May 31, 2018

Nurse Danielle's Bad Day - Tears Behind My Eyes, Smile In Front

Nurse Danielle's Bad Day - Tears Behind My Eyes, Smile In Front

I have never been one to sugar coat the ups and downs of the nursing profession; some days are so epically beautiful that you feel divinely blessed to be called a nurse. Some days are so painful you wonder how you will continue in the profession. This story is about one of my bad days. My patient was 35 years young and was admitted for vegetation on his mitral valve due to antibiotic-resistant strep throat. Through the course of his stay, we became extremely close. 

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Of note, I’ve noticed throughout the years that my attachment to patients seems to directly relate to traumatic events in my personal life. In this case, I was going through a breakup with someone I loved very much. Thus, perhaps I was seeking reason or distraction from my own life by submerging myself in this patient’s situation. Either way, nursing is an extremely personal career and some patient stories we carry with us forever. 

This patient needed surgery and had a high chance of dying. He requested to make a will, so I Googled the state law, printed off a template, filled it out and signed it as a witness. I overheard him making his final phone calls and watched him play a card game with his son, despite his intense dyspnea. Even though his chances of a poor outcome were high, he seemed at peace to me, whether he lived or died. 

He was sent to surgery the next morning and the outcome was poor. His organs failed one by one and by the time I returned to work after the weekend, the decision was made to withdrawal care. Appropriately, I was his nurse that day and started by caring for two patients because “I was just withdrawing care” on him. For many of us, withdrawing care on a patient is often perceived as an easy assignment. Although the culture is changing, at the time, this was regular. 

Because I could not be in two places at once, another nurse picked up my other patient, so I could remain in the room as he died. His family members said their goodbyes and I turned off his life-sustaining medications. I sat with him, almost paralyzed, cupping his cold hand in my warm hand, as his soul departed and his once perfect heart, ceased to beat. 

I ritualistically cleaned him, disconnected his lines, pulled his chest tubes, extubated him, washed his face, tied a toe tag on him, put a clean white sheet over his body, said a prayer, and rolled him into a plastic bag by myself. There is no feeling in the world that can duplicate putting a human life into a cheap, pliable, body bag. So many thoughts and feelings race through your mind - anger, sadness, numbness, and sometimes relief that the pain is over.

I went home after he died and cried while sitting on my porch, staring at the sun that opted to show its rays for the first time in months. For a fleeting moment, life was put into perspective. The warmth of the rays seemed to contain the touch of many people I did not want to lose and a reconnection with something existential. A short two hours later, I went back to admit another surgery patient, tears behind my eyes, smile in front.

Danielle LeVeck, DNP, ACNPC-AG, CNS, RN, CCRN is an ICU Nurse Practitioner, blogger, writer, and social media influencer, who strives to empower and inspire nurses from all backgrounds, to partake in regular self-care and multidisciplinary teamwork, for the sake of providing optimal patient care. Follow her on Instagram and Facebook for her latest. 


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