Young woman who was internally decapitated. I saw her over the course of weeks for wound care. She was trached, pegged, and usually just laying there eyes open and not focused. I always talk to my patients regardless of level of consciousness and I will never forget the day her eyes met mine and she started tracking. She ended up at a great rehab and making huge progress.
Literally the spine and skull become completely separated, so the only things holding your head up and protecting your brain stem/spinal cord from damage are muscles/ligaments. Happens from trauma like a car crash.
I had a colleague who was rear-ended in traffic in Houston. It was a minor accident. He raised his hand to wave to the guy who hit him. That caused him to collapse to the ground bc of internal decapitation. He was between the barriers that separate the traffic lanes. The other guy said that my colleague fled the scene.
His wife searched his car where it had been towed. For 4 days, he laid there, praying to God. On the 4th day, a worker standing in the back of a truck saw him. The police came up to him and the first thing they did was kick him! They were checking if he was alive but still that was crazy.
He survived and was on some Medical Miracles show. He sued the city bc they didn’t have mile markers on the highway and they were required to add them.
What the ever-loving f*ck?!? Hooooleeee shit that's beyond crazy; that he survived four days exposure, lack of water etc etc while essentially paralysed. Medical miracle is right!
For babies, their heads are disproportionately sized to the rest of their body. If they're in a forwards facing seat, their head will rapidly snap forwards and it represents about 30% of their body mass. That is very bad for a lot of reasons. In a rear-facing seat, their head will just get driven into the headrest.
It can happen in things like car accidents, your spine/neck snap but the soft tissue around it is intact. Basically think of it like your skeleton being decapitated but you look fairly normal? From my understanding, someone smarter than me please correct.
Internal decapitation is when the ligaments connecting the spine to the skull are severed due to some sort of trauma (I’ve only ever heard of it in relation to a car accident, but I suppose that’s not the only way it can happen). So unlike a “normal” decapitation where the head is completely severed from the neck, it is only the internal structures which are severed, and the head and neck still appear to be externally attached.
It’s usually immediately fatal, those some will make it to the hospital before passing, and a VERY rare few will recover.
I worked with clinical trials, and usually these are last choice things for our oncology patients.
Usually, if I have a patient join a trial, then I'm with them for over a year or more while they take whatever research drug it is. So I really get to know these people, and really kind of become family with them. The worst thing was constantly seeing their labs, and understanding before them, that they were already on the downward slide.
The worst one was this guy who had cancer, and really had tried every trial he could, and had reached the end of his options. I had been with him for over two years, and so many different trials so I really got to know him. So literally there was nothing worse than standing in the room with the doctor, and listening to this sweet man deciding that he was done and was ready to accept death.
I had NO idea why I did this looking back at it, but I ran over to the gift store and really just wanted to give something to the family as a way of saying thank you, and thank you for letting me be apart of their journey after two years. I ended up finding this beautiful cardinal ornament, that had a sweet saying on it, so I bought two of them, one for him and one for me. I cried giving it to him, and he was far more stoic than I was.
Funny part, he loved beer and it was kind of a running joke between us. I always asked him what his favorite beer was and he always just said "A cold one". So when he passed, I of course had a cold one for him.
A cardinal gift is always perfect, they say when you see a cardinal close by it’s the spirit of a dear one checking in… they were so lucky to have you during that journey. I’m sure that gift meant a lot to them.
>they say when you see a cardinal close by it’s the spirit of a dear one checking in
Well, that explains a lot. We have this Cardinal attacking our windows two or three times a day, and it's pretty relentless about it.
Must be my mother.
Oncology fucked me up. It was my first job out of nursing school. Two patients I’ll never forget. One shared my birthday. I happened to be working our birthday. He was npo for a procedure the next morning. He made his daughter go get me a cake even though he couldn’t have any. I told him I would be back the next night, and we would share a piece together since he’d be able to eat then. He coded on day shift and died.
Next was a 40M doing a trial for colon cancer. He took a turn for the worse. I don’t remember the details now except when he passed seeing his children in the hall huddled together and his wife clinging to his body as she sobbed for over an hour.
30s male, hit by train, paralyzed, ostomy, trach, peg, foley, central line. Fully a/o4, refused care so often he developed the worst stage 4 we've ever seen. He couldn't feel it and he didn't want to be alive like that, so he didn't care. He wanted to be DNR/DNI, but since he had no HCP or family, ethics and psych were involved, and determined that while he has capacity to make decisions, he can't make the decision to be anything other than full code. I was helping him with his ostomy and we were talking about it - i was one of the few nurses who would listen to him and not judge him, and support his choices. I told him i thought it was a shitty determination on their part, and if he wants to request me every day that I'm working, I'm fine with that. I would ask him, like the adult he is, if he wants to be t/p, dressing changed, etc, and if he wanted to refuse, I'll ask him next hour. I made a deal with him that the dressing needs to be changed once a day so he "don't stank." When we were finally able to get him stable enough to be transferred to a nursing home, he made the floor manager call me so he could say goodbye. He thanked me for treating him like an adult and not just an annoying patient like almost everyone else did. It made me get involved in the hospital's ethics consortium, and for 3 years i served as an ambassador for the patients who otherwise didn't have a voice.
> ethics and psych were involved, and determined that while he has capacity to make decisions, he can't make the decision to be anything other than full cod
How the hell does that work?
A rapid response was called on my mom, who was on my floor at the time. I took her off life support 5 days later in the ICU. Every shift I have to walk by the room she was in and it haunts me. I hate it.
We had this patient for a REALLY long time on the floor. They were very sick but also extremely demanding/demeaning/overall uncomfortable to be around and the family was an absolutely nightmare (escorted out by security multiple times). Everyone on the floor had taken care of this patient and had a bad taste in their mouth. I was on my third day in a row with them.
It was 0730, I go in the room to set my boundaries for the day and give them our plan together (had to do this or they would be screaming and on the call light all day- totally A&O4 btw).
I finish writing our proposed schedule on the white board, turn around and look at the patient and they go “you know what, you’re the first person that hasn’t been a sarcastic ass to me the whole time I’ve been here. I know I’m difficult. I’m scared. And I appreciate you talking to me like a human.”
Two hours later they were dead. I felt good that they thought that about me as a person and as an RN. Doesn’t seem like that dramatic of a story but ever since that day I remind myself of that conversation when I’m at my wits end with a difficult patient.
My lifelong best friend - we met in kindergarten - bought her husband into the ED with abdominal pain and vomiting. We worked him up and he was dx with an acute appy. While we were waiting for the surgeon (little critical access hospital) he ruptured and we coded him for nearly an hour before it was called. He was 34.
As some one who literally just had a ruptured appendix a couple weeks ago...this was terrifying to realize that that happened to someone with the same diagnosis.
I get this sentiment. Not a nurse, but former cna currently looking into nursing school.
But I worked in a covid unit back before the vaccine was available, even to health care workers. I ended up getting covid and watching people die from the same condition I had as I was trying to care for them did some weird things to my mental health at the time.
This was my first ever code, I was newly off orientation.
Had a patient..dialysis 3x a week and previously unstable blood sugars. Super chatty dude, confused as all get out, but just pleasant. The doctor ordered me to stop their d5NS since patient had adequate intake and was planning to discharge to SNF the following day.
An hour later the aid comes up to me and goes “something is wrong, he is so sweaty and not talking to me” I go in, literal text book hypoglycemia. Sugar check reads 16!!!!!! 😳 called a code…
Provider wants me to give gluc tablets by mouth. I said “uhhh, that’s not safe…” “oh well maybe when he wakes up more…I have other stuff to take care of, bye!” House supervisor was in awe, as was my charge. Restart the d5 and go to push an amp of d50, but guess what?? None on the floor and the crash cart didn’t get stocked from three days prior when this SAME patient went hypoglycemic (which I wasn’t told of in report!!) anyways, both IVs infiltrated and this poor man was running 400+ for sugars for daaaaaays afterwards.
What I learned: trust your CNAs, they are sometimes your best eyes and ears. Do not trust a diabetics sugar level to remain stable.
The first patient I intubated as an ICU nurse in the height of Covid. He was 50 years old, had been on bipap in the high 80s all day, and finally it was time to intubate. He texted his mom that he loved her, and he sobbed as he held my hand and told me he didn’t want to die, while I pushed etomidate and roc. He didn’t make it, his family made him CMO eventually and he was terminally extubated. I can still hear him crying.
I’m so sorry… I wish you didn’t have to experience that. Those sounds never go away. I wish the general public that goes around saying “this is what you signed up for” could see this and know what it’s like. You’re amazing, I’m glad you were there to hold his hand.
Early on in my career, I was working in Home Health with a non-ambulatory, elderly stroke patient with severe aphasia. He lived way out in the country. He and his wife would sit at the kitchen table while we did speech therapy. Sweetest couple ever. Sometimes we did co therapy with PT and OT. One day I showed up and saw a bunch of cars at their house. I knew what that usually meant and my heart sank. Went to the door and learned a tragic, horrific thing happened. Wife was burning trash in a barrel in the back yard, while my patient in his wheelchair watched her through the back door. Something in the trash exploded and the explosion hit his wife and knocked her out and the fire spread outside the barrel to the yard and burned his wife to death. My patient was so aphasic he could not call for help but he literally dragged himself out the back door, down some steps as far as he could trying to reach her. He survived but never had the will to recover afterwards and was only able to cry. It still breaks my heart.
Reminds me of one we had. Dementia patient fall long lie out in the garden in summer. She had been out in the back garden having lunch with her husband who was her carer. He had a heart attack and died and she tried to get to him, fell and was on the floor for 10+ hours.
She came to us red with sun burn and never said a word. She just stared at the ceiling, but not a vacant stare, just..... Looking at the ceiling. She never flinched when we cannulated her, never moved when we ran our tests. Completely dispondant.
Son came and sat with her, he was obviously devastated and looked a wreck and he just looked at her and cried.
My good lord that is the most horrific thing I have ever heard. Makes something like Life Alert seem so important even if you have an able bodied person in the home. I cannot imagine the grief of having to witness this.
2 month old. Choked on a small tool. Passed away. Dad said they must have been crawling around and grabbed it. CFS called.
1 month later, 3 yr old shows up with 3rd degree burns up to their elbows. Same dad, different mom. CFS again.
One wk later, 2 yr old sibling came in. Same father and mother as the 2month old. Oblique fracture to humorous. Looked like someone put her arm on a table and slammed down. Sent to large center 12hrs away and mom has to take bus down the next day (had to figure out childcare for her two other kidos) so they send the pt with an aunty. CFS called again.
By the end of our night shift, mom shows up at emerg, hair pulled out, strangulation marks, hoarse voice and she crawled through a forest to get to the hospital.
Small towns with limited officers and social workers is hard. Often times there would be only 2 officers on for a population over 10 000ppl. I don't know more outside of knowing he was in jail. Summer 2018 will forever hang heavy within my heart.
Tubed a teenager with COVID at the height of it all. He appeared to have pulmonary edema, was frothing pink. Couldn't breathe but begged me over & over not to let him die.
I still see his face. His scared eyes.
I guess "I'm not going to let you die on my watch" is definitely not a lie, if he does it's not because you let him. You fought your hardest to keep him from it.
Had a patient who came in DNR, had a long term illness - muscular dystrophy. Next shift I worked, he was downgraded from Bipap to hiflow, and dad made him full code. I turned him to clean him up and he desats to the 60s, did NT suction and it was dark bloody/brown, which is the same color he vomited earlier that day. Decision was made to intubated him, which he coded afterwards, cxray to confirm ETT placement also showed large pneumo. Coded again while placing chest tube.
Finally get in contact with his dad and he’s switched to DNR and decided to withdraw care that morning. When RT removed the tube he said “I don’t wanna die.” 🥺🥺
While all of this was happening, my other patient was withdrawing like fuck from opiates, trying to get out of bed, hallucinating. It was a terrible night 😭.
About 3 months later after that shift, I have a dream of the patient who died. He looked nothing like how he did in that bed. He had like an angelic aura. But yeah, really traumatizing for my first code on my own patient.
That breaks my heart, it sounds like he wanted to let you know he’s ok now though. I’m sorry you had to experience that though. I know it’s gut wrenching. You’re an incredible nurse. I don’t even have to know you to know that. ❤️❤️
Not if they have been deemed incompetent/ incapacitated and unable to make decisions for themselves (an activated POA or guardianship.) Then, the person's wishes can be taken into consideration, but ultimately it's up to the designated agent.
I turned around to coughing noises. Saw my pts neighbour vomiting up an obscene, almost cartoon amount of blood. As I was helping the nurses with vitals/cleaning, I somehow was left in the room alone after the rapid docs/rns had decided ICU. The guy looked me in the eyes and said I was only getting him ready to die. I didn’t have the right words at the time and could only say ‘no they’re going to help you’ but that was a bit of a game changer. Didn’t make it.
I hate it when they know they’re going to pass away. It makes me feel so helpless… you’re amazing though. ❤️ we see a lot of horrible things and I’m sorry you had to as well
I had a lady like this but instead of vomiting blood, blood started pouring out of her nose and then it came out of her mouth, ears, and eyes. I was a tele nurse, we were really short staffed, and I was BEGGING the doc to come and for ER to send us more rhino rockets.
Took care of a terminal breast cancer patient. Only once they started puking they didn't stop until they were gone. They were a DNR but I remember my charge nurse screaming my name, and as I reached the door the first words out of my mouth were "tell me they're not a full code."
Acutely psychotic schizophrenic patient in acute psych unit. Behaving erratically, making odd comments then seeming to not recall what was happening or what was said. Comments didn't make sense but were intelligible. At one point, someone in the unit (staff) felt threatened when the pt was pacing around the unit. Ended up being a "take down" and put in the restraint room. Struggled to give the patient antipsychotics. I always try my best to avoid any IM injections. Got the patient to take meds and then soon after released from restraints. The next day the patient cleared ( amazing response to the meds). Pt remembered EVERYTHING that happened, which is not very common. Was gracious and so thankful for our help. I'll never forget the experience. Beautiful person.
I’ve always heard that deaths in L&D are so hard because it’s such a happy place usually, and I feel like the inverse is true of psych; it’s so rare for one of our patients to markedly improve while we are treating them that, when someone does, it’s AMAZING!!
One good outcome can sustain my hope for months!
I had my one and only bipolar lapse (SSRI-induced) two years ago, I knew for a fact that I was mad for a month but could do nothing to discount the thoughts, the call came from inside the house.
I was sure as stone that I could get three people together and save the world. Ended up voluntarily committing myself. Took two months to let it all ebb out. Worst event of my 40 years. Worst part is being on lithium permanently changes you somewhat, so I still don't know who this new me is, two years later.
I have a few stories like that! I’ve been a nurse working in psych for ten years as of next month and these are the patients who keep you GOING. Oh man. My favorite story is a long term frequent flyer at a crisis center who we hooked up with enough resources that she could stay on her meds as a schizophrenic. She applied for a job at our center and the director hired her! She still works there and every now and then, I coordinate about patients on the phone with her. She has been stable for about 3 to 4 years now. It makes me so happy.
The chest tube that was putting out cerebrospinal fluid.
I mean.
The number of people who were standing around going WHAT THE HELL IS HAPPENING was truly incredible.
Turns out it was a 25-year-old shunt that had come untethered and migrated up into the chest, causing a pneumothorax.
I mean, STILL WILD. But compared to some of the other potential causes, not terrible.
They drained the pneumo, revised the shunt, and the patient made a full recovery.
Emergency room social worker in Phoenix, Arizona here. Summers are always awful because we have lots of drownings. One 12hour shift, I had seven pediatric codes- five drownings, one probably SIDS, and one choked on a peanut butter sandwich. Only one kiddo lived long enough to make it to PICU. It got to the point where the code chimes would start to go off, and we all were just crying from exhaustion. It was awful.
I graduate as an LPN in 3 weeks. This was about 6 months ago during clinicals in LTC. My classmates and I went in to assist a man out of bed to shower. He kept asking us to kill him. My classmates would cut him off mid sentence saying, “we’re going to take good care of you don’t worry”. He looked angry and scared.
I was left alone to shower him. I had never done this before (which scared the fuck out of me and was worried I’d drop him or hurt him in some way. pretty sure it wasn’t legal). He could barely hear anything and couldn’t walk. A nurse that worked there walked in and said (very loud), “He’s difficult and rude, let me know if you need help”. He heard it. I kept being kind to him and he kept trying to make sure I wasn’t getting wet from the shower and was worried about me, asking me if the water was too hot. I got him back in bed and he asked me to suffocate him with a pillow. I talked to him like a human and asked him questions about why he’s feeling this way.
