Wednesday, September 21, 2011

Go on a Journey...

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Author Mark McGrath discovers that to raise four children as a single parent, along with continuing a career in nursing, he needs more than a pair of ruby red slippers. He needs the help of family and friends. Tears and laughter flourish throughout his many adventures, trials and unforgettable moments as a nurse and as a father. Join him as he makes...

the journey home.


And we all continued to watch Rico.

Still he struggled, and his breathing remained in the high forties. His daughters were each holding an arm and his wife was stroking his face telling him it was all okay now, that they would be fine and to please go to wherever he needed to go. They all told him to let go, that the family loved him and would miss him, but that his suffering needed to end. His breathing came in short pants, much as a winded athlete breathes after a long race or shift of ice time on a hockey rink (something yours truly can personally relate to).

I listened silently and struggled with the scene myself as it was heart rendering and touching to
witness. I thought to myself how lucky he was to have a family who loved him so much that they wanted him to die so that the pain and illness he was suffering would finally come to an end. The girls were begging Daddy to please let go and stop suffering. The sobs coming from them were unbearable for me to hear.

I watched intensely as another half hour rolled past and Rico continued to writhe and moan. As soon as I was able, I increased the drop rate to eight mg an hour and went about monitoring his progress. His respiration rate dropped from the mid fifties to around forty. But even though the rate had dropped, he still was uncomfortable and was extremely rest-less.

I called Barbara when I increased the rate and asked her to please come speak with me on my dinner break. She told me she would be there shortly and to meet her in the conference room. I told her I would and got myself ready to leave for a well deserved half hour break.

I quickly gave my relief nurse an overview of what was going on and told her that I would change the drip rate if needed when I came back. Both of Rico’s daughters had left to get something to eat themselves and his wife had her head on his hand in what seemed to be a prayer vigil.

I met Barbara in the conference room and gave her the latest news on how he was doing. She knew I was still struggling with things and she sat listening again about how I felt. I told her that I felt I was contributing to his death and that I was having an issue increasing the drip to 16 mg.

What she said to me made a profound difference in how I have approached life and death since that day in the ICU. She told me to put myself in Rico’s place, and asked what would I want?

“Not to be in pain, that’s for sure,” was the first thing I said.

“Mark, he is terminal. You are smart enough to under-stand what’s happening and know that nothing more can be done. The family wants his suffering to stop. Whether he dies now, five minutes from now or five hours from now, don’t you think that the best thing is be humane and make him as comfortable as you can? You can’t kill someone with humanity, Mark. What you can do is treat him as best as you can given what you know, and make the last hours as pain free and comfortable as humanly possible. You need to increase the drip and not worry about how things look. Remember that you are the nurse in charge of making sure he is getting what he needs to be comfortable and pain free. If that was you there, what would you want your family to tell me to do?”

As I listened to her words, I realized that she was right. Both rules applied here: he was one of those patients who got sicker and was going to die, and nothing I knew or did would ever change the fact that he was going to die. So, I did what I would want someone to do for me in my time of dying, in pain, and suffering unbearably.

I went back into the ICU and turned the drip rate to 16 mg.

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