3-9-11
Before Janie the nurse left last night, she found me in the waiting room and hugged me. She said she would see me this morning but she wasn't here. Today we had Mary for a nurse.
When working in the hospital and doing clinicals, it was estimated that most patient declines happened overnight...
The evening started with Dr. Khichi sharing the news of our prolonged stay with very little hope in Gideon's recovery. My mom, dad and mother-in-law decided that they were going to stay the night. We had not been offered a sleep room, only two people were allowed to stay in Gideon's room so the option was for them to sleep in the waiting room. I explained to our night nurse that they were staying and she made mention of the surgical waiting room just down the hall. She said that it was locked but she may be able to get a key and that way they could at least have a little bit more of a private place to stay. I followed her to the front desk where I heard a guy in the booth say "Go home." Surely, he didn't. Surely, he was talking about someone else and not about the family of the 3 month old who is lying unconscious and intubated in the room down the hall whose doctor just minutes before told his family that these first 72 hours were going to be very critical. I was frustrated but I kept quiet. Pleasing to God--only God was going to give me my son and I had to be pleasing to God so I walked back down to my room and prayed over my son. The nurse came down and told me that they didn't have a key and that the room was for surgical patient families only. Prayerfully, she didn't tell me that my family needed to go home. So they slept in the main family waiting room and my dad in his truck. If you aren't familiar, then let me update you with what the waiting room feels like. Cold tiled floors, bright lights, cold temps, and people getting off and on the elevator all night long. My mother and mother in law slept on the floors on what few throw blankets and pillows Lance had been able to gather from home.
After everyone was situated for the evening and nearly 18 hours after my last pumping session, I was finally able to sit down, pump and be still. His pulse had been in the 145's all day and his BP in the 90-100's/50-60's. He had been opening his eyes, holding fingers and after only getting a pupillary response out of one eye, we were able to get both eyes to react. His pupils were dilated but we were told that this could be from the Atropine he was given during resuscitation but that it could also be from extensive brain damage. Now if only we could get him to hold steady...but then night set in...
His pulse and blood pressure were gradually declining. Surely his nurse saw that his pulse was now in the low 100's and his systolic blood pressure was dropping into the low 60's with an occasional upper 50. She sat outside his window while his monitor beeped and his BP flashed but nothing. Casually, I made mention and asked if it were okay. Someone had mentioned that I was a nurse practitioner to the staff and I didn't want to be that patient's mom who thinks she is a know-it-all and so now no one wants to be our nurse. She responded that it was fine because his pulse had been in the 120's and his BP had been in the 70's. I reminded myself--I am not the nurse, I am not the nurse. This is ICU. I do not do ICU. I know the basics but not the ins and outs. Then his pulse was dropping into the upper 90's, his systolic staying more toward that upper 50/lower 60. I was pacing, and praying and watching that monitor and watching him and watching the nurse. She came into get lab once more and decided that she would page the doctor after getting the hourly lab results. It felt like forever. Then finally, she came back and said a small bolus of normal saline was ordered. She gave the fluids and his stats started to trend up. Finally, I felt like I could get some rest. It didn't last long. I woke shortly after to the sound of the doctor's voice and three nurses in the room. The doctor was at the bedside giving orders and checking pupils. The words so clear--"How long have his pupils been like this?" I pulled out my phone and immediately sent out the word to wake up and pray. The doctor explained that there had been increased swelling and it had caused him to brady or drop his heartrate. His pulse had dropped to 65. A dose of Mannitol was ordered along with an epinephrine drip. No more resting. I pumped, showered and awaited meeting the next doctor on duty. Our nurse came in and introduced herself. No Janie. Today we had Mary and she had been called in last minute. What happened to Janie? Could she have known that today was going to be a bad day and she couldn't face losing a baby on her watch?
Mary let me know that Dr. Barton should be in shortly, I almost immediately started to cry and mumbled the words, "great, more bad news." I could see the sympathy in her eyes. I composed myself and waited for him to come in as I stood talking to and touching Gideon. The crowd gathered at the door. Dr. Barton, medical students, the social worker, the nurse manager, child life, other nurses. They discussed Gideon outside for what seemed to be eternity as they peered in through the glass doors. Finally, he came in. A battery of tests done and no response. He showed us the EEG--dictated as minimal activity by the neurologist. More bad news. But I continued to pray and find hope in the little things. In talking with friends and on my own knowledge, I could explain some of the things. Somethings I couldn't but that's what a miracle is for.
Mary was a great nurse. She let me help her change him and position him. She responded quickly to his blood pressure once again falling but this time she only let it get into the upper 60's before notifying the doctor and he gave LR. It had been a hard day, Fluid changes, vasopressin, potassium, insulin had all been initiated...his pole had ran out of room for IV pumps. In the midst of changing and positioning and starting new meds, Mary began to cry. She had to excuse herself and she apologized. She told us, "I'm so sorry. I will get it together. He just looks too perfect for this to be happening to." I agreed, "He is too perfect for this to be happening to." It was almost nine o'clock before Mary got to leave after her shift had ended at 7 but she too found me in the waiting room and hugged me. I asked when she worked next and she said Saturday. So I said, "I'll see you Saturday." I knew that so many people were praying for us. I felt a calm come over me. Lance felt it too. God was giving us some peace. Were things going to be okay? I prayed for the will of God to be so.
