Tuesday, February 10, 2009

such a mess-

in so many ways.

this past weekend was something of a cluster. All the stars aligned to make things insane. It was a lesson in how not to not to- run a code, transfer a patient, let someone die, keep someone alive, schedule.  I hope to never see that sort of nightmare again- The "leaders and the best" with no light? And...no one to fix it? Really? Seriously? Last time I checked, ALS is not done like that- I think everyone was so freaked out they panicked, and that created even more of the nightmare.  What I learned? If someone has been running low all damn day, you do not transfer them to the unit at 3:30 am.  And you don't put them in a room with no overhead light. And you don't have a resident at the end of their 80 hrs swan them, nor try and start an a-line when the pt is 60/d.  You get your lines established earlier, and be proactive. And it the pt says..."I'm dying..." believe them. They know. 

I was asked twice on Sun pm to make sure that they made it thru the night. Both my 90 yo woman as well as my 50 yo code. If the patient asks you this, you have an amazing responsibility. I left at 7:30- they both were still alive- and then, I felt horrible my lol wanted me there when she died; I had to leave. My other woman is intubated, and a mess-I wonder how she is today? 

Ms. A went home-I think- she was interesting, and came along as such an amazing time

Dirge without Music

Edna St. Vincent Millay

I am not resigned to the shutting away of loving hearts in the hard ground.
So it is, and so it will be, for so it has been, time out of mind:
Into the darkness they go, the wise and the lovely. Crowned
With lilies and with laurel they go; but I am not resigned.
Lovers and thinkers, into the earth with you.
Be one with the dull, the indiscriminate dust.
A fragment of what you felt, of what you knew,
A formula, a phrase remains, --- but the best is lost.

The answers quick & keen, the honest look, the laughter, the love,
They are gone. They have gone to feed the roses. Elegant and curled
Is the blossom. Fragrant is the blossom. I know. But I do not approve.
More precious was the light in your eyes than all the roses in the world.

Down, down, down into the darkness of the grave
Gently they go, the beautiful, the tender, the kind;
Quietly they go, the intelligent, the witty, the brave.
I know. But I do not approve. And I am not resigned.

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