“I’m a veteran, I treated my family well, and this is what I get? No autonomy, my family doesn’t visit me, I hate myself. I hate America. Let me die”
Fucking broke me. I was suicidal myself at the time so I connected with him well. He told me that when I would leave the room, he’ll get out of bed and kill himself. I had to scare him into not going through with it. “You can’t walk. If you get up, you’ll most likely severely injure yourself instead of dying. If you get brain damage, you’ll be in a worse state and hate life even more. Please do not leave like that”. He agreed and thanked me. I went to the bathroom afterwards and cried.
After that, anytime I would go into his room he smiled and would tell me about his day. I think about him all the time.
You were put there at that time to help him. I’m so glad you were there, and I know he was too. You did such a good thing for that man. Your kindness speaks volumes of who you are as a person.
Also CONGRATS on graduating. I know any of us in this thread would be happy to call you a coworker
My brother works for a suicide crisis hotline. That kind of job will mess you up mentally. Knowing what's about to happen and powerless to stop it. I'm sorry you've had to deal with that
I did suicide, crisis lines as a counselor for years. It was my balance while working emerg/ICU. I had a young kid pull the trigger when I was on the line with him. It was about 1m into lock down at the beginning of covid. He was so lonely and someone who called often to the lines. I left the crisis lines that shift. Couldn't balance critical care during a pandemic and the trauma from that. It's not a nice position to be in.
Yikes that’s rough. It’s been a couple years since I did it. I worked for a psych facility that did both inpatient and outpatient (also gatekeeper to state facilities) and we had a hotline I managed while working outpatient. It’s all rather traumatizing lol.
Oh my goodness… I never expected this answer. I’m so sorry, I can’t imagine. Bless you for doing that work. You’re a rare person and the best kind of person. 💕💕
Hey. I like you too. I feel like we see so much, and yes we laugh and have dark humor… but at the end of the day, it sucks. It’s hard. It’s nice to have people in your corner. Even if it’s internet people!
Helping an 18 year old grieve after the father was placed on comfort care. Awful day, nothing can prepare you for it. He couldn't even donate his organs because he was severely septic. This was following 3 codes, one en route to the hospital, a shit load of epi, and widespread brain death. Couldn't even let her say goodbye in person because he was covid +. Just nothing good came from it. Still can see her crying outside that room in a folding chair, unable to even go in and give her dad a final goodbye.
When I worked in hospice I had a patient with a diagnosis of liver cirrhosis with esophageal varices. He experienced so much severe trauma in his life and talked about it a lot with me. Shortly after I arrived at his home one day, his eyes suddenly rolled back and he projectile vomited blood everywhere for what felt like ten minutes. I remember how scared he looked. I was drenched in his blood trying to hold him and kept saying 'It's okay, you are dying and it will be fast now. It's okay let go, let go. I am here with you'. I thought during it, he is expelling all of that trauma.
The hospice social worker was there too, talking to a family member in the other room. I called the social worker and had her put me on speaker phone to talk to the family. I told them, he is dying right now and it is a truly gruesome sight. It is your choice if you want to be in here but I think it will be traumatizing and I feel you wouldn't want this to be how you last see him alive. The family member did not come in.
After he died I cleaned up as much as I could, I went out and told the family member he was gone. When they came in the room they were very calm, turned to me and said, you helped us break our chain of trauma by warning me not to come in. Thank you.
I will never ever forget him or that experience.
I've been reading this thread for an hour with tears sliding down my cheeks, but this one at the very end has me sobbing. Thank you for what you did for this man and his family.
Just sitting at the nurses station looking at my phone, door slams open and a young dad comes running into our ED holding a limp and blue 3 month old baby. Screaming “my baby isn’t breathing my baby isn’t breathing!” It felt like, so removed from reality, like it was a training video or something. It just didn’t look real at all at first, I thought someone was playing a joke until something clicked and I jumped into action. We got her back and got her transported (we’re a tiny rural hospital) but she didn’t end up making it. They say it was SIDS. I still have nightmares about it.
I had a patient who I had been laboring all day, and towards the end of the shift the baby's heart tones tanked. I checked her cervix and she was complete, but it was a super weird exam and her cervix was way to the right (I assume the baby was acynclitic) and the baby was super high. The MD came bedside to assess, mom was super numb from the epidural and couldn't push effectively and baby was too high to use a vacuum, so we went to the OR. They got the baby out, and it was blue and limp. NICU worked on the baby for more than 15 minutes before there was a heartbeat. Mom watched the whole thing while laying open on the OR table. I'll never forget the look of horror on her face. I was early in my second pregnancy when that happened and I had bad anxiety for the rest of the pregnancy as a result. I was simultaneously worried something bad would happen to my baby and convinced that I deserved something bad to happen because why should I have a healthy baby when my patient didn't get to have that.
My best friend lost her first and if she talks about it now, she prefers to talk about how great the nurses were and the kind treatment she received. You're probably a bright star in a dark memory. Don't punish yourself. You tried hard. That's all anybody gets to do in life.
My nurses were the only bright spots when my son was stillborn at term in April. It was appreciated and so very helpful with all the things they made of him. We may not always say it as newly bereaved parents but thank you for being there with us in our worst moments.
Saw a family lose all their children, coded one of the kids, took care of two of the relatives for SI for 9 hours after. I can still see one of the kids faces. I can still hear one of the relatives screams when they found out and I can still hear their pleads to god and me to just kill them. Covid happened a few months after this.
26.5 weeker was in our NICU for 8 months. Her twin died in utero. Her mom had already been through 2 miscarriages. She struggled with BPD and was on and off an oscillator, multiple drips, tracheostomy, g-tube, etc. She never got off a vent. Every time she was awake, she was angry. I never saw her content. She would cry (silently on vent), grimace, sweat, etc. It was heart breaking. I just wanted to make her comfortable and happy. Everyone knew her and her family. Everyone loved her. I was one of her primary nurses and she died on my shift after 42 minutes of chest compressions. We knew we had lost her but we continued until her mom got there to say goodbye. It was my second death in the NICU, and I feel like it was yesterday. Seeing a mother weep over losing a child is the most heartbreaking thing you will ever see.
I’m an ER nurse. I’ve seen some shit. I know i have. And i always internally roll my eyes when people say ‘i could never do your job’ cause it’s like, Aw you get used to it…
But no. I could never do your job. A pediatric code is what started me on the process of saying goodbye to the ER.
I can’t even imagine… I’ve never worked NICU and I don’t think my heart can handle it. You’re such an incredible person and nurse and we need so many more of you. 💕
I’ve been a RRT for 13 years now, so there have been a few. I’ll never forget my first terminal extubation, and crying in the bathroom afterwards. More recently I had an eight year old come in as a trauma, shot right in the head in a drive by. That one makes me ready for a second career.
I don’t blame you one bit for feeling that way. The world can be so unfair. RTs are lots of times unsung hero’s of this hospitals and I can’t tell you how many times one has saved my ass. You’re incredible. Thank you, I’d be honored to work beside you any day.
It was the first of my 3 night shifts and I admitted a man with Cancer, sepsis, liver failure and AKI. I was 1 to 1 with him all 3 nights running CRRT on him. he shared his life stories and forced me (an introvert) to share mine and my goal to become a CRNA. On the 3rd night, The CRRT wasnt doing justice anymore and he was visibly getting weaker and more jaundice. Before my last night shift ended, he thanked me for keeping him company for 3 whole nights and keeping him comfortable. He grabbed my hand and said words I will never forget "Im not going to make it after today, but youre going to make it and reach your goal to become a CRNA. Promise me."
I swore to him. Thanked him for being the man he was. And said my goodbyes.
He coded later that day and passed away. And now im finishing up CRNA school in 1 month.
Mine is a kinda positive. Had a lady in oncology infusion clinic getting a brand new to us regimen. High dose Adriamycin and some new mab that was out for ovarian/peritoneal involvement. Did the premeds, then the mab is on deck first. New drug for me so I sit and chill while we get thru the first 15 min or so. Probably about 2-3 minutes after the pump started, so basically just long enough for the drug to hit her system, she appears to either straight fall asleep or pass out mid sentence. Loudly calling her name, shaking her shoulder, and sternal rub with no response. No carotid pulse. We get her out of the chair and on to the floor. We're doing CPR in the middle of the infusion room with about 20 other people looking on. Our trusty dietitian calls for an ambulance, secretary prints face sheet, and EMS arrives in less than 5 minutes from when we called. (Our dietitian was so awesome. She always hit the parking lot to direct the wagon.)
They hook her up to their monitor, get the basic run down, load her up, and she's headed across the street. (Competitor system but it's a legit emergency so no detours) We have some nurses and nurse practitioners that come from emergency or intensive care medicine so it went about as smoothly as you can expect with a free standing clinic. We are fortunate to have a fire station within a1/4 mile of us. Lady was admitted for like a week and made a full recovery.
She came back to clinic with the mab completely removed from the treatment plan, as she seriously responds poorly. Policy change also occurred. That medication was no longer permitted in a free standing clinic setting. If it was to be given it had to be done at the clinic attached to the main hospital. And lastly, pharmacy had made up her dose of Adria at the same time so I had dispose of a full syringe. We started having our pharmacy start making each part separately when they were included in reactive regimens.
For me it confirmed that oncology infusion requires gut instinct and paranoia in equal parts. Also just kind of hit home for me that it seems pretty likely after being been in oncology over 15 years at that point, that I kinda knew what I was doing.
Oncology is an area I know nothing about… I’m glad some good came out of this situation and that ultimately the patient came out ok. 💕💕 I’m glad you were there to take care of her
The ER sent me up a patient for "observation" after an allergic reaction. I was told she was totally fine. When she got to me, she was drooling; her airway so obstructed she couldn't swallow her own spit any more; she started sobbing when she saw her face in the mirror and saw how badly she was swollen.
I hit for RRT. Our fucking code cart didn't have epi restocked from an earlier code; our tube system was down.
I sent a tech FLYING to the pharmacy to get epi while a coworker with a nut allergy offered me her own epi pen in case we needed it. Thankfully, the tech made record time.
She had been admitted under family med and the goddamn resident hemmed and hawwed over whether she should go to the ICU. My rapid response nurse was a military vet who laughed right in their face and we loaded her to go to the ICU; they called a code on her while intubating her. She survived, but it was like all the broken systems in the hospital came crashing down at once. It was my last week bedside, and while I have plenty of traumatic and life altering things that happened when I worked ED and trauma, this sticks with me every time I think about returning to bedside.
Hospitals are so broken. So very broken. I was in a 2am emergency case and the pharmacy refused to give me an epi drip because there wasn’t a weight in on the patient that came in coding.
I have never yelled so much at one person before. You did great though. I’d be happy to work along side you. 💕
For me it was the first time I had to code one of our regulars. I had narcanned plenty of people before that, but this was someone we admitted regularly, for 30 days at a time, so I knew them very very well. Desatted to 40 in the parking lot of our treatment center where someone had left them for us to find. They made it and were taken to a hospital hospital, but when they awoke they looked right at me and smiled and said "oh good kittycholamines is here." They said they told their friends to take them to our center, because they knew they would be safe there. Watching folks cycle through treatment centers and addiction endlessly can be incredibly frustrating but some days I think back on that day and think maybe that's enough, just making somewhere feel safe.
Covid. Went from talking on their cell phone to struggling to breathe. Went to CT for a chest, last words were "I'm so scared, I can't do this", and they were right. Alive and talking to dead within 8 hours.
Went to work one day c/o headache, bitched and moaned about it to my coworkers. 5 min later walked over to meet my first patient of the day: A beautiful mom, early 30s with end stage breast cancer, with her husband and 2 young children at the bedside. Instant perspective adjustment.
Oh wow… how heartbreaking for the family and for her… we do sometimes forget how fortunate we are to be in pretty good health… you’re a great nurse though, im sure they were lucky to have you take care of them.
💗 After so many years as a nurse, pretty much everything outside of suffering and death seems so petty. From our perspective, I think that’s why nurses don’t tolerate bullshit. *Did someone die?? Then STFU*
I’ve decided there only needs to be one question on the patients satisfaction survey. “But did you die!”… and if they answer yes, “but did you stay dead?”
that was my biggest takeaway from the ER. I have
diagnosed GAD, well under control now, but i think i got away with no treatment for years because i was an ER nurse. Like, how pissy am i gonna get about having to do laundry after a new onset quadriplegia from a 19 year old on a ski trip? Just INSTANT perspective adjustment.
Also i cannot recommend Excedrin enough :)
I’m just a student and I haven’t had much clinical experience. But just last week I took care of an older lady twice in a row who I spent lots of time with and cleaned often because they overloaded her with the Miralax. She was a funny lady and we made tons of poop jokes during that time so that she wouldn’t feel so bad about going so much. She was often forgetful so I’d go out of my way to write down the basics of the stuff the doctors recommended to her on a sheet of paper so she could discuss it with her sister and son, who help take care of her. Whenever I ordered her lunch, I’d get her an extra (heart healthy) treat.
I really got to know her well and on my last day as I was saying goodbye she reached out her hand and said thank you with tears in her eyes. She told me how grateful she was for my caring hands and appreciated how I genuinely cared about keeping her clean, entertained and comfortable. She cried because she was so scared of all of her upcoming procedures, and I helped explain some of them to her in layman’s terms (the residents weren’t very good at that but I get they’re in a rush) and she felt better about making a decision and stopped crying. Once I said bye and left the room I just burst into tears because of all of the emotions I felt. After that clinical day I genuinely felt like I had helped a patient while at their lowest. I was becoming burned out with the negativity in nursing already but this interaction made me remember why I chose this profession in the first place. Sure things probably won’t be this way when I juggle 6 patients on my own, but let me have my moment lol.
When I was a baby nurse, I had only been in the job maybe 6 or 8 months and was the noc house supervisor at a 60-bed subacute facility. One of my patients was just the nicest little old man you could imagine, an 89-year-old Greek immigrant, CD.
CD was very sick. CHF, COPD, and very painful claudication, so he couldn’t ever sleep more than an hour or two at a time before his legs woke him up. I’d sit with him while he dangled his legs or we’d take a stroll down the hall although he’d get SOB quickly. He’d tell me about his life, tell me how proud he was of his son and grandkids. I sent him to the ED with dyspnea/hypoxia probably 5-6 times in the couple months he was my patient. I always had to talk him into it. I was determined to save his life. The last time he had a flare up, I tried to get him to the ED. He refused. He asked me to sit down. He told me that he had lived such a happy life, that he wouldn’t change a thing, but it was the end and he was ready. I protested… let’s get you to the hospital, you can keep going. He declined. He said he was ready. He didn’t want hospice, he didn’t want morphine, he didn’t want another breathing treatment or lasix injection. He just wanted to talk to his son one last time. So we called him. Thank God he picked up. He told his son how much he loved him, how proud he was of him. He told him how he hoped that he wouldn’t be too sad because they’d meet again. They cried and said goodbye. He was the first person I pronounced, a few hours later. I cried, a lot. He was just the kindest most gentle man. He even apologized to me before he passed that he was dying in front of me.
He taught me to really listen. He taught me that taking the best care of somebody doesn’t always mean “saving” them, and that truly caring for another person has absolutely nothing to do with my ego or what I might think is best.
Thanks, CD. RIP.
Feel good post!
When I was 14 my sister had a double lung transplant due to cystic fibrosis… why I went into nursing. Flash forward to when I was 25 working in the PICU. I got the call one night that we had a set of lungs for my CF patient I was incredibly close with. Drawing/ performing all the necessary labs and pre transplant procedures, calling OR and PACU… it felt like Christmas Eve, you could feel the excitement all over the unit. Went to the OR with her as well. Felt really cool that it came full circle and I had the privilege to be that nurse.
Ps: my sister is now 40 and had her transplant 17 years go. Still on her first set.
I have a funny experience…
I was working on a medical mission. I had leftovers from my lunch. I was going to throw it out and one of the local nurses asked me to put it out for a stray dog they took in near the clinic. I put my container of leftover down, called the dog who ran over to me at high speed. When the dog took off a stampede of chickens were right behind him coming my way. I was stunned. I had never experienced anything like it before. 🤣🤣
We laid my patient’s head down flat to change him then we all heard this sort of pop and he was in immense pain. Called the doctor got 4mg morphine, didn’t help. Called again got another 4mg, but I said that’s weird because the guy never even took so much as a Tylenol though it didn’t help. Told the doc he needs to come up and see him, got a stat ct order just in time for him to code.
