Caring is not a choice

Once again, I'm reminded of my nursing history. This time, by Kim from Emergiblog, who writes about the death of one of her patients. And again I wonder just why it is that the death stories are the ones that stick with me in those little recesses of brain matter where they are available at a moments notice.

I was a temporary hire in a coastal city in Alabama once for about 6 weeks. This was during a 2 year period of time when DH and I were still pretty much newlyweds and lived the life of employed gypsies. We drove a trailer around and parked it in mostly beautiful campgrounds near wherever DH's engineering assignment led him. This time it was in a post Hurricane Frederick town near the Gulf of Mexico. The devastation was still evident, but streets were passable and the gunk mostly gone. What was still there were the uprooted trees and roofless houses.

This medical center needed help and even though I was only going to be there for 6 weeks, I had intensive care experience. It was mostly a piece of cake job - many of the cases they put in the intensive care would have mostly been handled on the floor at the last hospital I'd been at. But not this one.

The little boy came in - 6 years old, lethargic and clammy. The nurse could not start the IV. I got lucky and got one in only to have it infiltrate within about 20 minutes. Not nearly long enough to hydrate and medicate the youngster. A resident came in and proceeded to do a "cut down" to get an IV in place (a surgical procedure where you cut the skin to visualize the vein and thread the catheter directly into the vein - usually a very last resort). He then left the room and told me (the nearest nurse) to "go tape it". I said "WTF (not quite in those words, but pretty damn close - I was new there, remember?) - you left it unsecured???" and ran in there, "my" patient or not. The child promptly coded and the team ran in to resuscitate. About 15 minutes in (give or take - who knows), I notice the IV was laying on the bed, the meds and fluids soaking the sheet. I can't remember who was directing the code but I remember the incredulity on his face when he realized the IV had not been secured. He uttered some choice words that I felt were directed to me, tried a few more attempts to get access and the code was over.

It should have been the idiot who placed the catheter without taking the extra minute it would have taken to secure it properly who should have felt responsible. But it was me. Because I couldn't get it secured before he needed it. Because it came out at the time he needed it most. Because he was 6 years old. Because his family was going to face the rest of theirs lives without him.

Sometimes it sucks to care.

But the alternative is just not an option.

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