I thought it would never end. I was on call from 8am Sunday until 8am this morning, then I had to stay and see patients for my rotation, then attend our noon conference. I didn't get home until about 2pm...I was soooo tired. I did get some sleep but it was pretty staggered. I had to admit 12 patients to the hospital..which takes me about 1 1/2 hours per patient, then I had 2 codes in the middle of the night. The last one was a guy the family refused to make DNR despite the fact he's been unresponsive for several weeks in the ICU...it's that whole "futile care" thing I was talking about. He's been barely hanging on for weeks, his extremities were cold and he's had no signs of brain activity. Well, he finally flatlined and the daughter wanted us to keep trying to save him. To make matters worse, she spoke no English at all and at 3am we had to use an interpreter by phone to talk to her. After about 30 minutes of CPR and epinephrine, I put an end to it all. I still can't believe what people put their loved one's through...loved ones who really NEED to die. If someone has even the slightest chance of survival, I'm in total support of making sure all is done to save them, but in situations like the one I just mentioned, it makes me angry. People deserve to die with some amount of diginity, not the way this gentleman was forced to die.
The first code I had was a guy who should not have died. I don't exactly know what happened except that his blood pressure and heart rate dropped. The nurse called the "rapid assessment team" to see him and by the time I got there (in about 2 minutes) he had no pulses so we called a code. We worked on him a LONG time. I intubated him and we kept pushing drugs. The attending got there about 45 minutes later, we worked a bit longer and he then stopped us. We weren't going to get this guy back. The family was all out in the hall crying. I'm always amazed at how quickly family can get to the hospital in the middle of the night. So after the attending had us stop resuscitation, we all just stood there. The gentleman still had some basic brainstem function and took intermittent breaths every now and then, even though his heart was not pumping blood. We all just watched him. It was a very strange phenomenon I'd never seen before. I kept telling myself that for all practical purposes, he was already dead, but to watch him breathe.....I felt uneasy. After about 10 minutes he stopped.
I watched last night's Desperate Housewives with The Boyfriend tonight. I'd forgotten just about everything from the season finale, so I was a bit confused. Confused or not, I had a good time snuggling on the couch, getting to forget about the events of last night. My boyfriend is somewhat of a goofball. I invented a new kind of kiss...the Lizard Kiss. He didn't care for that too much and started giving me Lizard Pinches. What a copycat! : )
Bedtime.
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