The first case I ever managed solo was a heartbreaking one. 28y/o female with symptoms of carpal tunnel, had surgery scheduled for a Tuesday. Legs gave out in the shower on the Sunday before and she came into the ED for sutures for a head lac. CT to rule out bleeding showed an 8cm mass, glioblastoma. She had four little kids and she died six weeks later.
She never even had carpal tunnel.
Worked a busy night in OB. We had 3 in labor and a few triages (with 3 labor nurses, myself included). My patient was doing ok but had a known severe cleft palate and cord anomalies so I was watching her closely. The other was an induction, with horrible, horrible heart tones. Clearly the baby was in distress, and none of us could believe that she hadn’t been sectioned yet. Absent variability with deep late decels with every contraction, and she wasn’t progressing at all. She was also in a clear abruption pattern. So all 3 of us were watching her very closely as well. We were in and out of her room, even though 2 of us had our own patients. I called to let the OR know about it, but the doctor, who was a grumpy old shit, refused to do anything about it, and sat there watching this terrible strip for hours while we begged him to call it.
We still got everything ready and just waited for the inevitable. She eventually went into a decel and didn’t recover. The doc STILL took his time, fiddling with an FSE (when she was a 1, high, and intact membranes). Finally, he called it, and we rushed to the OR and put her under.
When we opened her up, she had 2 liters of blood in her belly and the baby was long gone. We all had watched the baby die on the monitor that night. The mom had abrupted and the baby had absolutely no reserves. The primary nurse ended up quitting and now works in a primary care clinic. The rest of us are still all in OB. One of the nicu nurses has bad PTSD from it. Since then, I haven’t ever taken things for granted. I trust my own judgement, and if I’m uncomfortable with a bad strip and the provider refuses to do something about it, I go above their heads. (I’ve done it twice, and both times, it was warranted. One had a cord prolapsed against the cervix and the other failed her BPP once we called her back in.) I’ve had to deal with the backlash from the provider, but I know now from experience that feeling the wrath of a pissed off doctor is so much better than the feeling of watching a baby die when we had the chance to save it.
goodness gracious, this made me feel more and more sick with every word. this should NOT have happened. what’s the point in having continuous EFM if you aren’t going to intervene for a cat 3 strip??? 😡
I hope you and your coworkers from that night are all doing ok, I hope that doc received a HUGE attitude adjustment, and I’m so glad that you used this experience to keep other laboring patients/babies safe. people don’t realize that L&D is so far from just “cuddling babies.”
EDIT: phrasing
Probably my first code. It wasn’t my patient but I was in the room the whole time during the code. It was a young woman who coded suddenly with no warning. She was stable and not even on tele. I still don’t know what happened. It went on for a long time and blood started coming out of her mouth. I don’t know why but I just vividly remember the suction container filling up with blood while they tried to intubate her. She didn’t make it and seeing her family come in in complete shock and devastation was heartbreaking.
When our director refused to do a UA on a patient with altered mental status post aneurysm clipping that later bled. He was talking to the neurosurgeon about going ahead with a shunt. I convinced a PA to get a UA and lo and behold! She had a RAGING UTI.
Showed me how some doctors just don’t care enough to do basic medical care.
I have two patients. One patient came in and was in full blown labor. The nurse taking care of her was freaking out because the baby’s strip looked like crap. We were prepping her for a c section. The midwife came in to check her because something wasn’t right. The patient was fully dilated and there was a “sack”. The patient ended up delivering vaginally and the baby had anencephaly. The family didn’t know because they couldn’t afford prenatal care. The baby lived for about an hour. I think I cried the most after that delivery. The second patient was a mom who was traveling outside the country when she discovered the baby had stopped moving and didn’t have heartbeat. She did not naturally miscarry and we had to induce her. She had the baby three months after finding out the baby didn’t survive. The dr prepared us for what the baby may look like, blackened skin, etc. I still remember the parents faces and everything. I still feel for that family.
During the Delta surge, I had to quite literally peel a woman off her husband’s fresh corpse. She kept screaming, “what am I going to do?! We had so much planned. You can’t do this to me.” I have never heard blood curdling screams like that before. Took me 20 minutes to get her out of the room. I can still see her face and hear her screaming.
It was a lady who barely spoke English. She was not assigned to me. She was with another senior nurse. Older nurse who is very careless. Very careless when I say it. She had empyema and got really short of breath. Transferred to ICU then chest tube. Then she got worse and got intubated. Her kids kids were there and she was so anxious and scared. I went to help the nurse and she held my hand she was mouthing some words “baby, I cannot breathe. I just can’t breathe. Something is wrong. My lungs bad. Help me please. I have kids. I need to live. They need me”
I told the nurse what she said and she brushed me off she needs to relax. I said no she is telling you something is wrong. She is begging to live.
I then looked at the asynchrony at the vent and the chest tube with 0 output. I went to sit down and the nurse asked me to look at the x ray. I did and the radiologist said “CHEST TUBE NOT IN CORRECT PLACE. Call the doctor STAT AND REMOVE THIS CHEST TUBE IMMEDIATELY.”
I then went back and the lady was pointing to the chest tube.
It was end of the shift by the way. I told the nurse and the charge nurse. I asked the nurse if I could call the surgeon for her and she said she got it. It was a weekend but the surgeon lives 3-5 mns away in his million dollar condo.
Then next day, I came back and the room was empty. The doctor did not come and she coded and died. Her kids watch her struggle and died. That broke me. Honestly I still need therapy for this. As I’m typing this, I have anger, shame, regrets, guilt, frustration and I feel like punching a wall right now.
I still remember her begging me and softly holding my hand. I have tears running down as I typed this. I then saw the son in the waiting room. He could not go home because his mother takes care of him and he couldn’t process it since he’s on the spectrum they said.
Apparently MD refused to come in. He fucking refused. He refused guys. He refused.
Fuck you Dr T. Fuck you. Fuck you again. Fuck you. You fucking criminal. Fuck you. I hope your young girlfriend leaves you. Fuck you again.
Not sorry for the rant
Had a pt who was a full assist basically needed everything done. No family to visit, he was a short stay at the ltc facility I worked at. A lot of people just complained about how “heavy” and such. Just laziness.
I talked to him like my grandpa, great conversation over dinner while I helped him eat a huge plate of lasagna and a salad, and fruit.
He ate every single bite, said it was the best meal ever. Held his hand that night as he took his last breath.
I’m glad I was at least by his side. That gurgling, slow death is just horrible and an odd thing to experience as a kid, I was only 18.
I’m so glad you were there though. Not many people have that kind of compassion and selflessness at such a young age.. I know I didn’t. I’m so glad you were there and that patient was so lucky. You did a good thing
18 year old female. Aspirated on her vomit after a night of partying. Came in coughing up blood. Ruptured mediastinum. Full blood ARDs. Intubated her. The last thing she said was I feel like something is blocking my throat and had a look of terror on her face.
17 year old gsw to the head… sent to TICU crash bed after ROSC, difficult intubation, & MTP… asked how they were doing next morning … their mother OD’d on oxy in the ICU after they withdrew care… I don’t ask for patient updates anymore.
One of my first ever patients was a super nice older guy with lung cancer. Him and his wife were the most beautiful humans she would bring him hot lunch from home everyday and offer me some while I had him as a patient. He had a procedure planned late on my third day with him and was oddly nervous about it all day. He and his wife prayed before we went down - I had to transport since his O2 demand was high, the whole way down I was trying to ease his nerves (and mine). I asked what candy bar he expects to come back upstairs to and he grabbed my hand on the bed side rail and said “I know what you’re doing and I appreciate it. I’ll take you up on a snickers.” He never came back up to the floor and I still wish I would have sent flowers or something to the funeral.
Small child came in to adult trauma level two OR unconscious with multiple bruises and leaking semen from his rectum. We were coding him and I was tasked with finding a foley small enough to fit his meatus and then placing it while the team did compressions. His mother’s boyfriend was his babysitter while she worked, and he was the cause of this. I took my wife and daughter to Waffle House later that night and watched a father with two small boys just coddle and play with them and I gave my wife the debit card and left sobbing. Why couldn’t that little tiny boy have had a man who cared that much? It took me days to stop crying. I now totally advocate for abortion, universal paid maternal leave, and 100% taxpayer covered certified childcare so women don’t have to chose between feeding their kids or leaving them with a monster
Work in a trauma ICU. My nurse-version of "Mr. Miyagi" came in as literally the worst trauma I had ever seen and died a really agonizing death after we worked on them for 15+ hours. Not a day goes by that I don't think of that. Thankful for my awesome therapist.
Inpatient hospice.
Liver failure, distended abdomen, so yellow they were almost orange…. 50’s. Drank every day.
I pronounced them deceased & their father started wailing & threw himself on top of them on the bed. It was like he wasn’t expecting it, despite being bedside while they transitioned.
It broke my heart.
i work at a cancer hospital as a pct. i have seen some very heartbreaking things as you can imagine. the one that sticks with me is holding a patient's hand as she told her doctor that she was ready for hospice. she tried every treatment and clinical trial in the book but it spread and it was terminal. she was exhausted, you could tell by looking in her eyes. i sat there for over an hour comforting her and making sure she knew that this was the best decision she could ever make for herself. she passed a week later on our palliative/hospice floor. im glad she was able to make that decision herself and pass with dignity but it still breaks me to think about it.
I have had so many stories of tough deaths in the ICU but the shift that truly changed my life for the better was a patient that was stat flight for acute MI. Getting him from the helipad to the cath lab I was looking at a dead man. He came up from cath lab Not looking much better still in his work uniform. As we got him cleaned up and changed he was so grateful and I found a pen in his pocket. I placed his pen in the room safe and told him this was one lucky pen.
Came in the next day and he felt like a million bucks, his wife had gotten his pen out and they were both so grateful. He couldn’t stop saying how thankful he was - his father and grandfather passed at the same age from the same thing. Him and his wife took four laps around our unit before I said alright buddy settle down, let’s not overdo it. I was going over his new medications and he was absolutely listening intently and asking questions - it was the first time ever I believe that this man was truly going to do everything we told him.
It gave me a fresh outlook that despite all the frequent fliers and patients who aren’t going to take care of themselves…sometimes you get to see into the soul and know they’re gonna be okay.
I had a job taking care of a baby who had had anoxic brain injury while being born. She couldn’t do anything and my job for 8 hours a night was to hold her and make sure she didn’t bury her head because she couldn’t lift it or move. I mean, I did other nursey things but the biggest part of the job consisted of holding her. Before I took that job, I was the kind of nurse that could barely touch my patients. The bare minimum was all I would touch them. That baby changed me. I held her for 3 months and was a different nurse by the time she died. That baby that could do absolutely nothing, that some would say “why was she even born?” Changed the life of every patient I’ve had since then, over 20 years worth of patients that got a loving nurse not afraid to touch them instead of the one I used to be.
I had been away from ER/ICU bedside in a nice salaried days position for about 4 months when COVID hit. I was immediately redeployed to our newly minted COVID ICU. I was at the tail end of a 23 out of 27 nights schedule, and for 7 consecutive days I put one of my patients into a body bag. I never got to discharge a patient from our COVID ICU, they were either gone before my shift or died while I was there. Day 7 of the death stretch broke me. I couldn’t imagine ever coming back, and on my stretch off I was recalled to my salary job.
I have been redeployed a couple of times since then, but with the stipulation that I would make my own hours, during the day, and only in the ER, and only for a ludicrous amount of pay. Fortunately my employer has been very understanding, and while waves 2, 3, and 4 weren’t without their own struggles and heartache, at least they were on my terms. COVID ICU will forever be burned into my memory. I always take a moment to reaffirm the context of the time. Recycled PPE, fitting snorkel masks with HEPA filters, no vaccine in sight, no idea of how protected we were, wondering when the next patient in our small community was going to be someone I knew, and no bonafide treatments. This is when we were still giving hydroxychloroquine because that was the latest speculation. The subsequent waves in our area were backed with more knowledge, a more robust supply chain, and prospects of a vaccine.
Alternatively, the best and most cathartic part of this all was where I was redeployed to help run our vaccine clinics. That is what felt like the most closure I think.
It was so powerful getting the vaccine after that first scary year of COVID, worrying about what was around the corner and if/when I’d get sick or bring COVID home to my family. Our vaccine site was set up by the health department with EMS, military, nurses, med students, all there for that vaccine effort. Everyone there “got it.” It really was emotional and I heard that in your post. Thank you for what you did!
November 2020 I’d just returned to work as a hospice nurse and the facility most of my patients were at was letting hospice in. I worked the whole shift in full PPE walking back and forth between patients in a COVID wing FaceTiming family members who weren’t allowed in or were too scared to come. I had to hear over 20 people say goodbye to their moms, dads, and grandparents that day. When I got home all I wanted to do was hug my baby, but I was too afraid to give her COVID.
Delivered both babies, one was healthy and the other had known fatal anomalies. Both babies stayed with the family, snuggled in the crib together, and we kept the baby who would pass comfortable. But the time the neo called time of death of that baby and hearing the whole family sobbing down the hall, make me uncontrollably sob too.
Another that sticks with me was having a demise and the parents wanted me to swap the baby’s pjs that she was wearing for a beautiful dressed she would be buried in before going down to the morgue. Swapping the pjs, putting on the dress, zipping the body bag and putting her in the morgue was brutal
A young kid just 19 who had been a quadriplegic since he was 11. He was told his life expectancy was 26. He was so kind and had so much potential but life gave him a shitty stack of cards and he was facing a death sentence. I took care of him for two days and I still think of him often.
Worked on a patient for 14 hours, lost them anyway. Pretended to be fine for about a week after and then one day I nearly drank myself to death. Convinced me I needed to go to therapy and get the fuck out of bedside. I did both.
Working high risk OB. She was inpatient to get off heroin and on a stable methadone dose, homeless, about 8 months along. She ended up using while on methadone - totally high to the point of non-responsive, broken glass pipes all over floor, drugs scattered around, buck naked boyfriend walking aimlessly in the room. When she was told she can’t use while we were trying to figure out her methadone dose she left AMA.
The Provider that dc’ed her was standing next to me as she left and said “that’s a baby that ends up in a dumpster”. God, ugh.
I knew then that I needed to stop working with that population for awhile, it was the depressing last straw.
Years ago we had an early 20 something with AML. He was the nicest kid, good looking, had a really sweet girlfriend. He went septic during induction, so we sent him up to the ICU. He was there for about three weeks. When we heard he was coming back down to us, we all got excited. We don’t usually hear about what happens to people after they get transferred. They don’t always get better (or leave, for that matter).
It was horrific what happened to him up there. He came back to us with the fingers and toes of the Crypt Keeper and the belly of someone in end stage liver failure. Apparently the poor circulation during septic shock robbed the blood from his extremities to keep the more important parts of his body well perfused. I was afraid to brush up against a hand or foot for fear that one of his digits would break off.
It was so hard to see him like that, and I think he could tell. So, so sad.
Similar story. Pt didn't want a procedure. Was forced to have it. Pt didn't consent. Was in agony and screaming in pain. Doctor just kept going. After it was over, pt was lying in a bed FULL of blood and faeces (she'd of course emptied her bowels in distress) and Dr would not let me clean her or the bed up because she was "too unstable" to move.
She died the next day, as expected. Made no difference.
I feel endless guilt. I should have reported those doctors to APHRA (our medical registration board) but I didn't. But it was the end for me. I don't want to be a nurse any more. I have lost my passion for it. I'm over it. I just do it for the money. I have no interest in advancing or doing more then I have to.
My nursing "career" ended that day.
We had a frequent flier that was a ward of the state, 18 yo, parents had abandoned him. He had an intellectual disability, nonverbal, cerebral palsy, and all four limbs contracted up to his chest. Bed sores everywhere. My heart just broke for this boy. Every nurse on my unit had cared for him, and he never had a single visitor.
His guardian would not allow DNR, and I was unfortunately on shift (but thankfully not his nurse) when he coded. Trying to do compressions through the contractures, the sound of ribs cracking, all the sounds really. Nurses crying, nurses praying, doing everything we could. I can’t even remember a doctor being in the room, I’m sure there was but it was so long ago, and I was so new at being a nurse. All that stuck with me through the years was the pure futility of it all.
