Monday, September 18, 2006
CalledLately I've been reticent.
I think about what I want to say, and then about what my colleagues would think of it. What the wry and acidic anaesthetic consultant would say if he knew I thought this way. How nurses on the floor, many of whom are already a bit sceptical about me, would react. I pause, and don't write anything at all. We're such good censors of ourselves, aren't we? It's insidious.
Then last night I--well, to do this right I have to go back a few days.
It has been, folks, a rough fortnight. Rough month, really. Our unit got worked. Everybody's tired. Things are just now starting to slow down this week, and I hesitate even to say that because they might speed up again!
Towards the end of the week I received an admission who coded on the ward. A few months old, disasterous medical history. As we worked to stabilise him, it became clear to us that this was not a child who would grow "to make old bones", as the saying goes.
It was one of the longest, hardest days I've had in recent times. One of those shifts where you're still catching up on documentation long after you should've been home. A fast, sad, taxing shift. I went home without much expectation that the infant would survive.
The next morning it was all absolutely clear: with a lactate above 30, terribly coagulopathic and on high ventilatory pressures, in fulminant liver failure, there was no going on. We withdrew care and he died.
I will leave the details out of this account. Suffice it to say I regard this as the hardest 'withdrawl' I've ever had to perform. Alone, in a single room, pulling out tubes and coping with the inevitable bleeding, managing analgesia and monitoring the patient, all amidst the loudest and most visceral outpouring of grief I have ever seen or heard.
I was beyond exhausted at the end of the day, and the weekend was rough. You do start to question whether or not you're in a sensible profession after all, that has these experiences in it. I don't know anybody in this city outside of work, so stewing in my apartment alone for two days didn't exactly help my frame of mind.
At the start of this week I met with our very smart psych who helps with debriefing after traumatic events on the unit, and talked it through. At the end of the day I went out of the hospital, down to the harbour and hopped a ferry across to one of our local beaches.
It was getting dark as I walked along the foreshore, and not the warmest of winter days. I was having trouble with the images: black deoxygenated blood oozing from central line sites and between my gloved fingers; the shock on the face of a young cousin, maybe three years old, eyes wide as he stared around the room at his crying relatives. Sometimes these images are addictive. It can be very hard to stop playing over them in your mind, once they get burned in there.
By the time I got to the end of the esplanade it was completely dark, and the wind was getting up. Lights flared on the ferries as they passed, making black waves. I said my goodbyes there, looking out over the water, told him I was sorry. A cold gust blew in across the sand, hit me in the face and I realised: this is what I was going to do for the rest of my life.
Suddenly I understood why people talk about their calling; why, in the face of difficulties that seem intolerable, with token pay and anti-social hours, they keep coming in to work. It's no longer cool to say it, but it has become inescapable for me... I feel the call. It is not just an occupation. It is a life's work.
I am where I am supposed to be.
The clarity of purpose I felt was astonishing. I can feel it now, surrounded by the distractions of the day. Perhaps my colleagues here would chuckle if they read this, but I reckon more than a few of them feel the same way, even the ones who would never admit it.
Is thirty-four years of age late to find your true calling?
Posted by PaedsRN at 6:15 PM