Wednesday, June 09, 2004

Never give in to a craving for cookies.

I suppose I should've known on Sunday night

Sunday night, as I was getting ready for bed, the water pressure dropped significantly. In this town, that means that somewhere there's a broken water main, and you'd better get cracking on filling up jugs and bowls with what water there is. So I was. Then the tornado sirens went off.

The man I was married to is a HAM radio operator. He helped work out the protocol for blowing the sirens. I knew, therefore, that this was serious business. I'll skip the excitement of listening to the weather radio and waiting for the all-clear and just say that I didn't, between the thunder and the sirens, get a lot of sleep.

what was going to happen on Monday

Monday was busy, busy. I had three patients who were of major concern: the first had had a large meningioma removed from her frontal lobe. The second was dying. The third had intractable pain.

But damn, they were stable. Pain Woman had gotten a new cassette for her PCA pump (that's that patient-controlled painkiller with the little button you push). Phred, the beloved night nurse from Vietnam, had put it up for me at shift change. Phred always takes care of me. Dying Woman was, well, dying. There's not a lot you can do when somebody's doing that. She was still talking and responsive at the time, so the main job was to keep her comfortable. A Do Not Resuscitate order doens't mean you leave the person to rot; you just don't burden them with life support. Meningioma Girl had no drift, pupils were equal and reactive; not even a headache.

Then Dying Woman was taken off DNR status and put on a full-code status. Why this happened, I'm still not clear. I'm not certain she knew what she was asking for, but it's better to be safe than sorry.

Then Pain Woman started having problems.

Then, just as I'd gotten the problems with PW resolved and the politics surrounding DW dealt with, I got a craving for cookie. Everybody was taken care of, my other two non-scary patients were bopping along just fine, and I figured a trip to the lobby for a cookie would not go amiss.

I'll never do that again

I was downstairs when Meningioma Girl had a generalized tonic-clonic ('grand mal') seizure.

Not gonna go into that, no sir. All I know was that I had a feeling of impending doom that I shook off. When I returned to the floor, they told me she had seized. Two of my colleagues were in the room, taking blood pressures and so on (the patient was post-ictal by this point and very sleepy). I moved fast.

As I was headed down the hall to get a milligram of Ativan, the respiratory therapist came out of Dying Woman's room to tell me that she had suddenly become nonresponsive. With a DNR patient, that's not a real big deal. It's simply another step in a natural process. With a code patient, it means a lot more.

"Ben," I said, "you have to deal with this. I can't. I've got a seizure down the hall."

Ben did, thank God. And the patient was fine.

I would not have gotten through the rest of that afternoon, what with stat CT scans and Cerebyx needing to be run and so on, had it not been for my coworkers. Three of them picked up so much slack that they were as busy as I was.

And the moral is....

This is why I love working where I do. If one person is snowed, everyone else pitches in to the best of their ability to make life easier. They don't just get patients up to the bathroom or take pain medications in to them; they draw blood, put nasogastric tubes down, take phone orders, set up BiPAP machines. I've done it for other people, and on Monday they did it for me.

I was so touched I nearly cried. Well, touched *and* tired.

And I will deny myself cookies now. There's nothing worse than being downstairs, or worse, at the McDonald's next door, and having a stat page come over your beeper.

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