Letting Go.

The image of finding my patient unresponsive is stuck in my head. I keep seeing him laying there all haphazard.
You get jumpy about things. Like whenever I hear a loud noise, my instinct is to go help whoever just fell or is seizing. I learned to watch for chest rise when I worked at the nursing home, so I always have, but now I'm jumpy about it. Maybe that will get better.

That night, I was talking in my sleep. Thomas told me I said, "Layers," like I was giving an answer in class. And there was nothing else. After he told me that, I just kept thinking about this story I heard once about a woman who had a near-death experience. She said the singing in heaven wasn't just harmony, it was like layers.

Yesterday, my voice teacher told me that singing is about trusting and letting go. Trusting that your voice knows how to do it, and letting it go. She's telling me about the anatomy of the voice, and it's amazing. Your larynx opens and closes hundreds, even thousands of times in one second depending on the pitch that you're singing. It's the same about running. Your legs know what to do. Actually, once you start walking, and I assume it holds true for running, it's a reflex. There's no brain involvement at all, just spinal cord. And breathing - well, it's all automatic. You don't have to control anything. You just let go and run.
 
Dead people usually look...dead. Shriveled. Dry. He looked like he was sleeping. Perfect. Peaceful. He had been working so hard to breathe for so long. He was labored at baseline. Then nothing. No movement. No more labor.
 
All of it helps me let go, and you have to let go, else you can't go back there again. But I went back twice already, and it wasn't so bad. I still like my job. It's a battlefield, and you question your decisions. But sometimes, you just have to let go.

Today

I lost a patient today. It's the first time at this hospital. I mean, yeah, I've had patients die here before, but they've been hospice beds. Today, I lost a full code. Actually, I'll be honest. I lost one of both today.

There's nothing like walking into a room and finding your friend unresponsive. He'd had trouble breathing on and off all day. I kept trying to get the doc to order different things. He wasn't interested. I bypassed him and got help from other people. Everything helped temporarily. I watched him so closely all day.

His CK was high from the labs we drew during the code. Maybe he had a heart attack. Maybe it wasn't respiratory. I can't say.

It's a hard lesson, and I'm not even sure what I'm supposed to learn. Should I have called a rapid response earlier and convinced the resident to take him to the ICU? Would that have saved his life? How much of it was out of my hands? How much?

The Solomon of nurses told me I practically ran the code today. It's not true, but looking back, I bet nobody would've guessed it was my first code. They always told me during mock codes that I wouldn't have to worry about pushing meds. Someone with know-how would be pushing. Except in the PICU. In the PICU, they told me to slam everything. So that's what I did. Epi in. Atropine in. Bicarb in...atropine...atropine. "How many atropines?" "We can only give three." And then, "After this bicarb, I'm calling it unless anyone has anything else." And that's when I swore, and somebody thought I stuck myself. It felt like ten minutes, but it was 45.

The guy asked me if it was my first time at the morgue. I told him it was my second time that day, but he wasn't listening. He wasn't asking for an answer. He was asking to fill his own ears.

Another one down to AML today.

Wrote this Yesterday

Today, I am tired of death. My patients' bodies are shutting down, and it makes me tired. Striker makes me tired, because he is tired. And his wife is tired. Baby makes me tired, because she is tired. AML is terrible. It takes healthy ones, defeats them over and over mentally, physically, emotionally, and then it kills them. Tonight, I am just tired, and I am going to go to bed now.

In other news, today was my first day as charge nurse, and it wasn't terrible.

A family lined the halls that day. All the same family, watching waiting. Then, when it finally came, a soberness rested on the whole place.

A young one died that day on our floor.

One nurse said, "I just don't get it." She didn't say, but I know she was talking about life and God. We're okay when the old ones die. It's part of the reason we work here. But the young ones take us deeper to ask questions about who is ruling the universe.

I've been thinking lately about how God is King. It changes everything. Everything. If God is king, then all the stuff that I think matters really doesn't. All of the stuff I think about on a daily basis has very little to do with reality. The world is upside down.