I used to call the PACU department paradise. COVID times have turned it into more of a PACU prison. It tends to be my hardest department, and it does not even have COVID patients. The real issue is that because all the other ICU and temporary ICUs occupy COVID, this unit is a catchall for everything else. It is disorganized and often feels like a distant island. Many other aspects make it hard, but overall I do not like going there.
Today was especially hard.
The aspect of patients dying without seeing family is so so sad, and incredibly hard. In some ways it makes the process easier for nurses to handle. Not that it does make the death any less meaningful or personal. Seeing family members is just another reminder that the patient is someones dad, mom, sister, etc. It's like twisting the dagger.
I had a patient that had been admitted at the beginning of April. There had been a lot of ups and downs. There was a lot of odds this patient was trying to beat. He had some of my favorite doctors taking care of him. They fought like hell for him. They became attached to him, like many of us did. The doctors had the family send in videos of them cheering their dad on. Saying how proud they were, how excited they were for him to come home.
The doctors played the videos by the patients ear this morning, his eyes watered, but other than that reaction, his body could not do anything else. He laid in bed with his eyes continuously open, with the ventilator keeping him alive.
His wife of 60 years came in with their youngest son. I went out to the lobby to escort them back to the unit. Before we walked in she stopped me. Asked if withdrawing care was the right thing to do. She knew that he did not want to live like this, but it was so hard to know what to do. I honestly could not help but cry. I told her that sometimes we do things for people that we love despite the pain it will cause us. That she knows him better than anyone else, she should trust that knowledge of what he would want.
We walked in. The doctors came to give their condolences. They spent time with him. After they said their goodbyes I walked them out. Both of them said that they felt at peace with the decision to withdraw care. I promised that he would die peacefully, that he would not feel any pain. That he would not be alone.
I kept that promise. He passed away several hours later. Several nurses surrounded him during his last breaths.
Britt.