calm before the storm

my nurse patient has been in the hospital for 87 days. in those almost three months, i have cared for her almost EVERY day that i have worked. since i work 144 hours per month, i figured that i have been with nurse patient for approximately 432 hours. and when stated that way, i realized... i have spent more time with nurse patient than with any other person in my life since february. i live alone. i'm not a hermit. but there is not a single family member or friend that i have spent that much time with in recent months. hence, almost by default, nurse patient has become an important part of my life.

sunday night, i returned home from a weekend of snow camping. i walked in the door, began unloading my wet gear, and checked my email. i had 50 emails! the last one was from a friend and colleague i work with. we sometimes email one another with random personal updates. i hoped that she was emailing with news of her son or random gossip regarding a co-worker (who got knocked up, who is leaving our unit). but instead, it was a patient update. my friend and colleague recognized how important nurse patient has become in my life and wanted to update me before i walked onto my unit for a shift. in case i needed to cry. or process my feelings while at home.

over the weekend, nurse patient started to decompensate. her respiratory status became more and more compromised. she was struggling to breathe. and when you breathe too fast and too shallowly, carbon dioxide builds up in your system. the pH of your body changes. your mental status is effected. your kidneys get grumpy. and eventually, you poop out. anticipating this, the team of doctors working with nurse patient decided to pre-emptively intubate her. a planned intubation is always better than an emergent one. but it's also a horrible "elective" procedure. as a nurse, i HATE watching someone get intubated. i always feel this huge sense of sadness. a patient is losing their voice, possibly forever. i'm glad i wasn't there on sunday. i'm glad i didn't witness or hear any last words exchanged by nurse patient and her amazing husband. i fear they were the last words nurse patient may have spoken.

on monday, i had a 4 hour computer class at the hospital. it was not on my unit, but i stopped by to check in. i visited nurse patient and her husband. and as i walked in, i saw a big smile spread across nurse patient's husband's face, even through his mask! he was calm. gave me the update. and asked why i wasn't an intensive care nurse. i can no longer be nurse patient's nurse. i am not an ICU nurse. i avoid situation like nurse patient's. and although i think i am skilled enough to master the ICU skill set, i don't want to lose all of my patients. as is, i lose A LOT of patients. but once someone gets intubated, the outlook is much more grim.

i'm sad about nurse patient. last week i felt like she was making progress. i told her i was feeling optimistic for the first time. for the first time in months, i heard some spirit in nurse patient's voice as she talked to her daughters on the phone. her white blood cell count was increasing ever so slightly. and instead of feeling doom and gloom (which is my typical attitude), i had a glimmer of hope. it was strange and out of character. and honestly, on my way home, i wondered if this was the calm before the storm. sure enough...