#11. Torturing People is Torturous Work
I think I felt something break or crunch.
If you did not, then you are not doing it right.
Some people need to be full code and have everything done. Sometimes it is because they are young and healthy. Sometimes it is because they are old and healthy. Sometimes they are not healthy but a freak thing happened and we can still turn them around.
But often times they are not healthy and the thing that has caught them is going to cause them to die and we are fighting the inevitable. Most often the family is not ready to let go and so we fight and fight and fight.
So, what does the fight look like.
It looks like a tube in every orifice. A breathing tube down the trachea. A nasogastric tube down the nose to the stomach. A foley catheter in the urethra to the bladder. A rectal tube in the anus to the rectal vault. A central line in the jugular vein or femoral vein. An arterial line in the radial artery. A pleural chest tube in the pleural cavity outside of the lung. An esophageal probe down the esophagus.
It looks like toxic drugs to keep them alive. Norephinephrine to shunt the blood away from their hands and feet and toward their heart and brain. Adrenaline to shunt the left over blood away from their hands and feet toward their heart and brain. Heparin to keep their blood from clotting. Dextrose to give them some energy. Insulin to keep their sugar levels down. Bicarbonate to fight their acidosis. Fentanyl for comfort. Versed for sleep. IV fluids for hydration.
We monitor to them so closely. They do not know if it is day or night. They do not know what day of the week it is. Every 15 minutes we take their blood pressure. Every hour we check their blood sugar, their urine output, their vitals.
We place them on machines. Mechanical Ventilator for breathing. Continuous Renal Replacement Therapy for dialysis. Sequential Compression Device to prevent blood clots. IV Pump to administer medications. Feeding Pump to provide tube feeding. Bare Hugger to warm them. Arctic Sun to cool them. Flow Trac to monitor the heart function.
There is so much more.
So very much more.
So, why do we do this job? Because of the ones that do not get caught, the ones who we can turn around and heal.
And.
And we do it to walk with those families who are in profound denial or misunderstanding. The families who want to push on at all cost. We walk with them to explain the fight. Both the battles we win and the battles we lose.
It is hard when you know that no matter what we do the patient is still going to die. It is hard to apply all the tubes, all the drugs, all the machines, and in the end, the hands to the chest that feel the break and then the crunch beneath them.
It is torturous work to torture the dying. Especially when they are old and have lived a good life and it is time for them to pass on. Ideally, to pass on peacefully.
There are things you will do that will break your heart.
Torturing people is torturous work.
3 comments:
I watched my mother-in-law die and helped care for her over 3 months. She never left the hospital. Grief, yes. Lessons in compassion, absolutely.
Beautifully written. I struggle with being the “torturer”. It’s not my frequent exposure to death that challenges me as a nurse. It’s being an active participant in prolonging suffering that eats at my soul.
This is so true. It seems we are more compassionate to animals who no longer have a good quality of life. If there were no Bible I would fight for euthanasia laws. I think it is one of Satan’s most cruel acts toward us...to make us die little by little, losing every ounce of dignity. Even so he loses... because after all the suffering and loss the Father is waiting. Heaven is my home.
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