i could have written this post on monday, after i learned that my patient passed away. but for some reason, i haven't been able to write. i don't know what to say.
i met jamie in november of last year. i began caring for her prior to her transplant and continued to care for her long after. she had several admissions to the hospital. her first visit was about a month long - chemo, transplant, mucositis, pain, infection. her transplant course was never uncomplicated. her subsequent visits were for more infections, for infusions of granulocytes, immunoglobulin. she returned with respiratory issues - lung nodules. sadly, her first transplant failed. her 29 year old feisty body did not accept her donor cells and hence, jamie never regained an immune system. infection after infection, complication after complication, riddled her weakened body. but never once did jamie lose her spirit, her optimism, or her sense of humor. she always had a smile to share. even on saturday, when i admitted her to uw one last time.
it's strange, almost every time jamie got re-admitted to the hospital, i was her nurse. it's like the powers above assigned me to her care. we enjoyed one another. it was easy to care for jamie - even when she was critically ill - because her pleasant demeanor and sarcasm made my shift enjoyable. i'd like to hope that jamie enjoyed my presence too; i'd like to think that she felt safe and cared for when i was her nurse.
jamie was sent via ambulance from seattle cancer care alliance to uw for low blood pressures and fevers. the report i received over the phone from the nurse made her sound sick, but not critical. i was not worried about the admission or her safety; instead, i was looking forward to catching up with what felt like an old friend. upon arrival though, i recognized that jamie was sick - very sick. her oxygen saturation was low. she was breathing rapidly, hungry for air. her blood pressures were low, despite fluid boluses. and her heart was racing. but even then, jamie smiled.
i settled jamie in to uw for a few hours, before my shift ended. we got more fluids ordered, antibiotics hung. she went down for a chest x-ray. an ekg was performed at the bedside. blood and platelets were ordered. potassium was being replaced. after just a few hours of work, i felt like i had done my best nursing care. i had thought of every last thing - even the little details. a commode chair by the bedside with toilet paper within reach (so that she wouldn't have to walk the extra steps to the bathroom). a stash of her favorite fruit punch gatorade. non-skid socks to prevent falls.
and despite my every effort (and the fantastic nursing care that followed me), jamie coded that evening. her young, tired body decided to stop working - it had been through TOO much. the team of nurses and doctors did all they could - they intubated her and got her heart to start beating again. amazing drugs increased her blood pressure. machines kept her alive. until her wonderful family was able to be at her bedside. on monday, with courage and bravery, jamie's family watched her take her last breaths. with borrowed strength from their daughter, they said goodbye. tears were shed. smiles upturned. stories and memories shared. it sounded beautiful - it was not all sadness. those that knew jamie could not mourn her loss without celebrating her beauty. aunt b (jamie's amazingly kind relative) says it best on jamie's caringbridge page:
I would like to take this opportunity to thank everyone for all your love and support of Jamie these last months as she has literally fought for her life. Your words of love and encouragement kept her strong. Unfortunately, the cancer prevailed. We lost our sweet Jamie on Monday March 21st with her family and friends surrounding her. To those who could not be there to say goodbye, she knew how much you cared.
Jamie amazed those around her (especially the medical staff) with her strength, stamina, and positive spirit to the end. I know I speak for all of us who love her when I say that she will be greatly missed.
We love you Jamie, you have truly touched many lives and we are better people because of you. Thank you for that. You will be in our hearts forever.
Goodbye sweet Jamie
Aunt B
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