I was floated again yesterday (but my frustration in never being on my unit is another story). Sent to ICU overflow, the majority of my 4 patients were needy and believed I should be constantly in the room with them.
Except the sickest one. In her early 80's, Josephine still lived alone, cooked all of her meals, drove, bought all her own stuff, had an active social life, and besides having a lump removed from her breast nearly 30 years ago, has never had any serious illness.
She's been hospitalized for two weeks now, and if yesterday was any indication, she's not quite half through.
She came to our ED with increasing SOB, and they couldn't stablize her oxygenation, so she was admitted.
She coughed up multiple mucus plugs the first week, then blood, and twice went into Afib with RVR and had to have a rapid response called. Several cardiac drips later, they also had to start her on continous bipap.
This week, she's had two more rapid responses called, and twice more, she was stablized.
I lifted her bipap mask for less than 90 seconds so she could take her pills, and she desatted into the 60s so fast it scared me.
So when it came to be lunchtime, I hovered in her room. I put her on hi-flo oxygen through a nasal cannula, but even at 15L, she hovered in the mid 80's. Since I was spending so much time with her, we got to talking.
And I was amazed. Besides having children, she has never stayed overnight in a hospital. She took two pills a day - pepcid and calcium. She participated in things to benefit the elderly, and often served people younger than her, and knew she should be thankful for how mobile and "with it" she was at her age.
"What did I do to get pneumonia and all this other stuff?"
I held her hand and reassured her, and talked about the (very) small improvements in her last couple daily chest xrays, but she never seemed convinced - and no small wonder, given how many times she had been through a rapid response, the scary unknown of 12 people filling your room and analyzing you.
Throughout the day, more cards and letters arrived, and I taped them to the wall in front of her - just today, her card collection grew from 12 to 18 - and most cards were signed by multiple senders. It touched me to see how much this woman is loved and known in her community, and how many people were on her side.
"I just want to do right by them." she would say.
So do I, Jo. It's not that we treat our patients any differently knowing there are people out there counting on you; I'll give you excellent care regardless. But we do feel the weight of how many people love you, and are pulling for you.