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Short pieces on a new theme every month
 
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This month...
  The Phone Call
 

Who Would Want to Do This?

Kristin Beard ~

"Get the patient on the monitor."

"How long has he been down? Someone get on the chest!"

"Keep ventilating. He's in v-fib. Defibrillate at 200."

"Charging, everybody clear?...Shock delivered."

"Resume compressions. Push one of epinephrine...Hold compressions. What rhythm is he in?"

"He's asystole, resume compressions."

We repeat the process a hundred times over. The medic said they started coding the patient an hour ago. The family is in the consult room with the chaplain.

It's getting harder to keep the patient breathing. His skin is turning blue. His pupils are fixed and dilated. He's motionless.

No one speaks. The only noise is the constant shrill of the monitor. He has no heartbeat.

"Someone call the chaplain."

"Time of death, 10:22 am."

As I silence the monitor and disconnect the patient from the defibrillator, I reflect on how, as an emergency-room nurse, I put myself through this agony on a daily basis.

Why would anyone want to do this?

As I take the dreaded walk towards the family-consult room, with the physician by my side, we look at each other and sigh.

When we open the door, the family stands, as if formally greeting their superiors. The dead man's wife is flanked by her two daughters, their arms draped around her protectively. Half a dozen other family members huddle close behind them. They're bracing for impact.

"Please have a seat," we say.

I can see that deep in their hearts they know what we're about to say.

The doctor expresses his condolences as he confirms their worst nightmare. He describes the procedures and decisions that were made during their loved one's final moments, a flood of medical jargon flowing from his mouth.

The family stares right through him, seemingly unable to comprehend. I wonder if they're wracking their brains trying to recall their last moment or conversation with their loved one.

As the doctor leaves, I stay behind with the family, as always. I never say a word, but I hope that my presence offers them a sense of support and respect. If my family and I were in their position, I would want a nurse to do the same for us. I give them a few minutes and wait for the inevitable question.

Slowly, the patient's wife walks over to me. She reaches out, seeming blinded by her tears, and then her glossy eyes meet mine. She takes my hands in hers.

"Can we see him?"

Does she know that the hands she's holding have been pushing on her husband's chest for the past hour? That they broke his ribs in an attempt to save his heart?

I squeeze her hands. "Of course."

Hands clasped, she and I walk down the hallway, with the rest of the family following behind like ducklings. As we go, the wife pulls me a bit closer for support.

We approach the large trauma room where her husband lies waiting. Before we enter, I try to prepare the family for what they're about to see.

I explain that the once boisterous and outspoken husband now has a breathing tube down his throat. The arms that once hugged his children have intravenous lines and tubing coiled about them like venomous snakes. His chest is bloody and bruised from thousands of compressions.

I know that no matter how much or little I tell his family, no words can prepare them.

I pull back the curtain to reveal the man's lifeless body covered in a white sheet. His family flocks to the bedside, weeping softly. I close the door behind us.

After a few minutes, his wife turns to me, her eyes full of tears. I can tell that she's struggling to find words. Now I'm crying too.

"I'm so sorry. We did everything we could," I say.

She looks back at her husband and wraps her arms around me.

"Thank you, thank you, thank you," she says.

She holds onto me for what seems like forever.

After ensuring that the family is comfortable, I leave the room to give them privacy. Closing the door, I wipe the last tears from my cheeks.

I'm exhausted--for the past few hours I've torn myself apart physically, mentally and emotionally. But I have to put on a strong face and pull myself back together. It's only the beginning of my twelve-hour shift: I have four more patients to take care of.

After the patient's family leaves, the staff and I prepare his body for burial. I wrap an identification tag around his toe, as if he were some kind of livestock. I zip him up in a plastic bag like a peanut-butter-and-jelly sandwich. It doesn't feel like I'm caring for a patient anymore.

I close the door to the morgue, and just like that, he's gone.

Being a part of the final hours of someone's life is hard, I reflect. You try your best, but sometimes your best efforts lead to the worst outcome. Still, although I couldn't save this man's life, I did offer his family care, compassion and support. And giving them comfort has brought me some peace of mind and a sense of satisfaction.

Taking solace in these thoughts, I turn to organizing the papers that have accumulated on my desk over the past few hours. I review the test results for my other patients, then make my rounds. At some point along the way, I reach a realization.