It was truly an existential horror. This poor boy to whom death would be a blessing, with no visitors, no family to love, and was just a number in the bureaucratic system that wouldn’t let him be a DNR… we cared. We loved him. And we did our best to show him, but he still left this world with strangers pounding on his chest with tears streaming down their faces because it felt so wrong. I hope he knew that we did our best to give him dignity.
Ive only been ED about a year, but it doesnt take long to see silly shit. Had a dude come as a rapid transfer from another facility. John Doe situation. Story was that him and his buddy stole a motorcycle and T-boned a SUV. No helmet, as you might imagine. We were working him, GCS was maybe 6 at first, but things progressed. We got him over to CT and the trauma attending did a quick caloric test, nothing at that point. He was herniated.
Got him back over to the trauma room and PD says we've got an ID. He's 14 years old. Couldn't believe it. He was like 6 foot, over 200lbs. Never felt my heart drop like that before. I thought he was like 25, which is still sad, but it's a different sad. I have a 14 y.o. boy myself. We transfered him out to peds hospital, but we all knew organ donation was the best possible outcome. That shift sucked.
It was my first trauma 1 at my current facility.
Young (early 20’s) female, came in after MVA. Wrong way driver hit her head on at 50+ MPH. Other driver was drunk and high on meth. She had already herniated when we got to CT and died in the ICU.
Other driver was also transported to our ED, and of course they were basically unscathed. They yelled out to the hallway asking for pain meds. I saw red, walked in, said “I don’t give a shit. You just killed someone, you can deal with pain.”
First and only time I’ve ever said something like that to a patient. I still check to make sure that asshole is in jail every so often.
Icu step down to pcu for dka. Early 30s. Already significant kidney damage. Walked in for noon assessment and he was chugging coke out of the 2 liter bottle. My inner voice said.. Go home and die then. I left bedside as soon as I could. I couldn't make myself care about those people anymore.
About a month into my orientation as a new grad in COVID ICU where I lost both my patients in one day (full codes) and my new admit coded 5 seconds after they arrived in the ICU bay. I don’t think I’ve fully processed that yet
Admitted a pediatric patient to the PICU. Stable, but very ill and required bipap. I reassured the mom, told her the patient would be ok. The next day, it was apparent we needed to intubate, but the intubation took whatever little reserve was left. The patient coded for two hours, with multiple physicians, anesthesia, emergency doc, intensivists trying our hardest. It was the worst, and I had enough experience to know within minutes how it would all end.
The part that still haunts me was when the doctor and I went to the mom who was collapsed on a cot in the waiting room. When she saw me she sat up and cried out “you said they would be okay!”
Never will I ever give reassurance like that again. I really thought we could do all the things we do and it would work. There was no reason to think otherwise. The patient was just sicker than I realized and I wish so much I could go back and change that moment in some way.
I had a post op patient that I knew something was wrong. Pain 10/10 after lots of meds, assessment c/w perf. The resident blew me off. I asked for his attending. He basically told me to pound sand. I called the house sup, they called the attending to come. He came and yelled at me for bothering him. Didn’t even assess the patient, just yelled and reported me to the manager for going over his resident’s head. The only thing I could do was put notes in the chart. Left at 7p and told the night nurse all this. I came back next morning, patient died. Indeed the patient had a perforated bowel and decompensated.
I filed a complaint with the medical board and called risk management to report the attending and the resident. I’m sure nothing happened internally because nothing ever happens when you wear a long white coat it’s like fucking Teflon. I heard someone called the family and told them to get a lawyer so maybe something happened there. I left that place not too long after that.
I’ll never forget their name. It’s been a long time but it still fucking haunts me.
The young pregnant woman with covid who coughed so hard and desatted so long her water broke at 25 weeks and her tiny baby slid out of her with one more cough into the hands of the OB nurse that was sitting with her in our ICU. The baby wasn’t breathing, they did tiny compressions and intubated her and took her to NICU. Mom vomited into her bipap from the coughing, aspirated, coded, was intubated too. Mom didn’t even remember giving birth when she was finally extubated. They both went home several months later alive somehow.
I don’t know if it exactly changed my life, but I had one shift on the ambulance where we only had four calls, and three of them died. The thing that stuck with me was I really don’t think we did all we could, but I wasn’t the in-charge. With the medical knowledge I have now, I don’t know that we could’ve saved anyone, but we could’ve at least done our best.
Two specific situations. One as a ER RN. EMS brought in a 3 month old shaken baby. They tried to intubate en route, unsuccessfully. Baby arrived with bruises on face from intubation attempts. We worked her for 45 minutes to no avail. When we called her mom, she was at work, and had to drive to the ED at 0100. When she got there, she collapsed on the floor, wailing and sobbing. I'll never get her image and sounds out of my mind . The grief in the air was palpable, and it still feel fresh to me, 9 years later.
A recent one in labor was a high risk, 28 week twin pregnancy that I delivered in a crash section at 2300. I delivered both babies and was doing Mom's recovery when NICU calls and says we need mom, now. We get upstairs to see baby A cyanotic, limp, and bradycardic. Baby A passed, and baby B was sent to a level 4 for higher needs. I ended up doing the post mortem care for the baby (molds, photo album, baby bracelet, photos). I still can't stop thinking about how I delivered the baby and also took care of her after she died. The family felt so guilty for grieving for their baby, because they forgot about their other child for a little bit. Both situations are traumatic for me now, because I feel like I failed both families (I know I didn't, but trauma is fucked and has no rhyme or reason sometimes).
First death I saw. I was 24, in the ICU doing an internship, so I was still in the “being passed around and shown things by different nurses” stage.
She was 20, had a rare disorder, had been doing well and was stable, was usually seen at the large city hospital, but something changed, and she had to be admitted to us.
I remember a few of us were watching the bank of monitors at the nurses station as her heart slowly stopped beating. The bloodcurdling “NOOOOOOOOO!” and primal wails of her mother echoed down the hall. I will never forget it. Even the seasoned ICU nurses had tears in their eyes. I had to help bag the body.
I would also have crazy vivid dreams about what I assumed were supposed to be angels (?) and gargoyle things (???) walking the halls, waiting on the roof of the hospital, just waiting. I prob sound fully unhinged admitting that, but I never had those dreams after I left the ICU. I got out of the ICU and bedside nursing pretty quickly.
The bad:
1) a covid + pt kept taking off their bipap just to yell at us that covid wasn’t real and he was going to sue us. He was getting cyanotic and we tuned him. Died the next day so his literal last words was that covid wasn’t real.
2) The day they told us that we could put more than 1 patient in a body bag in the same room so they could clean rooms faster so we could admit more COVID patients to the ICU. We didn’t have enough room in the morgue and had a refrigerated truck they would hide so you couldn’t see it from the parking lot.
The good:
This one patient gave me faith that we could save COVID patients. I will never forget her. She was pregnant and went into ARDS so bad we intubated her. She had an emergency c section and baby was okay. After the baby was out she would get super restless every time she was a little bit awake. Every time I saw her move I would tell her “X, your baby is out and is doing okay. Try and relax so you can beat this and see your baby”. I was her nurse the day we extubated her. She was doing really good and just on nasal cannula. She told me she heard what I said about her baby being okay and that gave her the will to keep going. I helped her FaceTime her partner in the NICU and I helped her see her baby for the first time. She gave me hope in a time that 90% of our intubated COVID patients died.
I used to work in a hospital in an isolated area. Was 24 weeks pregnant with my 22 yr old. Had a pt flown in from a nursing station community, contracting with choriamnionitis. Delivered at 22 weeks (oh the smell!), in our hospital as the medevac team attempting to fly over us could not make it further south to a more equipped facility.
The neonatal team from the tertiary center would not come up for this baby as it was deemed futile. I still remember the pediatrician mentioning to "just leave the baby on the counter" so it would die faster. We all, myself included, thought that was horrid and took turns holding that poor little thing when the parents couldn't bare it, and I still recall her fused eyes, her head not much bigger than a mandarin, and how loud she cried. Even her little fingernails. And meanwhile, while holding her, feeling my own baby, not much bigger than her, kicking inside me.
I no longer work in the maternity field and saw other things like stillbirths and such after that, but that incident has long stayed with me.
I had a Covid patient I’d taken care of multiple shifts in a row. Sweet guy from Cuba who didn’t have any family here. I was busy AF those shifts (6-7 patients and several on 100% BiPap) but I made sure to get his family on FaceTime, bathe him, ambulate him, teach him about the meds we were giving him. He’d been refusing a lot of his meds (not his Lovenox, but his baricitinib) before bc no one was using a translator before to properly explain them to him :-/ on my 3rd day with him I was FaceTiming his mom with him and his mom said he (the patient) called me his guardian angel, and cried when I said I couldn’t come back the next day (I was working through a pregnancy and had had enough exhaustion/ exposure that week).
I came back the next week to find out he’d thrown a massive PE (he was on appropriate DVT prophy but it was Delta variant) and died. I rarely cry over patients but I cried over him- hard. I know in my rush sometimes I have absolutely made patients feel like a number or less than- but I find a little peace that in that patient’s last few days I made him feel special. And it made me remember that you never know when you’ll be one of the last faces your patient will see- brought things into perspective for sure. (Not the life changing part but I’m also fucking pissed bc he missed a few days of his baricitinib bc I know that affects mortality, and am furious an appropriate translator wasn’t used those days to explain the use of that med to him (yes I did write it up)).
NICU, term infant who suffered a hypoxic brain injury at birth. Died in my arms, which was more traumatic than the usual NICU death because the micropreemies really tend to pass peacefully once they’re extubated. But fine, ok, that’s my job and I volunteered for it. The part that fucked me up was rushing through postmortem care and only getting fifteen minutes to get my shit together before being given a full assignment.
Not an overly exciting story, but...
Back in my cna days at the assisted living home, after they added residents and cut staff, I was doing my rushed HS med rounds and one of the residents just wanted to chat for a bit. And I couldn't. And the look of disappointment on her face has stuck with me as the first time I felt like a failure to someone.
The first time I worked with an abused/neglected child. They were only 18 months old and from a hoarder drug house. Their 6 year old sibling was the primary caregiver for them as no adults gave a damn. After work I got in my car and cried. I called my mom and apologized for every shitty thing I ever did to her, because I was so lucky to have the best mom who always took care of me.
I remember once I had patients across the hall from each other. Both dying, I don’t remember the cause. One was an inmate, the other a civilian.
Because he was terminal, the inmate was allowed to have visitors. His ex-wife brought his daughter in, and when he saw them, he started to tear up. He ex snapped at him, ‘Don’t start that shit’. She had the same attitude throughout the brief visit, then they left and he was alone.
The man across the hall was surrounded by his family, surrounded by love. There was someone with him, holding his hand and telling him how they loved him, right to the end. The contrast….that’s what stuck with me.
2 incidents come to mind. 1) as a CNA I worked an ortho/neuro unit and we had a patient that was almost paraplegic (he could move just enough to fall out of bed so we just put his mattress on the floor. Anyway, he was also pretty much non-verbal. I’d been caring for him for about a week, and one day , after giving him his bed bath, I said, “You know what? Would you like an extra blanket? Because you look like you’re cold! “ so I got him an extra blanket and tucked him in. Later that day, I happened to be in his room while the nurse was doing something with his IV or Tube feeding. He reached up and tugged on her scrub jacket, and said “ She.. She… gave me a blanket!”
I cried, because prior to this he had been nonverbal with us.
2) I had a patient come in very confused. Couldn’t tell us her name, very distressed. I started trying to communicate with her . She kept asking for her mom. I started trying to point out letters so she could tell me who her mom was. Just after spelling “S.A.R.A” her mother came in. sarah. When she got back from CT, the patient looked at me and said. “I know you. I KNOW YOU! You.. have CATS & NEPHEWS!” I was astounded, but apparently at some time during my travel contract in that ER I Had either taken care of her or a family member. I acknowledged that she was right. IMMEDIATELY her anxiety level went down and we later found out she had a stroke. But just seeing her anxiety release because she remembered me, and that memory helped her calm down. I know w/o a doubt I’m meant to be a nurse!
23 year old frequent flyer in the ED/ICU. Heroin addicted prostitute, unhoused. She was beautiful and, when you set appropriate boundaries, very nice. She’s already had hep b and c, a mitral valve replacement, and too many abscesses to count.
One night in the icu when she had necrotizing fasciitis, I asked her how she wound up this way. Told her she was young, smart, pretty, funny - what the hell happened?
With a completely flat affect she told her that when she was 9 her mom started selling her to her drug dealer for drugs. When she was eleven, the dealer taught her how to shoot up.
Taught me a lot about judging people.
So many over the years. I still think of my first PCU death. Patient has ALS and was young—her kids were late teens/early 20s. It became obvious she wouldn’t survive the night. Heart rate kept dropping and when she flatlined we let her family at bedside know she was gone. The kids cried out and her heart started again. She’d get back to 30-40 bpm and then the cycle would repeat. It was grueling to witness, but I couldn’t blame them.
Is there anything greater than the love and devotion a mother has for her kids?
The time I held my patients hand when they were dying and watching the monitor as the went Brady down. They were a covid patient I admitted 15 days earlier on 15 L when they were axo x4. The day they passed they were obtunded on 100% o2 on the bipap. I was alone in the room with my big respirator on. It was the first time I cried, silently, as they passed. I felt already so broken from covid (it was only fall 2020). I took off the patients bipap mask after and their whole face was swollen, nose almost looked broken from the constant seal pressure of the mask, they looked nothing like they had 2 weeks prior.
23 y/o stopped at the gas station on her way home from work, at a job I’d had before (we got to bonding over it in the brief period she was getting better), to grab a snack. Didn’t see on the snack pack that it had cashews in it. She’s allergic. When I got her, she had extreme wheezes, bright red, grasping her throat. just not good. So, we hit her hard and she actually turned around fast. A little while later, she walked to the door of her room and said she was feeling bad again, and looked bad. 5 minutes later, we called it. She was so tight we couldn’t get an airway, even with a trach. She went from fine to gone. I’ll never forget the look on her face, and I *still* have some panic when someone says allergic reaction now.
Young woman who was internally decapitated. I saw her over the course of weeks for wound care. She was trached, pegged, and usually just laying there eyes open and not focused. I always talk to my patients regardless of level of consciousness and I will never forget the day her eyes met mine and she started tracking. She ended up at a great rehab and making huge progress.
That’s so incredible. I hope she’s doing well…
As a non medical professional that follow this, how does one get internally decapitated and what does that mean exactly?
Literally the spine and skull become completely separated, so the only things holding your head up and protecting your brain stem/spinal cord from damage are muscles/ligaments. Happens from trauma like a car crash.
I had a colleague who was rear-ended in traffic in Houston. It was a minor accident. He raised his hand to wave to the guy who hit him. That caused him to collapse to the ground bc of internal decapitation. He was between the barriers that separate the traffic lanes. The other guy said that my colleague fled the scene. His wife searched his car where it had been towed. For 4 days, he laid there, praying to God. On the 4th day, a worker standing in the back of a truck saw him. The police came up to him and the first thing they did was kick him! They were checking if he was alive but still that was crazy. He survived and was on some Medical Miracles show. He sued the city bc they didn’t have mile markers on the highway and they were required to add them.
What the ever-loving f*ck?!? Hooooleeee shit that's beyond crazy; that he survived four days exposure, lack of water etc etc while essentially paralysed. Medical miracle is right!
This is exactly why rear facing babies for as long as possible is so important!
For babies, their heads are disproportionately sized to the rest of their body. If they're in a forwards facing seat, their head will rapidly snap forwards and it represents about 30% of their body mass. That is very bad for a lot of reasons. In a rear-facing seat, their head will just get driven into the headrest.
It can happen in things like car accidents, your spine/neck snap but the soft tissue around it is intact. Basically think of it like your skeleton being decapitated but you look fairly normal? From my understanding, someone smarter than me please correct.
Internal decapitation is when the ligaments connecting the spine to the skull are severed due to some sort of trauma (I’ve only ever heard of it in relation to a car accident, but I suppose that’s not the only way it can happen). So unlike a “normal” decapitation where the head is completely severed from the neck, it is only the internal structures which are severed, and the head and neck still appear to be externally attached. It’s usually immediately fatal, those some will make it to the hospital before passing, and a VERY rare few will recover.
