- In the book, Critical Care, there are several occurrences of patients’ deaths. Choose one account and discuss your impressions of this experience. What, if anything, surprised you about the situation. What are your feelings about dealing with patient deaths?
In the book Critical Care, written by Theresa Brown, she discussed many of her encounters with death. During the chapter “Condition A”, this condition really surprised me. In this chapter, she discusses the first time that she encountered one of her patients going into cardiac arrest and coding. The patient of hers had Lung Cancer and had been “stable” for the time being. Then, the patient ended up starting to spit up blood and they performed CPR for a long time, but she just kept bleeding out and could not stop. I think that this is probably one of the things that I am most nervous about in becoming a nurse. Even though I am trained in CPR and first aid, I can imagine how nerve racking this is. Someone’s life is in your hands and you have to do everything in your power to try and save them. I think that dealing with patients deaths, at least in the beginning, is going to be hard. As you become more experienced, I believe that it will get a little bit easier. The thing about her patient that surprised me the most is the bleeding out. I am not that experienced in the medical field, obviously, but I have never heard of someone bleeding out of their mouth and nose and coding like that. The patient was fine and then all of a sudden, she wasn’t. It is so scary to think that one minute you can be okay and the next, not. And to top that all off, they did not even know what the cause of the bleeding was, I think that was the most surprising to me.
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- In the chapter, Switch, Theresa Brown writes, “But nursing is too difficult and too important a job for help to come with a hierarchy.” Describe one example of where you see that hierarchy manifested and one example where you saw more egalitarian treatment in the book. This can include relationships between doctor and nurse, nurse and nurse, doctor and patient, or nurse and patient
Hierarchy and bullying within nursing is common. There is a saying that Brown mentions in the chapter Switch, on page 144, that is common among the nursing profession: “Nurses eat their young”. This saying is basically saying that the nurses that have more experience, and have spent more time working in the profession, tend to overlook and “bully” the newer, inexperienced nurses. In the same chapter, Brown is taking care of a patient who is experiencing air hunger. This occurs when a patient’s breathing becomes labored, due to their brain thinking it is not getting enough oxygen, when in reality, it is. Brown began to have a problem with the floor nurse, Crystal. Crystal is a clinician, which meant she was the floor nurse and had other responsibilities as well. The clinicians “saw themselves as disciplinarians, people who knew the rules and made sure they were followed. But when it got right down to it, they were often just bullies (137).” This is an example of where a hierarchy manifested itself. Crystal was trying to pull rank on Brown by telling her that she had to do this and that, but Brown was trying to tell Crystal that the patient and the family no longer wanted to treat her disease.
Egalitarian treatment, at least in Brown’s experiences, are a more common occurrence throughout the book. Especially with the doctors (interns, residents etc.). In
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the chapter Access, Brown had a patient who needed a triple lumen Hickman catheter, put into his subclavian vein. The patient was sent down to the OR to get it inserted and ended up staying down there for about four hours waiting. Brown then called the OR floor nurses and they were being stubborn, so a fellow took the phone and started “reeling off protocols related to INRs and fibrinogen values” (157). This is a point in the book where there was egalitarian treatment between the fellow and the nurse, Brown. Brown knew that what was happening down on the OR floor was not okay, and so did the fellow. The fellow and nurse both agreed on the same thing, and the fellow helped the nurse out. She did not pull and sort of rank with Brown or overlook her opinions, which is what usually happens with doctors when it comes to what the nurses think.
4. Choose one section of the book (sentence, passage, chapter) that was particularly meaningful to you and why.
In the Epilogue, the last two pages are meaningful to me. Brown discusses how her husband’s grandmother passed away and it left them with a good chunk of money, for them to do whatever they wanted with it. Like the responsible people they are, they put some of it away and used it to update parts of their home. However, there was still some left over and they ended up buying a piano for her husband. Brown mentions how his grandmother would not have been happy with that purchase, as it was not a necessity. Brown does not care though because it is what made her husband happy. She states in the last two sentences, on page 189: “People say, why wait? But really they should say, don’t wait. Listen when you can, tell the people in your life you love them, and buy the piano”. Brown also states on the same page a few paragraphs before,
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“‘Things’, life, can change in an instant-I know that now because I have seen it with my own eyes”. These two quotes from the book are particularly meaningful to me because she is saying how precious and short life is. As someone who has been affected greatly by family members having chronic and untreatable diseases, such as cancer, I have had to change my perspective on life. It has taught me to live in the moment and not worry about the future because that cannot be controlled. And it is true, things in life do change in an instant. You never know what is going to happen, ever. So, I agree with Brown. Always tell the people in your life that you love them. Life is short. And as Brown says, “don’t wait”.
5. Theresa Brown relates the following poem by Frank Bidart to a career in nursing: I hate and love. Ignorant fish, who even wants the fly while writhing. How do you react to the idea of loving and hating a career in nursing? What aspects of the nursing profession do you see on both sides?
I think that the idea of hating and loving the career of nursing is normal, and does not surprise me. On page 10, Theresa states “ I care deeply for my patients, and I loathe their suffering and disease…I love the idea of helping patients, even when I don’t know exactly what’s wrong with them.” I agree with her. Most people become nurses because they love and genuinely care about people and helping them. So naturally, most people would “love” the idea of being able to help their patients, but “hate” the idea of their patients being sick, like Theresa states. Nursing is a very demanding job and can be extremely hard at times. There are going to be
harder days, where nothing is going to be going well and your patients will not be getting better, but other days are going to be so rewarding and it is going to be amazing. I think that is where
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the idea of hating and loving the profession of nursing comes into play. The hating part I would say, comes more from the harder days, where nothing goes your way, and the loving part of nursing is what comes from the joy and happiness that it can bring to you.