The best and the worst are inextricably linked. They're two sides of the same job. This family's deepest distress has called up my deepest caring; on the worst day of their lives, I've given them the best of myself.

This leads to another thought:

Who wouldn't want to do this?

And I keep on going.


About the author:

Kristin Beard is a nurse in the emergency department at Lancaster General Hospital-Penn Medicine, PA. She received her ASN degree from Pennsylvania College of Health Sciences and is now pursuing a BSN degree there. "I've always been drawn to trauma and critical-care nursing; my career goal is to become a trauma nurse practitioner. This story was written for an English composition class in my degree program. I've never considered myself a writer, but I feel that giving voice to the stories in medicine is so important. I believe that in order to provide our patients with the best care, we need to first care for ourselves and each other. As medical professionals, we're like sponges. We soak up our patients' compelling, heart-wrenching, intriguing and miraculous stories, but we never get 'wrung out.' If we don't discuss them with others, these stories can weigh us down. Sharing a story is often the start of the healing process."

Story editor:

Diane Guernsey

Comments   

# doug babkirk 2017-07-19 14:25
Dear Kristin,

Thank you for modeling for each of us the power that comes through your vulnerability. Being present to yourself and to those you are with as a healer is an angelic gift that reflects your wholeheartedness.

Your colleagues, patients and family are blessed to have you in their circles.
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# John 2017-07-17 15:41
Praise the Lord for the Kristins of the world.
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# Sally 2017-07-13 21:45
"The best and the worst are inextricably linked. They're two sides of the same job. This family's deepest distress has called up my deepest caring; on the worst day of their lives, I've given them the best of myself.". Wow... beautifully said
Thank you for sharing your heart
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# Cate Wallace 2017-07-09 19:35
The turn in the final line is beautifully prepared for structurally. The nurse character pauses to wait for the shock to subside and questions to come just as the code is paused for electroshock. The nurse and the wife hold hands, then hold hands more closely, then embrace, just as the nurses's hands and arms were previously so busy attempting the resuscitation. The husband's heart did not respond; the wife's heart did—and so, in the end, did the nurse's heart. In my experience teaching writing, authors are often quite surprised when I point out patterns like this in their work. There is an art in us when we can get out of the way and let it happen. And how lovely it is when the art of medicine and the art of storytelling converge as in this piece.
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# Beth 2017-08-16 16:58
So true.
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# Don Middleton 2017-07-09 10:37
What is in a job? A chance to do something. A chance to be someone. To be part of something larger perhaps. Your job has a special bonus: emotion, often intense. The miracle is that you get paid to be able to feel. Of course who won't want to do it.
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# Pris Campbell 2017-07-09 06:06
I forgot to mention that the haiku is excellent. Have you ever considered some way to let readers know that more than the main story reactions can go here? I've read so many haiku but haven't seen comments on them....which, of course I coukd have missed :-)
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# Scott Newport 2017-07-09 05:58
The, "About the author," section was as wonderful as the essay. Loved them both. Thanks Kristin for your obvious love for life and the days when life is gone.
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# Hotel Service escort 2017-08-17 01:51
I found your article genuinely nice and useful for all your readers. I bookmarked it for future reference. Thanks!
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# janice mancuso 2017-07-08 17:32
This beautiful, modest essay (and the comments) reminded me of two things... 1) A favorite C.S. Lewis quote: "Friendship ... is born at the moment when one man says to another 'What! You too? I thought that no one but myself . . .'" 2) The Zen Buddhism word "satori" which translates to instant awakening or sudden enlightenment. To be able to take the reader from "Why would anyone want to do this?" to "Who wouldn't want to do this?" in barely a thousand words is a gift. Kristin, please keep writing. Medicine and nursing need your voice.
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# Pris Campbell 2017-07-08 06:42
A.heartbreeakin g, compasionate description.
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# Carol Thelen 2017-07-07 23:36
TFS your excellent essay. I especially appreciate your comment: "As medical professionals, we're like sponges. We soak up our patients' compelling, heart-wrenching , intriguing and miraculous stories, but we never get 'wrung out.' If we don't discuss them with others, these stories can weigh us down. "
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# Lee Kagan 2017-07-07 23:19
Powerfully written, relentlessly paced, heartfelt and deeply moving. This is a great piece of writing that captures the intensity of those frantic but controlled, desperate but professional moments we nurses and doctors have all had seared into our hearts and memories. As has so often been said, unless you've been there you can't really know what it's like. But your words have provided a way into at least a part of it for your readers. Well done and thank you.
Lee Kagan
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# Lynn Assimacopoulos 2017-07-07 21:18
I also am an RN who worked for many years in a University Hospital ICU and also worked there as a Nursing Aide while I was in Nursing School. This story is so true for those of us that dealt with this kind of scene every day; however, I chose this work because I loved this kind of nursing. I even wrote an article about it called "All I Needed to Know I Learned in ICU" (Nursing Forum Vol. 30 No 3 July-Sept 1995) where I listed 10 items to always be guided by and reasons why. These can and should be used in any field of Nursing as well. I also have written an article called "Hope Lost?" about 3 of my patients and there journey through the ICU which I am hoping to publish sometime. Us Nurses need to always remember that in our work we do for these critically ill patients, they are our teachers in so many ways!!
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# Elizabeth Hurlow-Han 2017-07-07 20:23
Dear Kristen:

