Chvi

The morbid things in life

I had a bad day today. Not personally. Not professionally. Well, not technically professionally.

After having a rather easy, straight foward day yesterday w all my patients (they were all stable, some where ready to go home, things just went a little haywire today.

Suddenly on our WR, our patients' condition had deterioated, and we're looking at ppl who are on the verge of death. Showing signs they're dying. Showing signs that u just know, this isn't going to work out well for them.

I don't know these patients that well. They sorta come and I go on WR and I take a look and write in their notes and that's abt it. But they are still my patients, and now that i'm part of the 'team' I feel more involved, and I feel that anything that happens on my watch is something I have to deal with.

And today, every news abt a patient was just bad news. A new patient came on our ward, and thinking it wouldn't be anything but L knee pain, my intern and I went to see him on our own.

Immediately stepping into his cubicle, we could tell something was wrong. He was a big man, and he was sweating profusedly, like his body was taking a huge hit of something. We constantly asked him if he had chest pain, SOB, any pain anywhere and he would say no. We asked if he was very hot and he'd say no. He denied and denied but doctors say u have this gut feeling abt things, and boy is that true. Something wasn't right.

Vital signs were taken. Everything was normal but his temperature. 34.4. Why so low?

Still sweating, we examined his chest. Chest had mild bibasal crackles. Doesn't explain this sweating and temperature. His heart had 2 heart sounds. His abdomen soft, mildy tender. What else do u need to look at? Oh right his heart rate.

His heart rate. Irregular. Not strong. 78 beats per minute said the machine. I couldn't even get it to beat to a min. It was just so hard to feel. My intern couldn't feel it properly either. So we stood there, either side, trying to determine if this is a bad sign. And suddenly, our patient, starts breathing harder. And harder. And then complained of nausea. And then dizziness.

I can remember the scene so well. I remember looking at the patient as he laboured at his breathing. I remember looking at my intern. I remember that we both thought, shit.

Overall, I think we both handled it well. She went to get O2 masks, I went to put the bed up for him to breathe easier, we called the nurses, we got the ECG. My intern left me then, not bc she's a bad intern, but to call our reg to come. She even sent another reg who happened to be on the ward to come and help.

And suddenly, I had to present this patient, who I hardly knew a thing, and give this reg I didn't know a run down of what I thought happened just 2 mins before. I think I did my best, bc the reg didn't ask me further questions. The nurses asked me if I was happy w the ECG. FUCK. How do I know when I'm happy w an ECG? That's not in the book!!!

It turns out he didn't have a cardiac event (we don't think). And he probably doesn't have a PE. But when our own reg finally came down and assessed him, he turned to us and said, "This patient is very sick. He'll probably die in hospital."

And my heart sank. I already discovered on WR that one of my other patients would die very soon. And to think, here's another one. It hurts.

I don't know why I feel like this. I don't really know these patients. I don't really show affection towards these patients, and nor do I want to. But to know they'll die there when they're there to be treated is hard. I just felt knowing these 2 patients would die probably while I was there made my day shit. I don't know how to process this and I don't know why it affects me.

But it has. Funny enough, it hasn't made me wonder why I'm in this profession. I just know I have to develop a tougher shell, and pull through this bc how am I going to handle this next year? Sigh.

I never thought I'd be scared of death. But I realise now, I am.

posted by chvi @ 8:56 PM