tales from the ICU

I find rarely talk about my work. Not in my blog, not in person, not to my family or friends, not really ever. Which ultimately makes my URL (as in nursey) pretty redundant.

Of course there is always the occasional story about the bizarre or hilarious admission (because someone ‘accidentally fell’, which often requires immediate surgery to remove various items from various cavities) or the really amazing people with such courage that survive the most horrific events. I enjoy that part. A lot. Oh the stories I could tell you - and I’d probably tell you the most revolting story I could whilst I shared a meal with you….”oh you can’t finish your meal after that story…? No worries ill help you!” (Stef, regularly)

But i guess its different working in the intensive care than in other parts of the hospital. We see the sickest of the sick, we see untreatable and unexpected injuries, disease, death, grief and loss in unimaginable quantities.

It’s difficult to talk about it, because if I didn’t leave the stories I hear and the patients I encounter at work behind, I wouldn’t survive. I have learnt to emotionally unattach myself and i have found blocking it out and forgetting about it, or making an inappropriate joke out of terrible and traumatic situations to be my best coping mechanism. Shoot me if you must, but that is the only way I am able to do what I do.

But last Sunday I looked after a patient that I can’t forget. Ever. It’s funny how you can encounter someone that you know will impact on your nursing practice, but more your life, forever.

A 21 year old girl, lets call her Emma, was admitted into my ICU just before midnight after drinking a small dose of weed killer earlier that afternoon - a suicide attempt. Her boyfriend of 2 months had broken up with her that day. She also had a past medical history of depression.

She arrived in the ICU and she was a little bit drowsy but speaking, and had on no intravenous support. She kept sobbing and repeating ‘I’m sorry’ to her dad as he sat crying by her bedside, holding her hand. And it was in this brief moment I think she had some insight into what she had done, and how sick she was about to get. And how much of a mistake she had just made.

By 2am, she was unconscious, ventilated, on a ridiculous amount of support for every organ, (ventilation, intropes, dialysis, vassopressors, blood products, plasma exchange, electrolytes, sedation, isolipids) incredibly sick, and ultimately, she was dying.

I will spare you the gory details, but it was physically the single most traumatic experience of my life. The small amount of toxin she drank had caused her to have huge volumes of internal bleeding, had put her into multi-organ failure and Disseminated Intravascular Coagulation (DIC) - whereby she ultimately was bleeding uncontrollably. Her blood results came back more and more deranged - and there seemed to be nothing we could do to stop this spiral.

Despite our best efforts (5 intensive care nurses and 4 intensive care doctors working non-stop) and having exhausted every single treatment option, by 5:40am she was dead.

This beautiful 21 year old girl who had her entire life ahead of her. And in one stupid decision, she lost it all.

I haven’t stopped thinking about her all week. I have never had a patient affect me so terribly - and i have seen some terrible terrible things. I think there needs to be more TALK about mental health and depression. Because its such a hush hush topic. Everyone seems so afraid to talk about it. The media rarely report on it. And there is such a stigma for those who suffer from these medical illnesses.

But we need to. We are losing too many people far too frequently.

The staff involved in her care had a debrief yesterday at work - and I think that everyone has been affected similarly by this young girl. Are we so affected by her because we care? Or because she was so young? Or because in one split second decision, she made a poor choice because of a sad circumstance? Or because hardly anyone talks about it, and therefore no one will learn from her mistake?

I believe when something bad happens you have three choices - you can either let it define you, you can let it destroy you, or you can let it strengthen you.

I feel for her family and friends and those left behind. And I feel for her. And the life she is missing out on. Because I know that regardless of how dark it all may have seemed, tomorrow is a new day, and there is endless possibility waiting for you. And there is always someone who will help you, if you let them.

RIP.