Starting a Shift

We had given him a ton of blood products overnight and we knew he was going to die. It was a routine simple procedure, something had gone wrong. His family got there right as I got on shift and I told them there loved one was going to die that day. Multiple family members gathered around his bed, held his hand, stroked his face. I spoke with the nurse often, giving pointless orders that were in the end ineffectual, as I had known they would be.

Rounds started and I left the room to join my team. Moments passed and the nurse came and got me. The end was near. The patient was bleeding out. I don't know what it was that I could do for this patient that the nurse couldn't do. Really, she had just gotten me for moral support; if I was her I would have done the same thing. It was awful. Blood poured out of his nose and mouth, and his family all stood there with horrid looks on there faces. Trying to look away, afraid he'd be gone if they did.

I suctioned his face, his nose, his mouth. The blood was gone from sight, but it would only be a matter of moments before it would pour out again. The arterial line showed he had no pressure and a moment later the monitor showed he was in asystole. He was on the ventilator, so his chest continued to rise and fall with breath, but it wasn't life, it was machine. I told the family I was sorry, but he had passed. I called the RT in to stop the ventilator. And then my attending called me back to rounds, back to work, back to reality. And so I regained the rotating circle that is rounds and reengaged in the conversations of the day. But my mind was back at the side of that man's bed, suctioning the blood from his nose and mouth, watching the monitor go into asystole, and seeing his family as I told them he'd passed.