The sun was beginning to set

the darkening hour was soon,

the graveyard was being dug . . .

oh, wait a minute!
Who is that sitting on the job?

This graveyard isn't going to dig itself mister!
We have bones to put away!

No worries for the ladies with this tough one in the Saloon keeping order!

Welcome to the Halloween Party preview!

Tonight is the night and most is ready

and I thought I'd share a sneak preview . . .

But, first of all, let me say 

Happy Halloween!

and a classic "boo boo", I'm in the frame!

With a Western theme this year, I still found a place for Halloween

in the decor. This in one corner . . .

and this scary one down below . . .

make for an inviting corner to sit a "spell "!

But, a Western ghoul greets you at the door,

with his skeletal crew and the jailhouse keys

we've even added authentic advertisement here!

But, as you enter, you come into the Dead or Alive Saloon!
Complete with "Wanted" posters, honky tonk music,
shot glasses for the tastin' and lanterns and
gold coins for the gamblin' on the tables!

I finished a post and sent it to draft.

It was most likely a little too graphic and

just too much information.

Let me do this again.

We've had a rough week at work.

I am recovering from a 5 days out of 6 stretch

of 12 hr nights.

2 nights with no breaks, at all.

And about 4 hours of overtime.

The S*#! Hit the Fan!

I've been in charge, so in the past, I've blogged about what

it's like being on the patient care end.

This is a little different.

I've got the whole unit on my mind, not just my patient.

I've got safety issues, break coverage, nursing support, parental

support, MD communication and issues with other units,

 staffing issues . . .

there is alot of S#%*! that goes down.

Not only are we having an unusually high census, but an unusually high

acuity. This means the patients are unusually really, really sick.

Murphy's Law.

When something could go bad, it seemed to find it's way there.

We were running codes nightly and sometimes more than one,

 putting kids on ECMO (life support),

opening chests at the bedside.

In a couple of days,

we have withdrawn on 2 patients.

This is one safe part of the draft not posted.

WARNING! This is a tough post.

Steel yourself, or move on NOW.

"But now, there was no reason to continue ecmo.

Of course, this takes time for the parents to come to realize.

We, usually can afford them this time.

However, her child had different plans.

She was deteriorating and

as the reality meets with the dismal

outcome, the harsh and bitter news had to be presented.

Unfortunately, we had to withdraw. Tonight.

There was conferencing with the parents, support

and exhaustive explanations.

We waited for several family to arrive for their

goodbyes. This was a small child taken home as a newborn,

care for, loved. Expectations held, plans made and excited

parents had prepared for a lifetime of love and

support for their cherished bundle of joy.

And in these few days, all those dreams crashed

into nightmares.

 There had already been

miscarriages. Loss relived.

Unimaginable grief.

Mom was sobbing. She picked up her baby's little hand.

I saw her start to wobble, auntie was behind her.

I moved closer as mom collapsed and we guided her to a soft landing.

A couple of hours later, her baby called, she was

ready to go. Dad brought mom back from the ER in a wheelchair.

We disconnected the baby from life support and wrapped her in

a blanket for mom to hold her warm baby one last time as the life

drained away."

 

"We could only witness this pain. And that is in and of itself is painful.

We each do the best we can to offer help, support, offer anything, but

this family, each one, ultimately, were all alone in their grief."

“You kind of put your emotions aside because there are other patients waiting for you.”

A quote I found from the nurse of a dying patient.

And we did.

That is how nurses survive.

That is how we continue to do this work that gives so many pause.

And we move to the next struggling patient hoping for, continue to work for,  a better

outcome. And when that happens, it changes everything.

"a turning point in her career — which made her decide not to quit her job — was a thank-you letter from a relative of the girl who died holding her hand in the burn center. “

another quote I found on dealing with nursing stress and death.

My turning point happened many years ago, when our unit was in its infancy.

A lung transplant, whose post-op course was so incredibly difficult, it felt like

torture to me. He was a young adult. Very young adult. The age of invincibility.

Six months of recovery in the ICU, 2 months on the floor. He finally went home, fell in love,

got the truck he dreamed of, and in 3 short months later, was back in our ICU

with acute rejection, dying.

Someone asked him, "was it all worth it for those 3 months?".

He smiled, "Yes".

That was my turning point.