Tuesday, June 21, 2005

Short Shift Report

He was young and had a congenital heart defect that had required the implantation of an internal defibrillator many years before. But he had never had it checked over the years, about maybe a decade.

There was a reunion of one of the bands he played in, and he went to the nightclub with heavy clown-face make-up on so that people would not immediately recognize him, and for fun. He was playing on stage when his heart tripped out, and he collapsed. At first, people were confused, so a few critical moments passed before those around him realized he lay dying.

Unconscious and not breathing. In the emergency room he was intubated, and the respiratory therapist had difficulty taping the breathing tube in place due to the greasy thick make-up. Eventually they scrubbed enough of it off.

Severe brain damage. He had been down a long time. He recovered the ability to breath on his own, and his family agreed to make his status "do not resuscitate." After extubation, he was transferred to the telemetry unit.

Oddly, we were going through a period of low census, and we were closing the telemetry floor and moving the remaining patients, with some of the monitoring equipment, to another floor. This happened occasionally, and when business picked up a shift or two later, we again moved equipment and patients, reopening the unit. But by briefly closing it, the hospital saved a little money as they did not have to pay for ancillary staff during the closed shifts.

A few hours after I got the patient from intensive care, he died. I was with him, turning him and performing mouth care, when he let out a sigh and expired.

He was the only "patient" left on the unit when the night shift nurses started to come in. We informed them that they were to float to the other unit, but one nurse was to stay with this one patient for awhile (until the funeral home came to pick him up.)

"Mary" (not her real name,) was chosen to stay. We sat down together and she asked me for a report on the patient.

"Two words," I said. She was of course a little puzzled, and said "Huh?"

"He's dead," I said, pausing to let it sink in. Then I gave her the whole story.

She only had to stay there for a little while. A short time later they picked up the patient, and she floated to another unit.

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