The Price

This has been a week at work. On Monday, I was in an "acute room" at one hospital-- instead of going to the bedside to the patient to do the dialysis, the patients are brought to us. In this particular hospital, two nurses work at once, two patients each. And in this particular hospital, we have a Licensed Practical Nurse (LPN) that the hospital provides, to help us with everything.

The other nurse and I were setting up, and the LPN started bringing in our patients. I had gotten in a little earlier, so I determined, with the LPN, which patients were going where-- the patients have different prescriptions for which dializer, dialysate, etc they use, so each machine is set up individually for each patient. As the other dialysis nurse got ready to set up one of his patients, who had been sleeping while waiting for dialysis, he tried to take an initial blood pressure. He realized he couldn't get a blood pressure.

We called a "Code Blue," and a "crash team" descended on the acute room. They worked on the patient for about half an hour, but were never able to revive him.

Yesterday, I was called to a hospital to I hadn't been to for a couple of months. I recognized the name, but it wasn't until I got there that I remembered the patient. I had done the first dialysis treatment that she had gotten when she entered that hospital, in late December. She had been lucid-- because she had a trach tube, she couldn't talk, but she could mouth words. She was one of the few patients who had ever thanked me for her life-saving treatment.

I noticed that she had nothing personal in her room-- not the pictures, flowers and cards I usually see with a lot of the patients. I talked to the primary nurse and discovered that she had no visitors. I made a mental note to stop the next time I was going to have her as a patient (we are usually told the night before who our patients are going to be) and get her a little pointsetta plant or some other little piece of holiday cheer.

As luck would have it, I wasn't called to do treatment on that patient, or even to that hospital, for a couple of months. When I arrived at her bedside, I was in for a shock. She looked nothing like the last time I saw her. She was not alert; her skin was dull and lifeless. She opened her eyes, but I could tell there was no cognition.

As I set up to do her treatment, I talked to her primary nurse, who told me that she had been doing better and better-- until two weeks ago, when she "coded." Obviously, she had been hypoxic (deprived of oxygen) while her heart and lungs were stopped long enough to damage her brain.

She was never going to get better.

As I finished the treatment, I quietly apologized to her that we medical professionals, with all of our expensive equipment and meds, couldn't help her get better. I found myself regretting that I hadn't been called to that hospital to treat her, and that I hadn't been able to drop off a pointsetta to brighten up the dreary room that will probably be where her last days will be. And I realized that the price I will pay to be in a profession that I love, and one that allows me to make a living helping people, is to be looking death in the face.