Storytelling

You were never short on words, always full of stories. I felt bad always saving you for last when it came to my rounds, but that way it gave me a little extra time to hear your stories. You battled leukemia for two years with a smile on your face. You tried several treatments, but your leukemia was stubborn and it just wouldn’t back down.

I’ll never forget the time you spent your birthday in the hospital. Your daughter coordinated a Cameo for your birthday from Flavor Flav. That quickly became your favorite story to tell. Your doctor’s reaction was priceless. When you told her about the Cameo, she said “is that the guy who wears the clock around his neck?” I feel grateful as a nurse to be able to share moments like these. It’s the little things like seeing a patient smile or laugh, even amidst some of the toughest times in their lives, that continues to fuel my passion for nursing.

Unfortunately, your story didn’t have a happy ending. You ended up developing a very serious complication called DIC, or disseminated intravascular coagulation. This condition causes increased clotting activity within the body, which can stop blood flow to vital organs, and uncontrolled bleeding. Your mouth was caked in dried blood. You had a central line that went straight to your heart, that wouldn’t stop bleeding. I remember changing that dressing several times throughout a shift overnight, but it was no use. Even the pressure dressings weren’t holding up. You were getting blood and platelet transfusions around the clock, but your body wasn’t holding onto them. Your high body temperature was eating away any new blood that entered your body.

The large volume of fluid that was being introduced into your body was very concerning. You needed these medications and blood products, but we couldn’t equalize your fluid balance. Your intake was far exceeding your output, meaning your body was holding onto all the fluid. When the fluid had no where else to go, it began backing up into your lungs. I saw this coming, and I became very worried about your airway. You were too weak to support your own breathing, but you were also too confused to advocate for yourself. I remember advocating for you for several consecutive shifts. You needed a higher level of care. I couldn’t give you the attention you needed and deserved with my five patient assignment. When you became confused, you became agitated. You required constant supervision-there were hours during my shift where I physically couldn’t leave your room, which meant neglecting my other four patients. It broke my heart to see you so agitated. Usually I could comfort you, but not anymore. You were inconsolable. I know you were so confused and so scared. I was scared too. I knew if we didn’t act fast, you would likely code on the floor. You were a ticking timebomb.

I advocated for an ICU transfer so you could receive a higher level of care. It was your only chance. They could do more for you there than we could on the floor. When I was able to get the team to come to the bedside to assess the situation, they agreed with my concerns. However, at the time there were no ICU beds available. All I could do was continue to watch you suffer. You reached a point of such confusion that my presence in your room caused more harm than good. You would yell, swearing at me to leave your room whenever you sensed me entering your room. Sometimes I had no choice but to leave you suffering alone because my presence at that point caused you more distress. I gave you doses of Haldol to try to calm you down, with minimal effect. I tried what I could, but it was never enough. Although you were a DNR, you were not CMO, and I felt that we needed to be doing more for you.

At the time, visitors were prohibited due to COVID. If I’m being honest, part of me was relieved your loved ones weren’t present, so they didn’t have to see what I was seeing. It wasn’t until the next day that a bed became available in the ICU. You were transferred to the ICU, at which time the doctors invited your family in to discuss your unfortunate, very poor prognosis. After your family met with the doctors, you were transitioned to CMO, and you passed away shortly after.

How sad is that because you were on the verge of death, your family could finally come in to see you? How sad is it that the last moments your family had to spend with you, you were already gone; your body was there, but your mind was absent. You weren’t you anymore; their husband, their father was already gone. How sad is it that all I could do at one point, was watch you suffer? My patient, who was a sweetheart, full of life, with a love for sharing stories, would never share another story. I’m so sorry your story didn’t end differently; your story deserved a better ending.