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.

Words

I just watched a movie about cooking and blogging and butter. It was lovely, and a couple of tears surfaced, though none dropped.


I met some people at work. One was the nicest man, and I wish I could have him over for Thanksgiving dinner. I don't know if I'll ever hear from him again, but I have mixed feelings about this. Oncology nurses face attachment issues, and everyone has his own opinion about what "too attached" means. If I see him again, I may understand more about that.


I think about people I've cared for in the past, and I have no regrets about attachments. I only feel honored to have cared for them. Sometimes, tears surface or even drop for them, but I am not a mess. My life has more meaning, because I cared for them. I think of the man whose hair I cut during his induction chemotherapy. I think of Norwegian man. I even think of yellow man who was more obviously close to death than the others. None of them are living now, and soon, my Thanksgiving friend will go, too. Normal people don't understand what an honor it is to care for these. They think about is the pain I must feel.


I met someone else at work that helped me remember simple math. If I expend more energy than I take in, I will lose weight and be tired. At work, there's very little replenishing built into the system for nurses. Bottom line: I need to eat more, buy more plants, and take more baths.


Recently, a friend asked me if I'm doing what I'm made for. I think I was wrong when I said, "Not yet". It's like sentences. Every word is important. And this word in my life is part of my testimony.


"They overcome him by the blood of the lamb and by the word of their testimony." Revelation 12:11

What I Saw

My day was spent seeing machines breathing for tiny bodies, babies with flat affects who startled as I drew near because of abuse. There are no opportunities for teaching when the parents are just not there. There are no opportunities for interaction when the other's consciousness is just not there. I gave pain medications based on a heart rate and a blood pressure. Sedatives, paralytics. I saw lifelessness, and I saw myself sustaining it. 

Even though my actions may have meant healing and life, I couldn't see that. It's why I wasn't cut out for the PICU. It's not because of the PICU, it's because of what I saw there. And I didn't want to stay long enough to become numb to it, to see something else.

Betty says crying is like washing the windows of your soul. I went into the shower after that day and spent some good time sitting on the floor of the shower all huddled up and crying for the children until he came in. He saw me, and got in the shower with me. He lifted me to my feet and held me. When he got out, he put the plug in the tub, and sat beside the tub and let the water fill up around me. We talked. I don't remember what we said. But it was good and healing.

Maybe it's because it was the first time anyone had ever really entered into my place of sorrow. Maybe it's because it was the first time it was really evident that I wasn't alone in anything anymore, that I didn't have to run away or hide to be sad. Maybe it's because it was a picture of God - how He enters into life with us and makes it bearable, because we're not alone, how we don't have to be clean to be with Him. Whatever the reason, I saw it as the very definition of precious itself. 

"I will make your battlements of rubies, your gates of sparkling jewels, and all your walls of precious stones." 

Isaiah 54:12

So Long Insecurity

I just have to repeat this from Beth Moore's book. 


"We can stop playing the game. ... When we work from an activated mentality of God-given security, we are fully capable of thinking another woman is beautiful without concluding we are ugly.  We can esteem another woman's achievements without feeling like an idiot. We can admire another woman's terrific shape without feeling like a slob. Where on earth did we come up with the idea that we have to subtract value from ourselves in order to give credit to someone else? You see, it's our insecurity that makes us so poor at math. It constantly leads us to the draw the wrong conclusion." 


Oh, it feels like relief. How freeing it is to be objective, to enjoy another woman's talents and beauty without comparing it to my own. Do you ever just feel happy for another person without thinking of yourself - even if it's a little kid? Please just extrapolate that feeling. You can feel happy for another person without thinking of yourself.