Would you consider allowing me to post this FABULOUS piece on my YES Blog? (Your Exit Strategy.org) 301.785.7619

For years I've been telling my adult children: In Chicago, they used to say, "Vote early and often." That's what I want you to do, ASK my Doctors--early and often, "Is it time to put my Mom in Hospice? She wants to get her full six months of hospice care. She's all about QUALITY, not Quantity of time."

After going through 30 hours of training to be a hospice volunteer, my 2004 breast cancer metastasized to my bones, 10//15. Luckily, many prayers are keeping me afloat, and after 10 radiation treatments to my cervical spine, and six months of braces--I'm staying stable with a daily Femara pill and used to have monthly Xgeva shots to strengthen my bones. I've graduated now to quarterly injections.

Look forward to hearing from you.

Blessings,

Elizabeth
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# Kristin Beard 2017-07-10 12:30
Hello Elizabeth, thank you so much for your kind remarks about my story. You may absolutely share it on your personal blog. It is wonderful to hear that your health is heading in a positive direction! I hope that the injections are a good treatment for you and I hope nothing but the best for your future health! My email is if you would need to contact me for future questions. Again, thank you for taking the time to read my story!
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# Susan Boyko 2017-07-07 20:03
Thank you. Written from the depths of your soul. Very honest and moving.
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# Susan Jimenez 2017-07-07 19:55
Thank you; well said. My last day of the best/worst jobs of my life was yesterday. I'm spent from the experience - and this story helped me squeeze out some of the emotion that I have soaked up. It is truly an honor to care for others on their worst day; it's just very difficult to work for others who have no idea what that is like.
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# Kristin Beard 2017-07-12 00:28
Susan, I can only imagine the stories you have witnessed unfold before your eyes throughout your career. Always hold onto the good memories and always remember what you learned from those difficult days. You are correct- it is impossible to understand someone's situation without being in their shoes. This is why we must share our stories. Thank you for taking the time to read my story and for responding with your thoughts.
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# Mary W Magnusson 2017-07-07 19:11
so deeply moved by this as I contemplate a difficult personal ministry I must perform in the next week, one I chose to commit to in spite of my own resistance. The best and the worst are absolutely inextricably bound together and it helps me to read this. It really does. Thank you to all nurses and doctors who bring this courage and generosity to their work. I am going to give care to a caregiver . This story helped me remember what that means.
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# Kristin Beard 2017-07-09 19:59
Hello Mary, it is such an honor to know that my story has brought some light and guidance during your personal mission. Thank you for your kind words.
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# Pam Mitchell, RN 2017-07-07 19:06
Beautifully written, Kristen. You have captured the essence of ER nursing so vividly and so eloquently. The science, and the art. The all-important hands that pound the chest then hold survivors hands. I'd say you nailed it: consider yourself a writer indeed. Avery good one at that. Thank you.
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# Kristin Beard 2017-07-09 18:03
Hello Pam, thank you so much for taking the time to read my story and for your kind words! It was certainly a powerful moment for me to hold the hands of the patients wife. Again, thank you for your response!
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