Ramblings of a Night Nurse: Sometimes...

I'm becoming painfully aware of the fragility of life and the importance of my job-but what's more painful is that sometimes, regardless of what I do or say, people will die. I fortunately have not lost my patient's while I'm on shift but last week I saw that four people that I cared for had passed away...in the same week.

I like to think that I'm a good nurse. I do all those things that a good nurse does. I use good nursing judgment and help make decisions for the care of these patients. But sometimes things are lurking that can't be avoided. Sometimes not everyone catches everything. And sometimes, I guess it's just time for people to die.

Two of the four patients, although it's hard to say, I'm glad they are finally at peace. They had to struggle with very long illnesses and weren't themselves anymore. I never thought I'd be saying or thinking "Oh thank goodness" when it came to someone's death. But then I think about how sick my Grandma was and I think "Oh thank goodness." People just shouldn't have to suffer.

We had a lady who was dying the other week and she was getting all the Palliative Care treatment, including a lot of pain meds. She was a DNR-Comfort Care and for some reason the nurse's had felt it wasn't appropriate to give her pain meds because her blood pressure was too low. Good nursing judgement physiologically but this poor woman was dying. She was in pain. Sometimes people are afraid to give the meds because they think they are "killing" the patient. But sometimes people are ready to go. They should go in as little pain as possible. I can't imagine spending my last hours on Earth in such horrible pain.

The other two patient's had no reason to die. They were young and could have gotten well. I did a lot to try to help both of them. I called doctor's a lot. I tried everything I could to let other nurse's know that something was going on. But sometimes all we have is intuition; something that no machine or lab test is going to pick up on. And how do you tell a doctor "I just know something is wrong"?? Sometimes there is nothing we can do because there is nothing to be done...even if we think there should be.

Sometimes all of this makes a nurse wonder if it's worth going into work that night-is what they do really going to help another person? Are they going to be alert to slight changes that occur in a patient and catch them fast enough? Is there anything to catch? Or is the inevitable just painfully prolonged?

And then something happens at work that lets the nurse know that she's right where she's meant to be. That maybe you can't help everyone but sometimes you can help more than you think. Sometimes people just need you to be there, to be in the room, to hold their hand, to comfort them, to provide the little bit of care that you don't think much of-but means the world to that patient. Sometimes a nurse knows that she was Born For This.