Before Janie the nurse left last night, she found me in the waiting room and hugged me. She said she would see me this morning but she wasn't here. Today we had Mary for a nurse.
When working in the hospital and doing clinicals, it was estimated that most patient declines happened overnight...
The evening started with Dr. Khichi sharing the news of our prolonged stay with very little hope in Gideon's recovery. My mom, dad and mother-in-law decided that they were going to stay the night. We had not been offered a sleep room, only two people were allowed to stay in Gideon's room so the option was for them to sleep in the waiting room. I explained to our night nurse that they were staying and she made mention of the surgical waiting room just down the hall. She said that it was locked but she may be able to get a key and that way they could at least have a little bit more of a private place to stay. I followed her to the front desk where I heard a guy in the booth say "Go home." Surely, he didn't. Surely, he was talking about someone else and not about the family of the 3 month old who is lying unconscious and intubated in the room down the hall whose doctor just minutes before told his family that these first 72 hours were going to be very critical. I was frustrated but I kept quiet. Pleasing to God--only God was going to give me my son and I had to be pleasing to God so I walked back down to my room and prayed over my son. The nurse came down and told me that they didn't have a key and that the room was for surgical patient families only. Prayerfully, she didn't tell me that my family needed to go home. So they slept in the main family waiting room and my dad in his truck. If you aren't familiar, then let me update you with what the waiting room feels like. Cold tiled floors, bright lights, cold temps, and people getting off and on the elevator all night long. My mother and mother in law slept on the floors on what few throw blankets and pillows Lance had been able to gather from home.
After everyone was situated for the evening and nearly 18 hours after my last pumping session, I was finally able to sit down, pump and be still. His pulse had been in the 145's all day and his BP in the 90-100's/50-60's. He had been opening his eyes, holding fingers and after only getting a pupillary response out of one eye, we were able to get both eyes to react. His pupils were dilated but we were told that this could be from the Atropine he was given during resuscitation but that it could also be from extensive brain damage. Now if only we could get him to hold steady...but then night set in...
His pulse and blood pressure were gradually declining. Surely his nurse saw that his pulse was now in the low 100's and his systolic blood pressure was dropping into the low 60's with an occasional upper 50. She sat outside his window while his monitor beeped and his BP flashed but nothing. Casually, I made mention and asked if it were okay. Someone had mentioned that I was a nurse practitioner to the staff and I didn't want to be that patient's mom who thinks she is a know-it-all and so now no one wants to be our nurse. She responded that it was fine because his pulse had been in the 120's and his BP had been in the 70's. I reminded myself--I am not the nurse, I am not the nurse. This is ICU. I do not do ICU. I know the basics but not the ins and outs. Then his pulse was dropping into the upper 90's, his systolic staying more toward that upper 50/lower 60. I was pacing, and praying and watching that monitor and watching him and watching the nurse. She came into get lab once more and decided that she would page the doctor after getting the hourly lab results. It felt like forever. Then finally, she came back and said a small bolus of normal saline was ordered. She gave the fluids and his stats started to trend up. Finally, I felt like I could get some rest. It didn't last long. I woke shortly after to the sound of the doctor's voice and three nurses in the room. The doctor was at the bedside giving orders and checking pupils. The words so clear--"How long have his pupils been like this?" I pulled out my phone and immediately sent out the word to wake up and pray. The doctor explained that there had been increased swelling and it had caused him to brady or drop his heartrate. His pulse had dropped to 65. A dose of Mannitol was ordered along with an epinephrine drip. No more resting. I pumped, showered and awaited meeting the next doctor on duty. Our nurse came in and introduced herself. No Janie. Today we had Mary and she had been called in last minute. What happened to Janie? Could she have known that today was going to be a bad day and she couldn't face losing a baby on her watch?
Mary let me know that Dr. Barton should be in shortly, I almost immediately started to cry and mumbled the words, "great, more bad news." I could see the sympathy in her eyes. I composed myself and waited for him to come in as I stood talking to and touching Gideon. The crowd gathered at the door. Dr. Barton, medical students, the social worker, the nurse manager, child life, other nurses. They discussed Gideon outside for what seemed to be eternity as they peered in through the glass doors. Finally, he came in. A battery of tests done and no response. He showed us the EEG--dictated as minimal activity by the neurologist. More bad news. But I continued to pray and find hope in the little things. In talking with friends and on my own knowledge, I could explain some of the things. Somethings I couldn't but that's what a miracle is for.
Mary was a great nurse. She let me help her change him and position him. She responded quickly to his blood pressure once again falling but this time she only let it get into the upper 60's before notifying the doctor and he gave LR. It had been a hard day, Fluid changes, vasopressin, potassium, insulin had all been initiated...his pole had ran out of room for IV pumps. In the midst of changing and positioning and starting new meds, Mary began to cry. She had to excuse herself and she apologized. She told us, "I'm so sorry. I will get it together. He just looks too perfect for this to be happening to." I agreed, "He is too perfect for this to be happening to." It was almost nine o'clock before Mary got to leave after her shift had ended at 7 but she too found me in the waiting room and hugged me. I asked when she worked next and she said Saturday. So I said, "I'll see you Saturday." I knew that so many people were praying for us. I felt a calm come over me. Lance felt it too. God was giving us some peace. Were things going to be okay? I prayed for the will of God to be so.
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