The Mini Christmas Tree
I was two years into my nursing career. You were approaching 90-years-old and made it clear that you wanted to stop treatment. It was Christmas time and I was working a night shift. You had a miniature tree with ornaments on your bedside table. Every time I came into your room to check on you throughout the night, I ended up knocking it over, and all the ornaments went flying everywhere. I knew how happy it made you to have it there, so every time I knocked it over, I picked all the ornaments up and redecorated your little tree. You were my most well-behaved patient that night. Your vital signs were perfect, you took all your medications like a champ, and you slept through the night without asking for a thing. You didn’t even make a fuss when the phlebotomist came by at 5:30am to stick you for labs.
It was just before 6:00am, and I was counting down the last hour of the shift. I had given you your 6:00am medication and headed down the other end of the unit to administer my last medication to another patient of mine. It’s always a great feeling when you can check off that final medication of your 12-hour shift. As I was finishing up with my other patient, the emergency alarm went off. My heart always skipped a few beats when I heard that alarm. Naturally, I ran out of my patient’s room. When I looked down the hall, I heard someone shouting out your room number. In that instant, I knew it was either an accident, or there was truly an emergency because you never called out for anything. As I got closer to your room, I heard screaming. Your roommate was being escorted out of the semi -private room by our LNA, or licensed nursing assistant, who had pushed the emergency button for you. It wasn’t an accident, this is a real emergency and it’s my patient, I thought. When I crossed the door’s threshold and looked at you in the bed, my heart stopped. I froze at the doorway. You had hemorrhaged from your mouth. My coworker was at the head of the bed suctioning your mouth, but your pupils were already fixed, you were grey, and you stopped breathing instantly. You were a DNR/DNI, which meant per your wishes, we were not to attempt resuscitation or perform intubation. Just like that, you were gone. I couldn’t believe it. Phlebotomy had just drawn your labs, and I had just given you your morning meds, how could you be gone? I questioned. The doctor relayed the tragic news to your family. I remember being so fearful of facing your family. I had no words. I was still so confused as to what had happened. How was I going to give your family answers when I still needed them myself? I couldn’t leave your bedside. I didn’t want you to be alone. I spent the remainder of the shift sitting by your side. To you and your family, I’m still so sorry.
And after all that was said and done, instead of rushing home to grieve, I had to sit myself down in front of a computer and try to put into words what had just happened, because as all nurses know, if you didn’t document it, you didn’t do it.