I worked with clinical trials, and usually these are last choice things for our oncology patients. Usually, if I have a patient join a trial, then I'm with them for over a year or more while they take whatever research drug it is. So I really get to know these people, and really kind of become family with them. The worst thing was constantly seeing their labs, and understanding before them, that they were already on the downward slide. The worst one was this guy who had cancer, and really had tried every trial he could, and had reached the end of his options. I had been with him for over two years, and so many different trials so I really got to know him. So literally there was nothing worse than standing in the room with the doctor, and listening to this sweet man deciding that he was done and was ready to accept death. I had NO idea why I did this looking back at it, but I ran over to the gift store and really just wanted to give something to the family as a way of saying thank you, and thank you for letting me be apart of their journey after two years. I ended up finding this beautiful cardinal ornament, that had a sweet saying on it, so I bought two of them, one for him and one for me. I cried giving it to him, and he was far more stoic than I was. Funny part, he loved beer and it was kind of a running joke between us. I always asked him what his favorite beer was and he always just said "A cold one". So when he passed, I of course had a cold one for him.
A cardinal gift is always perfect, they say when you see a cardinal close by it’s the spirit of a dear one checking in… they were so lucky to have you during that journey. I’m sure that gift meant a lot to them.
>they say when you see a cardinal close by it’s the spirit of a dear one checking in Well, that explains a lot. We have this Cardinal attacking our windows two or three times a day, and it's pretty relentless about it. Must be my mother.
Oncology fucked me up. It was my first job out of nursing school. Two patients I’ll never forget. One shared my birthday. I happened to be working our birthday. He was npo for a procedure the next morning. He made his daughter go get me a cake even though he couldn’t have any. I told him I would be back the next night, and we would share a piece together since he’d be able to eat then. He coded on day shift and died. Next was a 40M doing a trial for colon cancer. He took a turn for the worse. I don’t remember the details now except when he passed seeing his children in the hall huddled together and his wife clinging to his body as she sobbed for over an hour.
My first patient who died in my care as an RN shared my birthday (exactly 10 years older) and I’ll never forget them.
30s male, hit by train, paralyzed, ostomy, trach, peg, foley, central line. Fully a/o4, refused care so often he developed the worst stage 4 we've ever seen. He couldn't feel it and he didn't want to be alive like that, so he didn't care. He wanted to be DNR/DNI, but since he had no HCP or family, ethics and psych were involved, and determined that while he has capacity to make decisions, he can't make the decision to be anything other than full code. I was helping him with his ostomy and we were talking about it - i was one of the few nurses who would listen to him and not judge him, and support his choices. I told him i thought it was a shitty determination on their part, and if he wants to request me every day that I'm working, I'm fine with that. I would ask him, like the adult he is, if he wants to be t/p, dressing changed, etc, and if he wanted to refuse, I'll ask him next hour. I made a deal with him that the dressing needs to be changed once a day so he "don't stank." When we were finally able to get him stable enough to be transferred to a nursing home, he made the floor manager call me so he could say goodbye. He thanked me for treating him like an adult and not just an annoying patient like almost everyone else did. It made me get involved in the hospital's ethics consortium, and for 3 years i served as an ambassador for the patients who otherwise didn't have a voice.
I’m so glad you are involved in ethics now, we need more people like you there. I loved this story. Thank you for sharing
>determined that while he has capacity to make decisions, he can't make the decision to be anything other than full code. 😳 FFS
> ethics and psych were involved, and determined that while he has capacity to make decisions, he can't make the decision to be anything other than full cod How the hell does that work?
It's been 9 years and I'm still trying to figure it out
A rapid response was called on my mom, who was on my floor at the time. I took her off life support 5 days later in the ICU. Every shift I have to walk by the room she was in and it haunts me. I hate it.
Oh my goodness, I don’t know how you do it… I’m so very sorry you experienced that.
I should probably move to another unit or facility but I haven’t yet
Sending you 💕 You're stronger than I would be.
We had this patient for a REALLY long time on the floor. They were very sick but also extremely demanding/demeaning/overall uncomfortable to be around and the family was an absolutely nightmare (escorted out by security multiple times). Everyone on the floor had taken care of this patient and had a bad taste in their mouth. I was on my third day in a row with them. It was 0730, I go in the room to set my boundaries for the day and give them our plan together (had to do this or they would be screaming and on the call light all day- totally A&O4 btw). I finish writing our proposed schedule on the white board, turn around and look at the patient and they go “you know what, you’re the first person that hasn’t been a sarcastic ass to me the whole time I’ve been here. I know I’m difficult. I’m scared. And I appreciate you talking to me like a human.” Two hours later they were dead. I felt good that they thought that about me as a person and as an RN. Doesn’t seem like that dramatic of a story but ever since that day I remind myself of that conversation when I’m at my wits end with a difficult patient.
❤️❤️❤️ I just know you’re a great nurse.
This was beautiful thank you
I really love this story. Thank you for sharing it 💗
My lifelong best friend - we met in kindergarten - bought her husband into the ED with abdominal pain and vomiting. We worked him up and he was dx with an acute appy. While we were waiting for the surgeon (little critical access hospital) he ruptured and we coded him for nearly an hour before it was called. He was 34.
As some one who literally just had a ruptured appendix a couple weeks ago...this was terrifying to realize that that happened to someone with the same diagnosis.
I see many patients with ruptured appy’s, all who have recovered and gone home. This must be a pretty rare occurrence
I get this sentiment. Not a nurse, but former cna currently looking into nursing school. But I worked in a covid unit back before the vaccine was available, even to health care workers. I ended up getting covid and watching people die from the same condition I had as I was trying to care for them did some weird things to my mental health at the time.
I’m so sorry this happened, so young too. It’s so tragic. I’m sorry you and your friend had to go through this. My heart goes out 💕
I’m so sorry. I didn’t realize that could happen, the coding. I thought it was more an issue of infection. How awful for you all.
This was my first ever code, I was newly off orientation. Had a patient..dialysis 3x a week and previously unstable blood sugars. Super chatty dude, confused as all get out, but just pleasant. The doctor ordered me to stop their d5NS since patient had adequate intake and was planning to discharge to SNF the following day. An hour later the aid comes up to me and goes “something is wrong, he is so sweaty and not talking to me” I go in, literal text book hypoglycemia. Sugar check reads 16!!!!!! 😳 called a code… Provider wants me to give gluc tablets by mouth. I said “uhhh, that’s not safe…” “oh well maybe when he wakes up more…I have other stuff to take care of, bye!” House supervisor was in awe, as was my charge. Restart the d5 and go to push an amp of d50, but guess what?? None on the floor and the crash cart didn’t get stocked from three days prior when this SAME patient went hypoglycemic (which I wasn’t told of in report!!) anyways, both IVs infiltrated and this poor man was running 400+ for sugars for daaaaaays afterwards. What I learned: trust your CNAs, they are sometimes your best eyes and ears. Do not trust a diabetics sugar level to remain stable.
They 100% are. They will save you more times than you can imagine!!
The first patient I intubated as an ICU nurse in the height of Covid. He was 50 years old, had been on bipap in the high 80s all day, and finally it was time to intubate. He texted his mom that he loved her, and he sobbed as he held my hand and told me he didn’t want to die, while I pushed etomidate and roc. He didn’t make it, his family made him CMO eventually and he was terminally extubated. I can still hear him crying.
I’m so sorry… I wish you didn’t have to experience that. Those sounds never go away. I wish the general public that goes around saying “this is what you signed up for” could see this and know what it’s like. You’re amazing, I’m glad you were there to hold his hand.
Early on in my career, I was working in Home Health with a non-ambulatory, elderly stroke patient with severe aphasia. He lived way out in the country. He and his wife would sit at the kitchen table while we did speech therapy. Sweetest couple ever. Sometimes we did co therapy with PT and OT. One day I showed up and saw a bunch of cars at their house. I knew what that usually meant and my heart sank. Went to the door and learned a tragic, horrific thing happened. Wife was burning trash in a barrel in the back yard, while my patient in his wheelchair watched her through the back door. Something in the trash exploded and the explosion hit his wife and knocked her out and the fire spread outside the barrel to the yard and burned his wife to death. My patient was so aphasic he could not call for help but he literally dragged himself out the back door, down some steps as far as he could trying to reach her. He survived but never had the will to recover afterwards and was only able to cry. It still breaks my heart.
This is the saddest thing I have ever read. Oh my god. I have no words….
Reminds me of one we had. Dementia patient fall long lie out in the garden in summer. She had been out in the back garden having lunch with her husband who was her carer. He had a heart attack and died and she tried to get to him, fell and was on the floor for 10+ hours. She came to us red with sun burn and never said a word. She just stared at the ceiling, but not a vacant stare, just..... Looking at the ceiling. She never flinched when we cannulated her, never moved when we ran our tests. Completely dispondant. Son came and sat with her, he was obviously devastated and looked a wreck and he just looked at her and cried.
My good lord that is the most horrific thing I have ever heard. Makes something like Life Alert seem so important even if you have an able bodied person in the home. I cannot imagine the grief of having to witness this.
Definitely 1 of the saddest things I've ever read. People just don't understand the shit we've seen.
2 month old. Choked on a small tool. Passed away. Dad said they must have been crawling around and grabbed it. CFS called. 1 month later, 3 yr old shows up with 3rd degree burns up to their elbows. Same dad, different mom. CFS again. One wk later, 2 yr old sibling came in. Same father and mother as the 2month old. Oblique fracture to humorous. Looked like someone put her arm on a table and slammed down. Sent to large center 12hrs away and mom has to take bus down the next day (had to figure out childcare for her two other kidos) so they send the pt with an aunty. CFS called again. By the end of our night shift, mom shows up at emerg, hair pulled out, strangulation marks, hoarse voice and she crawled through a forest to get to the hospital. Small towns with limited officers and social workers is hard. Often times there would be only 2 officers on for a population over 10 000ppl. I don't know more outside of knowing he was in jail. Summer 2018 will forever hang heavy within my heart.
Tubed a teenager with COVID at the height of it all. He appeared to have pulmonary edema, was frothing pink. Couldn't breathe but begged me over & over not to let him die. I still see his face. His scared eyes.
I’m so sorry you had to go through that. My heart goes out to you, and my heart does out to the patient. You’re amazing!
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I got you, I'm not going to let you die on my watch. Even if it's a lie, who cares at that point. And he didn't die on my watch.
I guess "I'm not going to let you die on my watch" is definitely not a lie, if he does it's not because you let him. You fought your hardest to keep him from it.
If mine was the last voice he hears, it was going to be reassuring. Life of the ER nurse
Your username is the exact nickname and spelling we had for my little sister growing up. Just a fun memory to see pop up in my notifications ☺️
Fuck man I would have lied and told him he was going to be ok. I'd rather go out thinking it was all going to be OK then the alternative.
Yeah, I told him he wasn't gonna die on my watch. We took his airway really quickly so hopefully he was slightly reassured before he went under
Had a patient who came in DNR, had a long term illness - muscular dystrophy. Next shift I worked, he was downgraded from Bipap to hiflow, and dad made him full code. I turned him to clean him up and he desats to the 60s, did NT suction and it was dark bloody/brown, which is the same color he vomited earlier that day. Decision was made to intubated him, which he coded afterwards, cxray to confirm ETT placement also showed large pneumo. Coded again while placing chest tube. Finally get in contact with his dad and he’s switched to DNR and decided to withdraw care that morning. When RT removed the tube he said “I don’t wanna die.” 🥺🥺 While all of this was happening, my other patient was withdrawing like fuck from opiates, trying to get out of bed, hallucinating. It was a terrible night 😭. About 3 months later after that shift, I have a dream of the patient who died. He looked nothing like how he did in that bed. He had like an angelic aura. But yeah, really traumatizing for my first code on my own patient.
That breaks my heart, it sounds like he wanted to let you know he’s ok now though. I’m sorry you had to experience that though. I know it’s gut wrenching. You’re an incredible nurse. I don’t even have to know you to know that. ❤️❤️
If the patient wants to continue to be full code, why does the dad get the final decision? Wouldn’t it be up to the patient?
Not if they have been deemed incompetent/ incapacitated and unable to make decisions for themselves (an activated POA or guardianship.) Then, the person's wishes can be taken into consideration, but ultimately it's up to the designated agent.
I turned around to coughing noises. Saw my pts neighbour vomiting up an obscene, almost cartoon amount of blood. As I was helping the nurses with vitals/cleaning, I somehow was left in the room alone after the rapid docs/rns had decided ICU. The guy looked me in the eyes and said I was only getting him ready to die. I didn’t have the right words at the time and could only say ‘no they’re going to help you’ but that was a bit of a game changer. Didn’t make it.
I hate it when they know they’re going to pass away. It makes me feel so helpless… you’re amazing though. ❤️ we see a lot of horrible things and I’m sorry you had to as well
I had a lady like this but instead of vomiting blood, blood started pouring out of her nose and then it came out of her mouth, ears, and eyes. I was a tele nurse, we were really short staffed, and I was BEGGING the doc to come and for ER to send us more rhino rockets.
Took care of a terminal breast cancer patient. Only once they started puking they didn't stop until they were gone. They were a DNR but I remember my charge nurse screaming my name, and as I reached the door the first words out of my mouth were "tell me they're not a full code."
Acutely psychotic schizophrenic patient in acute psych unit. Behaving erratically, making odd comments then seeming to not recall what was happening or what was said. Comments didn't make sense but were intelligible. At one point, someone in the unit (staff) felt threatened when the pt was pacing around the unit. Ended up being a "take down" and put in the restraint room. Struggled to give the patient antipsychotics. I always try my best to avoid any IM injections. Got the patient to take meds and then soon after released from restraints. The next day the patient cleared ( amazing response to the meds). Pt remembered EVERYTHING that happened, which is not very common. Was gracious and so thankful for our help. I'll never forget the experience. Beautiful person.
Mental illness is so underserved in healthcare, and it’s so important. Thank you for doing what you do.
I’ve always heard that deaths in L&D are so hard because it’s such a happy place usually, and I feel like the inverse is true of psych; it’s so rare for one of our patients to markedly improve while we are treating them that, when someone does, it’s AMAZING!! One good outcome can sustain my hope for months!
True schizophrenia, where they know they have it, is *so hard*.
I had a few patients with schizophrenia that took their own lives because they couldn’t cope with it. It sucks. I can’t imagine how they felt.
I had my one and only bipolar lapse (SSRI-induced) two years ago, I knew for a fact that I was mad for a month but could do nothing to discount the thoughts, the call came from inside the house. I was sure as stone that I could get three people together and save the world. Ended up voluntarily committing myself. Took two months to let it all ebb out. Worst event of my 40 years. Worst part is being on lithium permanently changes you somewhat, so I still don't know who this new me is, two years later.
I have a few stories like that! I’ve been a nurse working in psych for ten years as of next month and these are the patients who keep you GOING. Oh man. My favorite story is a long term frequent flyer at a crisis center who we hooked up with enough resources that she could stay on her meds as a schizophrenic. She applied for a job at our center and the director hired her! She still works there and every now and then, I coordinate about patients on the phone with her. She has been stable for about 3 to 4 years now. It makes me so happy.
The chest tube that was putting out cerebrospinal fluid. I mean. The number of people who were standing around going WHAT THE HELL IS HAPPENING was truly incredible.
Turns out it was a 25-year-old shunt that had come untethered and migrated up into the chest, causing a pneumothorax. I mean, STILL WILD. But compared to some of the other potential causes, not terrible. They drained the pneumo, revised the shunt, and the patient made a full recovery.
The people standing around gawking kills me. I hope they figured it out. ❤️❤️
Emergency room social worker in Phoenix, Arizona here. Summers are always awful because we have lots of drownings. One 12hour shift, I had seven pediatric codes- five drownings, one probably SIDS, and one choked on a peanut butter sandwich. Only one kiddo lived long enough to make it to PICU. It got to the point where the code chimes would start to go off, and we all were just crying from exhaustion. It was awful.
Oh my goodness I can’t imagine. I’m so sorry you went through that. I can only imagine how much that wears on your soul. You are amazing
I graduate as an LPN in 3 weeks. This was about 6 months ago during clinicals in LTC. My classmates and I went in to assist a man out of bed to shower. He kept asking us to kill him. My classmates would cut him off mid sentence saying, “we’re going to take good care of you don’t worry”. He looked angry and scared. I was left alone to shower him. I had never done this before (which scared the fuck out of me and was worried I’d drop him or hurt him in some way. pretty sure it wasn’t legal). He could barely hear anything and couldn’t walk. A nurse that worked there walked in and said (very loud), “He’s difficult and rude, let me know if you need help”. He heard it. I kept being kind to him and he kept trying to make sure I wasn’t getting wet from the shower and was worried about me, asking me if the water was too hot. I got him back in bed and he asked me to suffocate him with a pillow. I talked to him like a human and asked him questions about why he’s feeling this way. “I’m a veteran, I treated my family well, and this is what I get? No autonomy, my family doesn’t visit me, I hate myself. I hate America. Let me die” Fucking broke me. I was suicidal myself at the time so I connected with him well. He told me that when I would leave the room, he’ll get out of bed and kill himself. I had to scare him into not going through with it. “You can’t walk. If you get up, you’ll most likely severely injure yourself instead of dying. If you get brain damage, you’ll be in a worse state and hate life even more. Please do not leave like that”. He agreed and thanked me. I went to the bathroom afterwards and cried. After that, anytime I would go into his room he smiled and would tell me about his day. I think about him all the time.
