Working on a ventilator unit as a new Nurse
| My first full-time job as a nurse was on the ventilator ward on night shift. I was 21 and inexperienced. All the patients on that ward were chained by plastic tubes to ventilators. Most received their breath through tracheostomy tubes, and those few who were alert were unable to speak aloud: I learned to read lips.
One man had ALS- Lou Gehrig's disease and during the 3 years I cared for him, though his mind was clear, he became physically weaker and weaker until he could only move his eyebrows to indicate yes or no before he died. When I first cared for "Bill," he was being spoon-fed all his meals, he was very particular about what he wanted and when. I imagine being unable to even wipe your nose, or mouth, or choose what to eat next, was maddening.
"Darnell" was a young man in his early 20's, a year or so older than I was. He had been shot in gang related violence and had extensive abdominal injuries, and lost much of his intestines. He was skin and bones, and came to our ward with a huge decubitus ulcer on his coccyx. His every bowel movement was yellow mush that crept up into the bedsore and the wound had to be washed out and repacked. He was alert and angry...he made clicking sounds with his lips and tried to give instructions most of the time I cared for him.
There were so many comatose patients, not dead, but just alive, barely.
Some post-strokes, some post-MI's (heart attacks), some gunshot wounds, spinal cord injuries, a man in his 40's who had choked while eating, then had a stroke. He lived several years in a deep coma...his wife would bring their young sons to visit occasionally on Sunday. He did not respond and eventually died.
I remember several of the ladies. One woman was young and beautiful, smooth black skin, a healthy, well-proportioned body, and deep in a coma. She had had a drug overdose, then a heart attack... her teenaged daughter was brought to "visit" by a family member sometimes. "Cynthia" was contracted with stiff limbs. She had a tracheostomy, a gastrostomy for feedings, and a foley catheter for urinary drainage. There was a time period when her body kept expelling the foley catheter from her urethra with the 30ccs balloon intact. Painful one would think? Her contractures were such that we had to replace her catheter from behind her. It actually worked well because one leg was permanently bent and the other straight. Some of the other women were contracted with their legs straight and tight... they were very difficult to catheterize. She is one of the patients that I think about when I consider overdosing.
I am against euthanasia. But I am for DNR, Do Not Resuscitate, particularly for myself. In case of medical emergency: I want no ventilators, no tracheostomies, no gastrostomy tubes, no nasogastric tubes. No, no, no, no, don't start those interventions, and there is nothing to decide to stop, right?
Another woman, "Lillian", appeared to be of Northern European background: fair, nearly white skin, white hair, pale blue unfocused eyes. Shortly before she died her blood sugar readings went haywire. we had to do bedside glucose monitoring every 6 hours. Poking and squeezing pale cold fingers to get a drop of blood to test, then, often giving her insulin, and repeating the cycle later in the shift.
I remember when she died. I remember so many of them dying. I suppose it is not surprising, since this was a Chronic Disease Hospital. The patients were not going to go home. Why did it seem to happen so often on the night shift when I was working? When we found them lifeless, we called the doctor and he came to pronounce them "dead." For real. Then we removed all the tubes, cleaned the body and tied the limbs with gauze, and wrapped their jaw in gauze, placed a toe tag on the big toe, wrapped the naked, cold, stiff body in a plastic sheet, transferred it to a stretcher, and two of us took the corpse to the morgue at the hospital. At the morgue we placed it in the cold room with any others that had died recently and returned to care for the living. The somewhat living.
What broken bodies, interrupted lives: like human road-kill. Was their remaining physical existence purposeless? I wonder. Am I mistaken?
When life gets stressful, really stressful, I dream I am working (or walking) among the undead again.