Why do I wake up every day and continue to do this job? This question has crossed my mind a time or two since graduating from nursing school and taking a job at St. Vincent Mercy Medical Center. It seems that this is a career where many people may become burned out quickly, between the stressful nature of the job and poor treatment from staff, patients, and families. Don't mistake what I'm saying for dissatisfaction in my job. However, I have tossed around the question of why I continue to do what I am doing – that is, up until several months ago, when I had a day that completely redefined how I viewed my career and how I approach it day-by-day.
On this particular day in my life, I woke just like any other day, very tired and worn out. When I arrived to work, I found that I only had one patient in our Neuroscience ICU, which is abnormal because in our ICU, we care for two patients at a time. This patient was very sick though, and the chances this patient would survive the traumatic accident of what we deemed "car vs. pedestrian," were very slim. The number of medications hanging from the patient's lines were unbelievable. He had medications for raising and lowering blood pressure, multiple piggybacks for various reasons, an insulin drip, medications for a GI bleed, Mannitol, and 3% sodium chloride to reduce intracranial pressure, as well as about ten to fifteen other medications. This day had become the hardest day of work in my life, or at least I thought. It would be a day where sustaining a life seemed more feasible than saving one, a day when sustaining a family in the face of a tragedy seemed like an impossible task.
I spent the majority of my day maintaining the patient's vital signs, electrolytes, and fluid balance, not to mention counting the minutes until this patient coded. He ended up coding on me twice through the day, but because this patient was so young, he continued to survive, and his family continued to ask us to keep him alive. When all was said and done, I left to go home that night and the patient continued to fight for his life. All I could think about while driving home was either this patient would not survive the night, or he wouldn't survive the next shift with me.
Normally, on our unit, you take care of the same patients as you did the day before if you work multiple days in a row, but when I arrived the next day, my assignment was changed and I was on our palliative unit, rather than in our ICU. Through the night, the patient quickly went from bad to worse. His family decided that they would take him off of the ventilator that day, which explains why I was not in the ICU, but with him on our palliative unit.
Once again, I continued to care for the patient throughout the day, until the family approached me with their decision that they were ready to let the young man go. We took him off the ventilator, keeping him comfortable with various medications. Upon removing the tube, he took three breaths before ceasing to inhale. Sobs filled this small room, with about thirty people standing around the bed. These are the moments in which you don't stay strong for the family, but cry with them. 23 years-old, after all, is much too short of a life. As the initial grieving passed, the family began to file out and hug me, one by one. And when the last relative left, an empty feeling began to fill my stomach because I felt like I had failed at what I'd gotten into this job to do. I continued to feel this way for several days.
The sickening feeling eventually passed and I tried to forget about these two days, until I received a letter in the mail. It was from the patient's family and inside was the most sentimental letter I could ever read. At the end, it simply said, "Thank you for doing everything you did. You deserve to be proud of yourself every day."
Now, when I wake up every day, I try not to ask myself what I am doing this job for, but remember what I have done that drives me to do it. I often think about that day and how sometimes in this field we look at our jobs as trying to save a person's life, not necessarily trying to sustain one and their family until they are ready to let go. Furthermore, we don't think about what these types of families and patients do for us. Sometimes, it's not nurses and doctors who impact the patient or family, but rather they impact us. Sometimes, these people change us, sustain our reason to work, and drive us to simply help.