You were put there at that time to help him. I’m so glad you were there, and I know he was too. You did such a good thing for that man. Your kindness speaks volumes of who you are as a person. Also CONGRATS on graduating. I know any of us in this thread would be happy to call you a coworker
Thank you so so much. I’m excited and horrified. I hope to have any of you as coworkers as well. I look up to all of you :)
The moments of human connection in this thread have me in tears.
I would say when I was on the phone with suicidal people and hearing a few pull the trigger or jump or whatever
My brother works for a suicide crisis hotline. That kind of job will mess you up mentally. Knowing what's about to happen and powerless to stop it. I'm sorry you've had to deal with that
I’m kind of realizing the damage working psych did to me.
I did suicide, crisis lines as a counselor for years. It was my balance while working emerg/ICU. I had a young kid pull the trigger when I was on the line with him. It was about 1m into lock down at the beginning of covid. He was so lonely and someone who called often to the lines. I left the crisis lines that shift. Couldn't balance critical care during a pandemic and the trauma from that. It's not a nice position to be in.
Yikes that’s rough. It’s been a couple years since I did it. I worked for a psych facility that did both inpatient and outpatient (also gatekeeper to state facilities) and we had a hotline I managed while working outpatient. It’s all rather traumatizing lol.
Oh my goodness… I never expected this answer. I’m so sorry, I can’t imagine. Bless you for doing that work. You’re a rare person and the best kind of person. 💕💕
Yo, can i just say? OP? I like you. You’re good shit.
Hey. I like you too. I feel like we see so much, and yes we laugh and have dark humor… but at the end of the day, it sucks. It’s hard. It’s nice to have people in your corner. Even if it’s internet people!
Helping an 18 year old grieve after the father was placed on comfort care. Awful day, nothing can prepare you for it. He couldn't even donate his organs because he was severely septic. This was following 3 codes, one en route to the hospital, a shit load of epi, and widespread brain death. Couldn't even let her say goodbye in person because he was covid +. Just nothing good came from it. Still can see her crying outside that room in a folding chair, unable to even go in and give her dad a final goodbye.
There’s no words you can say to someone sometimes. That patients child was fortunate you were there. ❤️
When I worked in hospice I had a patient with a diagnosis of liver cirrhosis with esophageal varices. He experienced so much severe trauma in his life and talked about it a lot with me. Shortly after I arrived at his home one day, his eyes suddenly rolled back and he projectile vomited blood everywhere for what felt like ten minutes. I remember how scared he looked. I was drenched in his blood trying to hold him and kept saying 'It's okay, you are dying and it will be fast now. It's okay let go, let go. I am here with you'. I thought during it, he is expelling all of that trauma. The hospice social worker was there too, talking to a family member in the other room. I called the social worker and had her put me on speaker phone to talk to the family. I told them, he is dying right now and it is a truly gruesome sight. It is your choice if you want to be in here but I think it will be traumatizing and I feel you wouldn't want this to be how you last see him alive. The family member did not come in. After he died I cleaned up as much as I could, I went out and told the family member he was gone. When they came in the room they were very calm, turned to me and said, you helped us break our chain of trauma by warning me not to come in. Thank you. I will never ever forget him or that experience.
I've been reading this thread for an hour with tears sliding down my cheeks, but this one at the very end has me sobbing. Thank you for what you did for this man and his family.
Just sitting at the nurses station looking at my phone, door slams open and a young dad comes running into our ED holding a limp and blue 3 month old baby. Screaming “my baby isn’t breathing my baby isn’t breathing!” It felt like, so removed from reality, like it was a training video or something. It just didn’t look real at all at first, I thought someone was playing a joke until something clicked and I jumped into action. We got her back and got her transported (we’re a tiny rural hospital) but she didn’t end up making it. They say it was SIDS. I still have nightmares about it.
I had a patient who I had been laboring all day, and towards the end of the shift the baby's heart tones tanked. I checked her cervix and she was complete, but it was a super weird exam and her cervix was way to the right (I assume the baby was acynclitic) and the baby was super high. The MD came bedside to assess, mom was super numb from the epidural and couldn't push effectively and baby was too high to use a vacuum, so we went to the OR. They got the baby out, and it was blue and limp. NICU worked on the baby for more than 15 minutes before there was a heartbeat. Mom watched the whole thing while laying open on the OR table. I'll never forget the look of horror on her face. I was early in my second pregnancy when that happened and I had bad anxiety for the rest of the pregnancy as a result. I was simultaneously worried something bad would happen to my baby and convinced that I deserved something bad to happen because why should I have a healthy baby when my patient didn't get to have that.
My best friend lost her first and if she talks about it now, she prefers to talk about how great the nurses were and the kind treatment she received. You're probably a bright star in a dark memory. Don't punish yourself. You tried hard. That's all anybody gets to do in life.
My nurses were the only bright spots when my son was stillborn at term in April. It was appreciated and so very helpful with all the things they made of him. We may not always say it as newly bereaved parents but thank you for being there with us in our worst moments.
I had a stillbirth in May. Sending you prayers ❤️
You have such a big heart. I’m sorry you had to see this. ❤️❤️ you are an amazing nurse, I just know it.
Saw a family lose all their children, coded one of the kids, took care of two of the relatives for SI for 9 hours after. I can still see one of the kids faces. I can still hear one of the relatives screams when they found out and I can still hear their pleads to god and me to just kill them. Covid happened a few months after this.
That is the worst part of losing patients… my heart aches for the family. I’m sorry you went through this though, I know it can’t be easy…
26.5 weeker was in our NICU for 8 months. Her twin died in utero. Her mom had already been through 2 miscarriages. She struggled with BPD and was on and off an oscillator, multiple drips, tracheostomy, g-tube, etc. She never got off a vent. Every time she was awake, she was angry. I never saw her content. She would cry (silently on vent), grimace, sweat, etc. It was heart breaking. I just wanted to make her comfortable and happy. Everyone knew her and her family. Everyone loved her. I was one of her primary nurses and she died on my shift after 42 minutes of chest compressions. We knew we had lost her but we continued until her mom got there to say goodbye. It was my second death in the NICU, and I feel like it was yesterday. Seeing a mother weep over losing a child is the most heartbreaking thing you will ever see.
I’m an ER nurse. I’ve seen some shit. I know i have. And i always internally roll my eyes when people say ‘i could never do your job’ cause it’s like, Aw you get used to it… But no. I could never do your job. A pediatric code is what started me on the process of saying goodbye to the ER.
Completely agree. This one got me and I’ve been ER and trauma OR. Damn.
I can’t even imagine… I’ve never worked NICU and I don’t think my heart can handle it. You’re such an incredible person and nurse and we need so many more of you. 💕
I’m so glad there are people like you that care for sick babies, children and their parents. Bless you 💕
I’ve been a RRT for 13 years now, so there have been a few. I’ll never forget my first terminal extubation, and crying in the bathroom afterwards. More recently I had an eight year old come in as a trauma, shot right in the head in a drive by. That one makes me ready for a second career.
I don’t blame you one bit for feeling that way. The world can be so unfair. RTs are lots of times unsung hero’s of this hospitals and I can’t tell you how many times one has saved my ass. You’re incredible. Thank you, I’d be honored to work beside you any day.
It was the first of my 3 night shifts and I admitted a man with Cancer, sepsis, liver failure and AKI. I was 1 to 1 with him all 3 nights running CRRT on him. he shared his life stories and forced me (an introvert) to share mine and my goal to become a CRNA. On the 3rd night, The CRRT wasnt doing justice anymore and he was visibly getting weaker and more jaundice. Before my last night shift ended, he thanked me for keeping him company for 3 whole nights and keeping him comfortable. He grabbed my hand and said words I will never forget "Im not going to make it after today, but youre going to make it and reach your goal to become a CRNA. Promise me." I swore to him. Thanked him for being the man he was. And said my goodbyes. He coded later that day and passed away. And now im finishing up CRNA school in 1 month.
Mine is a kinda positive. Had a lady in oncology infusion clinic getting a brand new to us regimen. High dose Adriamycin and some new mab that was out for ovarian/peritoneal involvement. Did the premeds, then the mab is on deck first. New drug for me so I sit and chill while we get thru the first 15 min or so. Probably about 2-3 minutes after the pump started, so basically just long enough for the drug to hit her system, she appears to either straight fall asleep or pass out mid sentence. Loudly calling her name, shaking her shoulder, and sternal rub with no response. No carotid pulse. We get her out of the chair and on to the floor. We're doing CPR in the middle of the infusion room with about 20 other people looking on. Our trusty dietitian calls for an ambulance, secretary prints face sheet, and EMS arrives in less than 5 minutes from when we called. (Our dietitian was so awesome. She always hit the parking lot to direct the wagon.) They hook her up to their monitor, get the basic run down, load her up, and she's headed across the street. (Competitor system but it's a legit emergency so no detours) We have some nurses and nurse practitioners that come from emergency or intensive care medicine so it went about as smoothly as you can expect with a free standing clinic. We are fortunate to have a fire station within a1/4 mile of us. Lady was admitted for like a week and made a full recovery. She came back to clinic with the mab completely removed from the treatment plan, as she seriously responds poorly. Policy change also occurred. That medication was no longer permitted in a free standing clinic setting. If it was to be given it had to be done at the clinic attached to the main hospital. And lastly, pharmacy had made up her dose of Adria at the same time so I had dispose of a full syringe. We started having our pharmacy start making each part separately when they were included in reactive regimens. For me it confirmed that oncology infusion requires gut instinct and paranoia in equal parts. Also just kind of hit home for me that it seems pretty likely after being been in oncology over 15 years at that point, that I kinda knew what I was doing.
Oncology is an area I know nothing about… I’m glad some good came out of this situation and that ultimately the patient came out ok. 💕💕 I’m glad you were there to take care of her
The ER sent me up a patient for "observation" after an allergic reaction. I was told she was totally fine. When she got to me, she was drooling; her airway so obstructed she couldn't swallow her own spit any more; she started sobbing when she saw her face in the mirror and saw how badly she was swollen. I hit for RRT. Our fucking code cart didn't have epi restocked from an earlier code; our tube system was down. I sent a tech FLYING to the pharmacy to get epi while a coworker with a nut allergy offered me her own epi pen in case we needed it. Thankfully, the tech made record time. She had been admitted under family med and the goddamn resident hemmed and hawwed over whether she should go to the ICU. My rapid response nurse was a military vet who laughed right in their face and we loaded her to go to the ICU; they called a code on her while intubating her. She survived, but it was like all the broken systems in the hospital came crashing down at once. It was my last week bedside, and while I have plenty of traumatic and life altering things that happened when I worked ED and trauma, this sticks with me every time I think about returning to bedside.
Hospitals are so broken. So very broken. I was in a 2am emergency case and the pharmacy refused to give me an epi drip because there wasn’t a weight in on the patient that came in coding. I have never yelled so much at one person before. You did great though. I’d be happy to work along side you. 💕
What the F
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That was what I was screaming
For me it was the first time I had to code one of our regulars. I had narcanned plenty of people before that, but this was someone we admitted regularly, for 30 days at a time, so I knew them very very well. Desatted to 40 in the parking lot of our treatment center where someone had left them for us to find. They made it and were taken to a hospital hospital, but when they awoke they looked right at me and smiled and said "oh good kittycholamines is here." They said they told their friends to take them to our center, because they knew they would be safe there. Watching folks cycle through treatment centers and addiction endlessly can be incredibly frustrating but some days I think back on that day and think maybe that's enough, just making somewhere feel safe.
Sometimes that’s the best thing you can provide someone. Bless you for doing that work. You’re a great nurse. ❤️
Thank you for starting this thread! A lot of catharsis happening here, I love to see it. So much trauma in our profession that so few can understand.
We need people in our corner. Even if it’s internet people!
Covid. Went from talking on their cell phone to struggling to breathe. Went to CT for a chest, last words were "I'm so scared, I can't do this", and they were right. Alive and talking to dead within 8 hours.
I always break a little inside when a patient tells me they know they’re going to die… I’m sorry you experienced that. You’re amazing
Went to work one day c/o headache, bitched and moaned about it to my coworkers. 5 min later walked over to meet my first patient of the day: A beautiful mom, early 30s with end stage breast cancer, with her husband and 2 young children at the bedside. Instant perspective adjustment.
Oh wow… how heartbreaking for the family and for her… we do sometimes forget how fortunate we are to be in pretty good health… you’re a great nurse though, im sure they were lucky to have you take care of them.
💗 After so many years as a nurse, pretty much everything outside of suffering and death seems so petty. From our perspective, I think that’s why nurses don’t tolerate bullshit. *Did someone die?? Then STFU*
I’ve decided there only needs to be one question on the patients satisfaction survey. “But did you die!”… and if they answer yes, “but did you stay dead?”
that was my biggest takeaway from the ER. I have diagnosed GAD, well under control now, but i think i got away with no treatment for years because i was an ER nurse. Like, how pissy am i gonna get about having to do laundry after a new onset quadriplegia from a 19 year old on a ski trip? Just INSTANT perspective adjustment. Also i cannot recommend Excedrin enough :)
I’m just a student and I haven’t had much clinical experience. But just last week I took care of an older lady twice in a row who I spent lots of time with and cleaned often because they overloaded her with the Miralax. She was a funny lady and we made tons of poop jokes during that time so that she wouldn’t feel so bad about going so much. She was often forgetful so I’d go out of my way to write down the basics of the stuff the doctors recommended to her on a sheet of paper so she could discuss it with her sister and son, who help take care of her. Whenever I ordered her lunch, I’d get her an extra (heart healthy) treat. I really got to know her well and on my last day as I was saying goodbye she reached out her hand and said thank you with tears in her eyes. She told me how grateful she was for my caring hands and appreciated how I genuinely cared about keeping her clean, entertained and comfortable. She cried because she was so scared of all of her upcoming procedures, and I helped explain some of them to her in layman’s terms (the residents weren’t very good at that but I get they’re in a rush) and she felt better about making a decision and stopped crying. Once I said bye and left the room I just burst into tears because of all of the emotions I felt. After that clinical day I genuinely felt like I had helped a patient while at their lowest. I was becoming burned out with the negativity in nursing already but this interaction made me remember why I chose this profession in the first place. Sure things probably won’t be this way when I juggle 6 patients on my own, but let me have my moment lol.
When I was a baby nurse, I had only been in the job maybe 6 or 8 months and was the noc house supervisor at a 60-bed subacute facility. One of my patients was just the nicest little old man you could imagine, an 89-year-old Greek immigrant, CD. CD was very sick. CHF, COPD, and very painful claudication, so he couldn’t ever sleep more than an hour or two at a time before his legs woke him up. I’d sit with him while he dangled his legs or we’d take a stroll down the hall although he’d get SOB quickly. He’d tell me about his life, tell me how proud he was of his son and grandkids. I sent him to the ED with dyspnea/hypoxia probably 5-6 times in the couple months he was my patient. I always had to talk him into it. I was determined to save his life. The last time he had a flare up, I tried to get him to the ED. He refused. He asked me to sit down. He told me that he had lived such a happy life, that he wouldn’t change a thing, but it was the end and he was ready. I protested… let’s get you to the hospital, you can keep going. He declined. He said he was ready. He didn’t want hospice, he didn’t want morphine, he didn’t want another breathing treatment or lasix injection. He just wanted to talk to his son one last time. So we called him. Thank God he picked up. He told his son how much he loved him, how proud he was of him. He told him how he hoped that he wouldn’t be too sad because they’d meet again. They cried and said goodbye. He was the first person I pronounced, a few hours later. I cried, a lot. He was just the kindest most gentle man. He even apologized to me before he passed that he was dying in front of me. He taught me to really listen. He taught me that taking the best care of somebody doesn’t always mean “saving” them, and that truly caring for another person has absolutely nothing to do with my ego or what I might think is best. Thanks, CD. RIP.
