that it only took me a couple of days to get back into the routine of working 12 hour shifts and doing nursing duties. I had to start my first IV in over 3 months yesterday, and of course got it on the first try, must still have the touch.
The hospital that I am working at is much bigger than where I came from, but it isn't huge. Basically we will see everything in the ICU except open heart surgeries and transplants. Other than that pretty much everything else is fair game. They do a lot of heart caths, so we see several patients like that who will have to be transfered for bypass surgery to our sister hospital Methodist in Omaha, NE.
Today started out pretty slow, but there was a code in the ER and at least one of the ICU nurses has to respond to the code, so I went down to help out. What an adrenaline rush, for lack of a better word, it was fun. (for me, not the patient).
I thought that being around all the specialized equipment and the monitors would bring back memories of when we were at Children's Mercy, but it hasn't really until today when they were setting up the ventilator. It was pretty hard hearing the ventilator, not the alarms, but the actual sound of the air going though the tube. I guess the reason is that because when we finally got to hold Elli, they switched her over to the conventional vent, and I remember everything about those few hours, and the sound of the vent today sent me right back there. Luckily it wasn't my patient, but I am going to have to get used to it, considering it is coming on flu season and pneumonia time, where we will have several patients on the vent.
Brian has been so busy with harvest. He has been working pretty much non-stop trying to get corn out right now. They finished up at my house today, so they have moved on to yet another field. The corn seems to be yielding pretty good considering some of it got a lot of hail damage. I have been keeping Brian company on my day's off by riding in the truck and tractor with him. We have been seeing a lot of deer around and my dad says that he has seen a "huge" buck on every field, although Brian has yet to see any of them. Hopefully he will be able to find one and try out his new muzzle loader he got when we moved up here. He has been so busy he hasn't even had time to shoot it.
Trigger is still grounded, I want to let him and Molly out, but I am too afraid he will run off again, so they have to stay kenneled up when we are gone, which on the days I work is ALL day. Wish that little turd would just stay around the house. Gabby our cat is doing well also, she is so vocal and will sit at the living room door and meow constantly. She still thinks she is supposed to be an inside cat, considering we kicked her booty out when I found out I was pregnant last December.
Hello Elli my sweet. First off I just want to let you know how much Daddy and I miss you baby girl, but we are so glad that you will never have to suffer through any more surgeries, or spend a life time struggling to breathe. As hard as it was to let you go, it would be so much harder knowing that you would have to live a life of pain and suffering, so knowing that you are pain free and able to enjoy being a baby in heaven brings comfort to Daddy and I. I thought of you so much this weekend. I wish that I could have put you in a car seat and we could have taken Daddy lunch and went for rides in the tractor. I can just imagine you sitting on Daddy's lap learning how to honk the horn and pretending to drive and it puts a smile on my face just thinking how cute the two of you would have been. I really like my new job sweetie, even though it is hard to see sick patients, I know that I will be able to help most of them get better, and those that don't, I will be there for them during their entire stay on earth, just like the amazing nurses at Children's mercy were there for you and us during those last days. You know all that milk that mommy pumped for you Elli, some other sick babies are going to get to use it since you weren't able to. I got word today that I passed my blood tests and that I will officially be donating my milk to a bank in Ohio. I am so glad that all that work will help some babies, and not be wasted. I got some pictures hung up this last week, and put two pictures of you in your room. They look so good, chocolate brown frames on the light pink wall. I leave the door open so I can catch a glimpse of you when I walk by on the way to put in yet another load of laundry. Well Elli, I thought on Friday that you were finally going to get your headstone, I was on my way to have lunch with a friend from high school and followed a CLA Monument truck from Henderson to Carson, but it didn't turn to head to Treynor, just kept on going north of Oakland, so I will assume that they were not going to deliver it that day. I keep my fingers crossed that they will be able to place it before the freeze, because if they don't, we will have to wait until the spring. I think about you all day Elli, and especially when I use the hand sanitizer at work. I know that sounds weird sweetie, but we use the same kind that they used at CMH, and after you rub it in, it kind of smells like baby powder. I hope the other nurses don't catch me smelling my hands on occasion just to get a whiff of Elli Smell. I have told a couple of nurses about you Miss Elli, but not everyone yet, but I will in time. I miss you so much Elli, and wish things would have been so different, but enjoyed every minute of those 20 days you were with me. I miss you always. Breathe Easy Elli. Love Mommy and Daddy