I am beginning to understand

When I tell people I work as an ICU nurse, many think I am crazy or amazed at how I am able to work in that kind of environment. I didn't fully understand their responses until this past week. I would say, "Yeah, it is a bit stressful, but it isn't that bad. I like it so far." That was the old "ignorance is bliss me" talking.

Simply said, most people in the ICU are VERY sick. Sick, like teetering on the brink of death or already with one foot over the edge. As Dr Dorian on "scrubs" said, "So many people die in the ICU you begin to think Death is your co-worker." These last few months as I was being trained to work the unit, that concept really wasn't sinking in. I never participated in a "code blue" drill. I had seen some people die, but I knew they had fought the long hard battle and were done and it was probably their time. It was a peaceful death for someone, a welcomed release from the mortal coils. For the most part though, I saw people live and the work I did seemed beneficial.

However, I saw first hand this past week that anyone can go at any given moment. Someone you would least expect. I had two patients. One, talking to me all day. His family talking to me. Everything stable. The other patient, she was dying from lung cancer and the family decided to withdraw all support and just keep her comfortable until she died. She was taken off a ventillator and wasn't expected to last 30 minutes. Almost 9 hours later she was still alive, not responsive, resting calmly, but still breathing. However, my other patient was dead. It happened in an instant. He was talking to me one moment and the next, I had to call a "code blue". We did chest compressions, gave medications, shocked him, tried to get him to breath, to respond, anything. 45 minutes later, the doctors called a time a death.

I heard the wife scream in agony in the waiting room after the doctor told them. After I restored some sense of calmness to the patient's room and cleared away the signs of the chaos, I ushered the crying family members into the room to see him. I offered hugs, tissue and water and tried not to cry with them. I briefly explained what had happened, but all I could think was "I am so sorry."

All my co-workers give me this knowing look as they realize it was my first real "code" and they tell me it will be ok, but I said, "It is not ok." I think about the loss this will be for the family. It just saddened me and it didn't feel ok at all. I get to go home now and be with my family and this family now has to deal with funeral arrangements and decisions on whether there should be an autopsy.

But, a few days later I am feeling a little better. I talked to some friends and a mentor. The other concept I am beginning to fully understand is that we all die sometime. Immortality is unnatural. We just do the best we can with the time we have and try not to worry about when our time will end. My job is to do my best for the patient and realizing that sometimes, the best will no stop death from coming.