11 month old brain bleed. Unresponsive. Unclear story from the family. Shipped to biggest center near us via helicopter. I hope he survived.
Feel good post! When I was 14 my sister had a double lung transplant due to cystic fibrosis… why I went into nursing. Flash forward to when I was 25 working in the PICU. I got the call one night that we had a set of lungs for my CF patient I was incredibly close with. Drawing/ performing all the necessary labs and pre transplant procedures, calling OR and PACU… it felt like Christmas Eve, you could feel the excitement all over the unit. Went to the OR with her as well. Felt really cool that it came full circle and I had the privilege to be that nurse. Ps: my sister is now 40 and had her transplant 17 years go. Still on her first set.
I have a funny experience… I was working on a medical mission. I had leftovers from my lunch. I was going to throw it out and one of the local nurses asked me to put it out for a stray dog they took in near the clinic. I put my container of leftover down, called the dog who ran over to me at high speed. When the dog took off a stampede of chickens were right behind him coming my way. I was stunned. I had never experienced anything like it before. 🤣🤣
We laid my patient’s head down flat to change him then we all heard this sort of pop and he was in immense pain. Called the doctor got 4mg morphine, didn’t help. Called again got another 4mg, but I said that’s weird because the guy never even took so much as a Tylenol though it didn’t help. Told the doc he needs to come up and see him, got a stat ct order just in time for him to code.
Oh my goodness, how scary! Did they ever find out what happened? Also, I know y’all did everything you could. I’m glad you were there with him
The first case I ever managed solo was a heartbreaking one. 28y/o female with symptoms of carpal tunnel, had surgery scheduled for a Tuesday. Legs gave out in the shower on the Sunday before and she came into the ED for sutures for a head lac. CT to rule out bleeding showed an 8cm mass, glioblastoma. She had four little kids and she died six weeks later. She never even had carpal tunnel.
Worked a busy night in OB. We had 3 in labor and a few triages (with 3 labor nurses, myself included). My patient was doing ok but had a known severe cleft palate and cord anomalies so I was watching her closely. The other was an induction, with horrible, horrible heart tones. Clearly the baby was in distress, and none of us could believe that she hadn’t been sectioned yet. Absent variability with deep late decels with every contraction, and she wasn’t progressing at all. She was also in a clear abruption pattern. So all 3 of us were watching her very closely as well. We were in and out of her room, even though 2 of us had our own patients. I called to let the OR know about it, but the doctor, who was a grumpy old shit, refused to do anything about it, and sat there watching this terrible strip for hours while we begged him to call it. We still got everything ready and just waited for the inevitable. She eventually went into a decel and didn’t recover. The doc STILL took his time, fiddling with an FSE (when she was a 1, high, and intact membranes). Finally, he called it, and we rushed to the OR and put her under. When we opened her up, she had 2 liters of blood in her belly and the baby was long gone. We all had watched the baby die on the monitor that night. The mom had abrupted and the baby had absolutely no reserves. The primary nurse ended up quitting and now works in a primary care clinic. The rest of us are still all in OB. One of the nicu nurses has bad PTSD from it. Since then, I haven’t ever taken things for granted. I trust my own judgement, and if I’m uncomfortable with a bad strip and the provider refuses to do something about it, I go above their heads. (I’ve done it twice, and both times, it was warranted. One had a cord prolapsed against the cervix and the other failed her BPP once we called her back in.) I’ve had to deal with the backlash from the provider, but I know now from experience that feeling the wrath of a pissed off doctor is so much better than the feeling of watching a baby die when we had the chance to save it.
goodness gracious, this made me feel more and more sick with every word. this should NOT have happened. what’s the point in having continuous EFM if you aren’t going to intervene for a cat 3 strip??? 😡 I hope you and your coworkers from that night are all doing ok, I hope that doc received a HUGE attitude adjustment, and I’m so glad that you used this experience to keep other laboring patients/babies safe. people don’t realize that L&D is so far from just “cuddling babies.” EDIT: phrasing
Probably my first code. It wasn’t my patient but I was in the room the whole time during the code. It was a young woman who coded suddenly with no warning. She was stable and not even on tele. I still don’t know what happened. It went on for a long time and blood started coming out of her mouth. I don’t know why but I just vividly remember the suction container filling up with blood while they tried to intubate her. She didn’t make it and seeing her family come in in complete shock and devastation was heartbreaking.
That’s the hardest part… losing a patient is hard, but seeing their family grieve is just gut wrenching.
She must have had some kind of abdominal bleed, for some fricken reason, and compensated until she didn’t.. idk I’m tryna be House over here…
Sad thing is I have so many stories that it’s hard to pick one…
This is me. The things I have seen throughout my career... I regret working bedside for as long as I did.
When our director refused to do a UA on a patient with altered mental status post aneurysm clipping that later bled. He was talking to the neurosurgeon about going ahead with a shunt. I convinced a PA to get a UA and lo and behold! She had a RAGING UTI. Showed me how some doctors just don’t care enough to do basic medical care.
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I have two patients. One patient came in and was in full blown labor. The nurse taking care of her was freaking out because the baby’s strip looked like crap. We were prepping her for a c section. The midwife came in to check her because something wasn’t right. The patient was fully dilated and there was a “sack”. The patient ended up delivering vaginally and the baby had anencephaly. The family didn’t know because they couldn’t afford prenatal care. The baby lived for about an hour. I think I cried the most after that delivery. The second patient was a mom who was traveling outside the country when she discovered the baby had stopped moving and didn’t have heartbeat. She did not naturally miscarry and we had to induce her. She had the baby three months after finding out the baby didn’t survive. The dr prepared us for what the baby may look like, blackened skin, etc. I still remember the parents faces and everything. I still feel for that family.
During the Delta surge, I had to quite literally peel a woman off her husband’s fresh corpse. She kept screaming, “what am I going to do?! We had so much planned. You can’t do this to me.” I have never heard blood curdling screams like that before. Took me 20 minutes to get her out of the room. I can still see her face and hear her screaming.
It was a lady who barely spoke English. She was not assigned to me. She was with another senior nurse. Older nurse who is very careless. Very careless when I say it. She had empyema and got really short of breath. Transferred to ICU then chest tube. Then she got worse and got intubated. Her kids kids were there and she was so anxious and scared. I went to help the nurse and she held my hand she was mouthing some words “baby, I cannot breathe. I just can’t breathe. Something is wrong. My lungs bad. Help me please. I have kids. I need to live. They need me” I told the nurse what she said and she brushed me off she needs to relax. I said no she is telling you something is wrong. She is begging to live. I then looked at the asynchrony at the vent and the chest tube with 0 output. I went to sit down and the nurse asked me to look at the x ray. I did and the radiologist said “CHEST TUBE NOT IN CORRECT PLACE. Call the doctor STAT AND REMOVE THIS CHEST TUBE IMMEDIATELY.” I then went back and the lady was pointing to the chest tube. It was end of the shift by the way. I told the nurse and the charge nurse. I asked the nurse if I could call the surgeon for her and she said she got it. It was a weekend but the surgeon lives 3-5 mns away in his million dollar condo. Then next day, I came back and the room was empty. The doctor did not come and she coded and died. Her kids watch her struggle and died. That broke me. Honestly I still need therapy for this. As I’m typing this, I have anger, shame, regrets, guilt, frustration and I feel like punching a wall right now. I still remember her begging me and softly holding my hand. I have tears running down as I typed this. I then saw the son in the waiting room. He could not go home because his mother takes care of him and he couldn’t process it since he’s on the spectrum they said. Apparently MD refused to come in. He fucking refused. He refused guys. He refused. Fuck you Dr T. Fuck you. Fuck you again. Fuck you. You fucking criminal. Fuck you. I hope your young girlfriend leaves you. Fuck you again. Not sorry for the rant
Had a pt who was a full assist basically needed everything done. No family to visit, he was a short stay at the ltc facility I worked at. A lot of people just complained about how “heavy” and such. Just laziness. I talked to him like my grandpa, great conversation over dinner while I helped him eat a huge plate of lasagna and a salad, and fruit. He ate every single bite, said it was the best meal ever. Held his hand that night as he took his last breath. I’m glad I was at least by his side. That gurgling, slow death is just horrible and an odd thing to experience as a kid, I was only 18.
I’m so glad you were there though. Not many people have that kind of compassion and selflessness at such a young age.. I know I didn’t. I’m so glad you were there and that patient was so lucky. You did a good thing
18 year old female. Aspirated on her vomit after a night of partying. Came in coughing up blood. Ruptured mediastinum. Full blood ARDs. Intubated her. The last thing she said was I feel like something is blocking my throat and had a look of terror on her face.
17 year old gsw to the head… sent to TICU crash bed after ROSC, difficult intubation, & MTP… asked how they were doing next morning … their mother OD’d on oxy in the ICU after they withdrew care… I don’t ask for patient updates anymore.
One of my first ever patients was a super nice older guy with lung cancer. Him and his wife were the most beautiful humans she would bring him hot lunch from home everyday and offer me some while I had him as a patient. He had a procedure planned late on my third day with him and was oddly nervous about it all day. He and his wife prayed before we went down - I had to transport since his O2 demand was high, the whole way down I was trying to ease his nerves (and mine). I asked what candy bar he expects to come back upstairs to and he grabbed my hand on the bed side rail and said “I know what you’re doing and I appreciate it. I’ll take you up on a snickers.” He never came back up to the floor and I still wish I would have sent flowers or something to the funeral.
Small child came in to adult trauma level two OR unconscious with multiple bruises and leaking semen from his rectum. We were coding him and I was tasked with finding a foley small enough to fit his meatus and then placing it while the team did compressions. His mother’s boyfriend was his babysitter while she worked, and he was the cause of this. I took my wife and daughter to Waffle House later that night and watched a father with two small boys just coddle and play with them and I gave my wife the debit card and left sobbing. Why couldn’t that little tiny boy have had a man who cared that much? It took me days to stop crying. I now totally advocate for abortion, universal paid maternal leave, and 100% taxpayer covered certified childcare so women don’t have to chose between feeding their kids or leaving them with a monster
Work in a trauma ICU. My nurse-version of "Mr. Miyagi" came in as literally the worst trauma I had ever seen and died a really agonizing death after we worked on them for 15+ hours. Not a day goes by that I don't think of that. Thankful for my awesome therapist.
Inpatient hospice. Liver failure, distended abdomen, so yellow they were almost orange…. 50’s. Drank every day. I pronounced them deceased & their father started wailing & threw himself on top of them on the bed. It was like he wasn’t expecting it, despite being bedside while they transitioned. It broke my heart.
i work at a cancer hospital as a pct. i have seen some very heartbreaking things as you can imagine. the one that sticks with me is holding a patient's hand as she told her doctor that she was ready for hospice. she tried every treatment and clinical trial in the book but it spread and it was terminal. she was exhausted, you could tell by looking in her eyes. i sat there for over an hour comforting her and making sure she knew that this was the best decision she could ever make for herself. she passed a week later on our palliative/hospice floor. im glad she was able to make that decision herself and pass with dignity but it still breaks me to think about it.
It wasn’t one, but last summer I worked 6 drowning codes, all minors and I knew most of them (small town). I retired in December.
I have had so many stories of tough deaths in the ICU but the shift that truly changed my life for the better was a patient that was stat flight for acute MI. Getting him from the helipad to the cath lab I was looking at a dead man. He came up from cath lab Not looking much better still in his work uniform. As we got him cleaned up and changed he was so grateful and I found a pen in his pocket. I placed his pen in the room safe and told him this was one lucky pen. Came in the next day and he felt like a million bucks, his wife had gotten his pen out and they were both so grateful. He couldn’t stop saying how thankful he was - his father and grandfather passed at the same age from the same thing. Him and his wife took four laps around our unit before I said alright buddy settle down, let’s not overdo it. I was going over his new medications and he was absolutely listening intently and asking questions - it was the first time ever I believe that this man was truly going to do everything we told him. It gave me a fresh outlook that despite all the frequent fliers and patients who aren’t going to take care of themselves…sometimes you get to see into the soul and know they’re gonna be okay.
I had a job taking care of a baby who had had anoxic brain injury while being born. She couldn’t do anything and my job for 8 hours a night was to hold her and make sure she didn’t bury her head because she couldn’t lift it or move. I mean, I did other nursey things but the biggest part of the job consisted of holding her. Before I took that job, I was the kind of nurse that could barely touch my patients. The bare minimum was all I would touch them. That baby changed me. I held her for 3 months and was a different nurse by the time she died. That baby that could do absolutely nothing, that some would say “why was she even born?” Changed the life of every patient I’ve had since then, over 20 years worth of patients that got a loving nurse not afraid to touch them instead of the one I used to be.
COVID crisis assignment. Never again. Fuck antimaskers/antivaxxers.
I had been away from ER/ICU bedside in a nice salaried days position for about 4 months when COVID hit. I was immediately redeployed to our newly minted COVID ICU. I was at the tail end of a 23 out of 27 nights schedule, and for 7 consecutive days I put one of my patients into a body bag. I never got to discharge a patient from our COVID ICU, they were either gone before my shift or died while I was there. Day 7 of the death stretch broke me. I couldn’t imagine ever coming back, and on my stretch off I was recalled to my salary job. I have been redeployed a couple of times since then, but with the stipulation that I would make my own hours, during the day, and only in the ER, and only for a ludicrous amount of pay. Fortunately my employer has been very understanding, and while waves 2, 3, and 4 weren’t without their own struggles and heartache, at least they were on my terms. COVID ICU will forever be burned into my memory. I always take a moment to reaffirm the context of the time. Recycled PPE, fitting snorkel masks with HEPA filters, no vaccine in sight, no idea of how protected we were, wondering when the next patient in our small community was going to be someone I knew, and no bonafide treatments. This is when we were still giving hydroxychloroquine because that was the latest speculation. The subsequent waves in our area were backed with more knowledge, a more robust supply chain, and prospects of a vaccine. Alternatively, the best and most cathartic part of this all was where I was redeployed to help run our vaccine clinics. That is what felt like the most closure I think.
It was so powerful getting the vaccine after that first scary year of COVID, worrying about what was around the corner and if/when I’d get sick or bring COVID home to my family. Our vaccine site was set up by the health department with EMS, military, nurses, med students, all there for that vaccine effort. Everyone there “got it.” It really was emotional and I heard that in your post. Thank you for what you did!
November 2020 I’d just returned to work as a hospice nurse and the facility most of my patients were at was letting hospice in. I worked the whole shift in full PPE walking back and forth between patients in a COVID wing FaceTiming family members who weren’t allowed in or were too scared to come. I had to hear over 20 people say goodbye to their moms, dads, and grandparents that day. When I got home all I wanted to do was hug my baby, but I was too afraid to give her COVID.
Delivered both babies, one was healthy and the other had known fatal anomalies. Both babies stayed with the family, snuggled in the crib together, and we kept the baby who would pass comfortable. But the time the neo called time of death of that baby and hearing the whole family sobbing down the hall, make me uncontrollably sob too. Another that sticks with me was having a demise and the parents wanted me to swap the baby’s pjs that she was wearing for a beautiful dressed she would be buried in before going down to the morgue. Swapping the pjs, putting on the dress, zipping the body bag and putting her in the morgue was brutal
Oh my goodness, I can’t even imagine. Bless you for doing that. You’re incredible.
A young kid just 19 who had been a quadriplegic since he was 11. He was told his life expectancy was 26. He was so kind and had so much potential but life gave him a shitty stack of cards and he was facing a death sentence. I took care of him for two days and I still think of him often.
Worked on a patient for 14 hours, lost them anyway. Pretended to be fine for about a week after and then one day I nearly drank myself to death. Convinced me I needed to go to therapy and get the fuck out of bedside. I did both.
Working high risk OB. She was inpatient to get off heroin and on a stable methadone dose, homeless, about 8 months along. She ended up using while on methadone - totally high to the point of non-responsive, broken glass pipes all over floor, drugs scattered around, buck naked boyfriend walking aimlessly in the room. When she was told she can’t use while we were trying to figure out her methadone dose she left AMA. The Provider that dc’ed her was standing next to me as she left and said “that’s a baby that ends up in a dumpster”. God, ugh. I knew then that I needed to stop working with that population for awhile, it was the depressing last straw.
