I started off the shift with 4 patients:Ā
But really, it was 3 patients, because one of my patient was in the middle of a rapid response, which means the ICU nurses are caring for them (they were coughing up blood/blood clots all night).Ā
My other patients seemed okay: one was a line infection patient, one was a comfort care/hospice patient (not great since I just attended my grandpaās funeral after him being on hospice with cancer), and one with hypoxic respiratory failure after a COVID infection.Ā
I usually start my shift with the patient who is awake, but nobody was at this point, so I decided to start with my hospice patient. When I walked into the room, the patientās breathing was adequate, at 20 breaths per minute, but the patient was not very responsive with me. Usually, when a patient isnāt responsive to verbal communication, the next think is tactile (which is touch). The patient was responsive when I touched her shoulder. At this point, she was not safe to take any oral medications, so I omitted all medications in the morning. The patient was on a PCA pump, which is a manual pain pump. On that first assessment, I was able to determine that the patient was wayyyy too weak to press the pump to administer medication, so I advocated for a basal rate throughout the entire day to keep her comfortable.Ā
My two other patients did not really have much going on besides waiting for meals, PT/OT, and procedures, so I donāt have a lot to say about them. I responded to their needs as needed throughout the day, whether they had called the nurses station with their button or I had stopped by to check on them.
Aroun 1650, I was standing outside my comfort care patientās room with her daughter. Her daughter was telling me various stories about either her or her momās life, giving me an insight to what life was like for her. I think that may have been the happiest I was that day, listening to the different stories of the family/patient.Ā
I had a meeting at 1700, so I left the floor and gave my pager to the charge nurse, who was aware of the situation.Ā
I came back to the unit around 1730, and the first patient I checked on was my comfort care/hospice patient. When looking in the room, it appreared as if the patient was no longer breathing. I was unsure as to how to bring this up to family, so I walked to the patient bedside to feel the radial pulse, which I was unable to feel. The daughter asked if the pulse was weak. At this point, I responded to the daughter, informing her that I had not felt a pulse, but I was going to listen for one. After listening to the patientās heart, I heard no sounds.Ā
When I removed the stethoscope, the daughter asked what I heard - I told her that I didnāt hear anything, but I would have another nurse listen. At this point, the daughter said,Ā āWell Meika, what do YOU think?ā I told the daughter that I believed her mother had passed, which she began to cry, understandably.Ā
Moral of the story - losing a patient is NEVER easy; regardlesss of if it was expected or not. Losing someone is never an easy thing to do, as nursing staff, friends, or family, losing someone is not ideal. There is heartbreak. There are tears. You will be consoled. You will be checked on, and you will be asked if you are okay. You will be lost for words. You will feel lost.
The thing is, you will continue on eventually...
But you will always have this person in your mind at all times, doing the best you absolutely can for them and everyone else in your path.Ā
