Sunday, July 27, 2014

An Important Few Moments in Time

It's one of those ultra crazy ER days with all the beds full, waiting room restless,  and the hallway filling up as well.  A rescue call comes in over the "bat phone" for an elderly gentleman needing assistance with depression and suicidal ideation.  Where can I put him to keep an eye on him and keep him safe? Which nurse can take another patient?  I wonder what medical issues he has as well?? I have no actual room to put him in.

The patient arrives, somewhat inebriated, with sad eyes and with oxygen on.  I'm told by the paramedic that his medical issues include COPD, hypertension, and depression.  He is placed on a stretcher in the hallway in between  my charge nurse station and another nursing station...the more eyes on him the better.  He is attended to by a nurse and my mind returns to the rest of the department. 

Hours go by with no change in the bulging at the seams ER.  I go to the bathroom and return to see our elderly, depressed gentleman making a beeline for the ambulance bay exit, minus his oxygen and shoes.  I take off down the hall after him and catch up to him as he reaches the outside.  He stops once outside.  I stand beside him.  "Whatcha doin?" I ask.

"I just wanted some air." 

"I get that, sometimes I come out here for a minute just to catch my breath too."

We stand still in the warm sun and take  a few breaths of gorgeous 75 degree air.
I turn to look at him and notice for the first time his ball cap...a veteran. 

We really need to get back inside.  I am the charge nurse and I need to know what's going on in there and you need to put your oxygen back on.  "ok"

I settle him back on the stretcher and put his oxygen back on.  His sad eyes pierce my heart.  I grab a stool and sit.  "So you are a veteran I see.  What branch of the military did you serve?"  He tells me.
"I was just a boy over there and I saw things that I never should have seen. "

His sad brown eyes bore into mine.  My heart cracked.  "I cannot even fathom what you saw."

"My best friend got his head blown off right beside me and I ran... fearing I was next."

I said nothing as my eyes filled with tears.  Our eyes never moved from each others.   "I see this happening over and over just about every day now and I want to die." 

"Is that why you are here today, because the urge to kill yourself is too strong?"

"Yes, I want to die...I don't want to kill myself because of my children, but I just cannot turn off my mind.  Please don't send me back home."

I sit with him for several more minutes listening to his thoughts.  For these few moments it was just he and I.  I was unaware of the chaos around me.  I just wanted to stay there and listen...stay present in that moment with him...the bat phone rings and catches my ear...and I have to go.  "I have to answer that phone, it's another ambulance call."

"Thank you for your time and for your compassion."

I thought about this man for most of the night.  I had to write about him today.  I pray that once crisis got to him they came up with a plan that would actually help him.  I may never know.  Those few moments of my 12 hour shift touched my soul, and I hope that I touched his.  It is truly sad to me that medicine has become such a business model that it takes nursing away from their patients!  We are so budget conscious that staffing is reduced~~ taking time away from nurses so that they can actually CARE for their patients.  We have just enough time to do all of the tasks required in the patient care (the IV, the blood draw, the EKG, the medications, the xrays...etc) but it is the time required to sit and be present that has been taken away.  It is not right.  That patient needed more of my time...and I wanted to give it to him...