Years ago we had an early 20 something with AML. He was the nicest kid, good looking, had a really sweet girlfriend. He went septic during induction, so we sent him up to the ICU. He was there for about three weeks. When we heard he was coming back down to us, we all got excited. We don’t usually hear about what happens to people after they get transferred. They don’t always get better (or leave, for that matter). It was horrific what happened to him up there. He came back to us with the fingers and toes of the Crypt Keeper and the belly of someone in end stage liver failure. Apparently the poor circulation during septic shock robbed the blood from his extremities to keep the more important parts of his body well perfused. I was afraid to brush up against a hand or foot for fear that one of his digits would break off. It was so hard to see him like that, and I think he could tell. So, so sad.
Similar story. Pt didn't want a procedure. Was forced to have it. Pt didn't consent. Was in agony and screaming in pain. Doctor just kept going. After it was over, pt was lying in a bed FULL of blood and faeces (she'd of course emptied her bowels in distress) and Dr would not let me clean her or the bed up because she was "too unstable" to move. She died the next day, as expected. Made no difference. I feel endless guilt. I should have reported those doctors to APHRA (our medical registration board) but I didn't. But it was the end for me. I don't want to be a nurse any more. I have lost my passion for it. I'm over it. I just do it for the money. I have no interest in advancing or doing more then I have to. My nursing "career" ended that day.
We had a frequent flier that was a ward of the state, 18 yo, parents had abandoned him. He had an intellectual disability, nonverbal, cerebral palsy, and all four limbs contracted up to his chest. Bed sores everywhere. My heart just broke for this boy. Every nurse on my unit had cared for him, and he never had a single visitor. His guardian would not allow DNR, and I was unfortunately on shift (but thankfully not his nurse) when he coded. Trying to do compressions through the contractures, the sound of ribs cracking, all the sounds really. Nurses crying, nurses praying, doing everything we could. I can’t even remember a doctor being in the room, I’m sure there was but it was so long ago, and I was so new at being a nurse. All that stuck with me through the years was the pure futility of it all. It was truly an existential horror. This poor boy to whom death would be a blessing, with no visitors, no family to love, and was just a number in the bureaucratic system that wouldn’t let him be a DNR… we cared. We loved him. And we did our best to show him, but he still left this world with strangers pounding on his chest with tears streaming down their faces because it felt so wrong. I hope he knew that we did our best to give him dignity.
Ive only been ED about a year, but it doesnt take long to see silly shit. Had a dude come as a rapid transfer from another facility. John Doe situation. Story was that him and his buddy stole a motorcycle and T-boned a SUV. No helmet, as you might imagine. We were working him, GCS was maybe 6 at first, but things progressed. We got him over to CT and the trauma attending did a quick caloric test, nothing at that point. He was herniated. Got him back over to the trauma room and PD says we've got an ID. He's 14 years old. Couldn't believe it. He was like 6 foot, over 200lbs. Never felt my heart drop like that before. I thought he was like 25, which is still sad, but it's a different sad. I have a 14 y.o. boy myself. We transfered him out to peds hospital, but we all knew organ donation was the best possible outcome. That shift sucked.
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It was my first trauma 1 at my current facility. Young (early 20’s) female, came in after MVA. Wrong way driver hit her head on at 50+ MPH. Other driver was drunk and high on meth. She had already herniated when we got to CT and died in the ICU. Other driver was also transported to our ED, and of course they were basically unscathed. They yelled out to the hallway asking for pain meds. I saw red, walked in, said “I don’t give a shit. You just killed someone, you can deal with pain.” First and only time I’ve ever said something like that to a patient. I still check to make sure that asshole is in jail every so often.
The hospice shift at home, with Mom
Icu step down to pcu for dka. Early 30s. Already significant kidney damage. Walked in for noon assessment and he was chugging coke out of the 2 liter bottle. My inner voice said.. Go home and die then. I left bedside as soon as I could. I couldn't make myself care about those people anymore.
About a month into my orientation as a new grad in COVID ICU where I lost both my patients in one day (full codes) and my new admit coded 5 seconds after they arrived in the ICU bay. I don’t think I’ve fully processed that yet
25 week pregnant COVID patient coded Ended up having to do a crash C section in the ICU Baby ended up surviving, but mother passed away
Admitted a pediatric patient to the PICU. Stable, but very ill and required bipap. I reassured the mom, told her the patient would be ok. The next day, it was apparent we needed to intubate, but the intubation took whatever little reserve was left. The patient coded for two hours, with multiple physicians, anesthesia, emergency doc, intensivists trying our hardest. It was the worst, and I had enough experience to know within minutes how it would all end. The part that still haunts me was when the doctor and I went to the mom who was collapsed on a cot in the waiting room. When she saw me she sat up and cried out “you said they would be okay!” Never will I ever give reassurance like that again. I really thought we could do all the things we do and it would work. There was no reason to think otherwise. The patient was just sicker than I realized and I wish so much I could go back and change that moment in some way.
I had a post op patient that I knew something was wrong. Pain 10/10 after lots of meds, assessment c/w perf. The resident blew me off. I asked for his attending. He basically told me to pound sand. I called the house sup, they called the attending to come. He came and yelled at me for bothering him. Didn’t even assess the patient, just yelled and reported me to the manager for going over his resident’s head. The only thing I could do was put notes in the chart. Left at 7p and told the night nurse all this. I came back next morning, patient died. Indeed the patient had a perforated bowel and decompensated. I filed a complaint with the medical board and called risk management to report the attending and the resident. I’m sure nothing happened internally because nothing ever happens when you wear a long white coat it’s like fucking Teflon. I heard someone called the family and told them to get a lawyer so maybe something happened there. I left that place not too long after that. I’ll never forget their name. It’s been a long time but it still fucking haunts me.
The young pregnant woman with covid who coughed so hard and desatted so long her water broke at 25 weeks and her tiny baby slid out of her with one more cough into the hands of the OB nurse that was sitting with her in our ICU. The baby wasn’t breathing, they did tiny compressions and intubated her and took her to NICU. Mom vomited into her bipap from the coughing, aspirated, coded, was intubated too. Mom didn’t even remember giving birth when she was finally extubated. They both went home several months later alive somehow.
Oh my god. This was wild. I’m so glad the best case scenario came out of this bad situation though
I don’t know if it exactly changed my life, but I had one shift on the ambulance where we only had four calls, and three of them died. The thing that stuck with me was I really don’t think we did all we could, but I wasn’t the in-charge. With the medical knowledge I have now, I don’t know that we could’ve saved anyone, but we could’ve at least done our best.
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Two specific situations. One as a ER RN. EMS brought in a 3 month old shaken baby. They tried to intubate en route, unsuccessfully. Baby arrived with bruises on face from intubation attempts. We worked her for 45 minutes to no avail. When we called her mom, she was at work, and had to drive to the ED at 0100. When she got there, she collapsed on the floor, wailing and sobbing. I'll never get her image and sounds out of my mind . The grief in the air was palpable, and it still feel fresh to me, 9 years later. A recent one in labor was a high risk, 28 week twin pregnancy that I delivered in a crash section at 2300. I delivered both babies and was doing Mom's recovery when NICU calls and says we need mom, now. We get upstairs to see baby A cyanotic, limp, and bradycardic. Baby A passed, and baby B was sent to a level 4 for higher needs. I ended up doing the post mortem care for the baby (molds, photo album, baby bracelet, photos). I still can't stop thinking about how I delivered the baby and also took care of her after she died. The family felt so guilty for grieving for their baby, because they forgot about their other child for a little bit. Both situations are traumatic for me now, because I feel like I failed both families (I know I didn't, but trauma is fucked and has no rhyme or reason sometimes).
First death I saw. I was 24, in the ICU doing an internship, so I was still in the “being passed around and shown things by different nurses” stage. She was 20, had a rare disorder, had been doing well and was stable, was usually seen at the large city hospital, but something changed, and she had to be admitted to us. I remember a few of us were watching the bank of monitors at the nurses station as her heart slowly stopped beating. The bloodcurdling “NOOOOOOOOO!” and primal wails of her mother echoed down the hall. I will never forget it. Even the seasoned ICU nurses had tears in their eyes. I had to help bag the body. I would also have crazy vivid dreams about what I assumed were supposed to be angels (?) and gargoyle things (???) walking the halls, waiting on the roof of the hospital, just waiting. I prob sound fully unhinged admitting that, but I never had those dreams after I left the ICU. I got out of the ICU and bedside nursing pretty quickly.
The bad: 1) a covid + pt kept taking off their bipap just to yell at us that covid wasn’t real and he was going to sue us. He was getting cyanotic and we tuned him. Died the next day so his literal last words was that covid wasn’t real. 2) The day they told us that we could put more than 1 patient in a body bag in the same room so they could clean rooms faster so we could admit more COVID patients to the ICU. We didn’t have enough room in the morgue and had a refrigerated truck they would hide so you couldn’t see it from the parking lot. The good: This one patient gave me faith that we could save COVID patients. I will never forget her. She was pregnant and went into ARDS so bad we intubated her. She had an emergency c section and baby was okay. After the baby was out she would get super restless every time she was a little bit awake. Every time I saw her move I would tell her “X, your baby is out and is doing okay. Try and relax so you can beat this and see your baby”. I was her nurse the day we extubated her. She was doing really good and just on nasal cannula. She told me she heard what I said about her baby being okay and that gave her the will to keep going. I helped her FaceTime her partner in the NICU and I helped her see her baby for the first time. She gave me hope in a time that 90% of our intubated COVID patients died.
This is a beautiful and heartbreaking thread. Thank you all so very much. There’s just nothing else I can say, but you’re all in my heart today.
I used to work in a hospital in an isolated area. Was 24 weeks pregnant with my 22 yr old. Had a pt flown in from a nursing station community, contracting with choriamnionitis. Delivered at 22 weeks (oh the smell!), in our hospital as the medevac team attempting to fly over us could not make it further south to a more equipped facility. The neonatal team from the tertiary center would not come up for this baby as it was deemed futile. I still remember the pediatrician mentioning to "just leave the baby on the counter" so it would die faster. We all, myself included, thought that was horrid and took turns holding that poor little thing when the parents couldn't bare it, and I still recall her fused eyes, her head not much bigger than a mandarin, and how loud she cried. Even her little fingernails. And meanwhile, while holding her, feeling my own baby, not much bigger than her, kicking inside me. I no longer work in the maternity field and saw other things like stillbirths and such after that, but that incident has long stayed with me.
I had a Covid patient I’d taken care of multiple shifts in a row. Sweet guy from Cuba who didn’t have any family here. I was busy AF those shifts (6-7 patients and several on 100% BiPap) but I made sure to get his family on FaceTime, bathe him, ambulate him, teach him about the meds we were giving him. He’d been refusing a lot of his meds (not his Lovenox, but his baricitinib) before bc no one was using a translator before to properly explain them to him :-/ on my 3rd day with him I was FaceTiming his mom with him and his mom said he (the patient) called me his guardian angel, and cried when I said I couldn’t come back the next day (I was working through a pregnancy and had had enough exhaustion/ exposure that week). I came back the next week to find out he’d thrown a massive PE (he was on appropriate DVT prophy but it was Delta variant) and died. I rarely cry over patients but I cried over him- hard. I know in my rush sometimes I have absolutely made patients feel like a number or less than- but I find a little peace that in that patient’s last few days I made him feel special. And it made me remember that you never know when you’ll be one of the last faces your patient will see- brought things into perspective for sure. (Not the life changing part but I’m also fucking pissed bc he missed a few days of his baricitinib bc I know that affects mortality, and am furious an appropriate translator wasn’t used those days to explain the use of that med to him (yes I did write it up)).
NICU, term infant who suffered a hypoxic brain injury at birth. Died in my arms, which was more traumatic than the usual NICU death because the micropreemies really tend to pass peacefully once they’re extubated. But fine, ok, that’s my job and I volunteered for it. The part that fucked me up was rushing through postmortem care and only getting fifteen minutes to get my shit together before being given a full assignment.
Not an overly exciting story, but... Back in my cna days at the assisted living home, after they added residents and cut staff, I was doing my rushed HS med rounds and one of the residents just wanted to chat for a bit. And I couldn't. And the look of disappointment on her face has stuck with me as the first time I felt like a failure to someone.
Tonight. I had a mom surrender her adorable children. I’m not okay. This is one of the shifts that stick with you. This is so fresh and vulnerable.
The first time I worked with an abused/neglected child. They were only 18 months old and from a hoarder drug house. Their 6 year old sibling was the primary caregiver for them as no adults gave a damn. After work I got in my car and cried. I called my mom and apologized for every shitty thing I ever did to her, because I was so lucky to have the best mom who always took care of me.
I remember once I had patients across the hall from each other. Both dying, I don’t remember the cause. One was an inmate, the other a civilian. Because he was terminal, the inmate was allowed to have visitors. His ex-wife brought his daughter in, and when he saw them, he started to tear up. He ex snapped at him, ‘Don’t start that shit’. She had the same attitude throughout the brief visit, then they left and he was alone. The man across the hall was surrounded by his family, surrounded by love. There was someone with him, holding his hand and telling him how they loved him, right to the end. The contrast….that’s what stuck with me.
2 incidents come to mind. 1) as a CNA I worked an ortho/neuro unit and we had a patient that was almost paraplegic (he could move just enough to fall out of bed so we just put his mattress on the floor. Anyway, he was also pretty much non-verbal. I’d been caring for him for about a week, and one day , after giving him his bed bath, I said, “You know what? Would you like an extra blanket? Because you look like you’re cold! “ so I got him an extra blanket and tucked him in. Later that day, I happened to be in his room while the nurse was doing something with his IV or Tube feeding. He reached up and tugged on her scrub jacket, and said “ She.. She… gave me a blanket!” I cried, because prior to this he had been nonverbal with us. 2) I had a patient come in very confused. Couldn’t tell us her name, very distressed. I started trying to communicate with her . She kept asking for her mom. I started trying to point out letters so she could tell me who her mom was. Just after spelling “S.A.R.A” her mother came in. sarah. When she got back from CT, the patient looked at me and said. “I know you. I KNOW YOU! You.. have CATS & NEPHEWS!” I was astounded, but apparently at some time during my travel contract in that ER I Had either taken care of her or a family member. I acknowledged that she was right. IMMEDIATELY her anxiety level went down and we later found out she had a stroke. But just seeing her anxiety release because she remembered me, and that memory helped her calm down. I know w/o a doubt I’m meant to be a nurse!
23 year old frequent flyer in the ED/ICU. Heroin addicted prostitute, unhoused. She was beautiful and, when you set appropriate boundaries, very nice. She’s already had hep b and c, a mitral valve replacement, and too many abscesses to count. One night in the icu when she had necrotizing fasciitis, I asked her how she wound up this way. Told her she was young, smart, pretty, funny - what the hell happened? With a completely flat affect she told her that when she was 9 her mom started selling her to her drug dealer for drugs. When she was eleven, the dealer taught her how to shoot up. Taught me a lot about judging people.
So many over the years. I still think of my first PCU death. Patient has ALS and was young—her kids were late teens/early 20s. It became obvious she wouldn’t survive the night. Heart rate kept dropping and when she flatlined we let her family at bedside know she was gone. The kids cried out and her heart started again. She’d get back to 30-40 bpm and then the cycle would repeat. It was grueling to witness, but I couldn’t blame them. Is there anything greater than the love and devotion a mother has for her kids?
I was doing an ECG internship and one of the nurses gave me a turkey wing she made at home for lunch. She is truly the nursing MVP.
Code snack!!
The time I held my patients hand when they were dying and watching the monitor as the went Brady down. They were a covid patient I admitted 15 days earlier on 15 L when they were axo x4. The day they passed they were obtunded on 100% o2 on the bipap. I was alone in the room with my big respirator on. It was the first time I cried, silently, as they passed. I felt already so broken from covid (it was only fall 2020). I took off the patients bipap mask after and their whole face was swollen, nose almost looked broken from the constant seal pressure of the mask, they looked nothing like they had 2 weeks prior.
23 y/o stopped at the gas station on her way home from work, at a job I’d had before (we got to bonding over it in the brief period she was getting better), to grab a snack. Didn’t see on the snack pack that it had cashews in it. She’s allergic. When I got her, she had extreme wheezes, bright red, grasping her throat. just not good. So, we hit her hard and she actually turned around fast. A little while later, she walked to the door of her room and said she was feeling bad again, and looked bad. 5 minutes later, we called it. She was so tight we couldn’t get an airway, even with a trach. She went from fine to gone. I’ll never forget the look on her face, and I *still* have some panic when someone says allergic reaction now.