I drove home tonight to the start of large snowflakes falling from the sky. Everything was so quiet and peaceful. The flakes were highlighted in the street lights and I thought about loss and how short life is.
Today I let go of someone I love. Tonight I may have saved a patient.
"M" was found in the bathroom unresponsive, purple, with copious amounts of mucus coming from her mouth. She was unresponsive to everything except painful stimuli. "M" has a DNR in place so I took her vital signs (78/42, 94.6, 61, 11, 53% on RA) and determined that she was not likely to make it and that we should begin comfort care. I had the CNA's put her in bed, change her shirt and raise the head of the bed. I asked them to reapply her O2 but to increase it to 4L. After calling the family and advising them of the situation, I went back to check on "M." Though still mostly unresponsive, "M" was able to respond to her name and though she couldn't yet speak, her vital signs were slowly improving. Her blood sugar was high but that was likely do to the stimulation of the sympathetic nervous system and compensation. By the time I left my shift, her vital signs were normal and she was fully responsive. When asked what she remembered she said that she remembered feeling "murky" but had no memory of getting out of bed and attempting to get to the bathroom.
I am lying in bed, watching the snow fall and thinking about how strange life can be... of how I lost someone and saved someone in the same day. I grieve and celebrate with the same breath. I cry tears of sadness and tears of joy.
I am grateful for what I have and yet long for so much more.
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