Wednesday, December 28, 2011

Stress Eating

When a crisis arrives and I'm at home the immediate reaction is to clean the entire house from top to bottom.

When a potential crisis arrives at work, my immediate reaction is to wish I had some fountain Dr. Pepper and Nacho Cheese Doritos.

Yesterday at about 3:30 my supervisor said, "Is Dr. G going to do that ICU patient tonight?"

"What ICU patient?  He didn't mention it to me."

"It's that patient that coded this morning.  He wants to do her tonight, and he needs anesthesia, but they can't come until after 6."

Well, great.  I immediately began needing some Doritos and DP.  After all, if she coded odds are she's pretty sick.  And I hate dealing with really sick people late in the evening.  The rest of the crew has left, and that leaves the call nurse, the doctor and two radiology techs... unless you drag the ICU nurse into the procedure with you...

I went out to ask the doctor if we "had" to do the case that night, or could we wait and do it the next day and we'd book anesthesia...And of course, that would mean our entire department would be there in case things started going south...

He called the attending doctor who responded, "I think her gallbladder is obstructed.  If that is the cause of her sepsis, then she won't make it through the night."

Well, crap.  I called the anesthesiologist who was immediately annoyed that we were wanting him to put a patient under for a procedure when her labs were terrible, she's on the ventilator, and her blood pressure is still sketchy even though she was on the maximum dose of pressor meds.  (Pressor meds are given when a person's blood pressure is too low.)

 Oh, I just feel compelled to tell you in an aside note that one time I tried to refuse to do sedation on a very sick patient with Dr. G, because I was almost certain they were going to die on the table.  I wanted them to stabilize the patient more before we did the procedure.  He looked at me and said, "Andrea, this patient is going to die very soon if we don't do this.  So, he can either die with us trying to save him, or we can do nothing and he will still die."  What do you say to that?  We did the case, and the patient lived.  But I swear I carried knots in my neck and shoulders from the stress of that case for weeks afterwards....

After speaking with the anesthesiologist, I reported back to Dr. G that the anesthesiologist said I couldn't bring the patient to our department until he had seen her himself in the ICU.  And I was very okay with that...

However, my dad gum doctor just said, "That's okay.  I'm on my way to the ICU right now.  I think we are just going to drain her gallbladder, so I will just need sedation, and you can do that.  Come with me."

I could?  I didn't WANNA do sedation on this lady!  Grrrrrr...I grabbed my DP and chips and headed out the door with him...

(Thankfully, one of the radiology techs that was NOT on call had ran down to the cafeteria and bought me a fountain Dr. Pepper and Cool Ranch Doritos as they were out of Nacho Cheese...She knows me well.)

He and I took off down the hall, sharing my bag of Doritos...Yet, he pointed out that he thinks it's tacky to eat and walk at the same time.  I told him to "Shut up and eat a chip."  And he did.  He knows when he's living dangerously.  (By the way, we tell each other to shut up on a regular basis.  In fact, I pointed out that I've told him to shut up more than any other human in my life.  He said it's ditto for him, unless we count his sister and that took an entire LIFETIME to reach the quantity of shut ups that he's given me.  We aren't sure if this is a good thing or not.)

He walked into her room, where three family members were at bedside.  He immediately started telling them what we were about to do.  As he was talking, I noticed that she was on continuous hemodialysis...This means her kidney function was so poor that they had a machine hooked up pulling her blood out and cleaning it continuously.  I then noticed that her blood pressure was 66/47.

YIKES!!!

I immediately went to find the ICU nurse and tell her that if I had to take this patient and sedate her, then she was darn well coming with me.  And to shove a few more Doritos in my mouth and suck down some more liquid Xanax...Well, fortunately, the nurse had already talked to the attending and convinced her that the patient would probably not survive the transfer to our department and subsequent sedation.  She told Dr. G this, and asked if there was any way possible he could put the drain in at bedside.

"Sure.  We can try that."

How do you spell relief?

Well, we put the drain in at bedside, and the poor woman hurt tremendously as we did it, because her blood pressure was too low to give her anything to ease the pain.  The doctor kept asking us to give her something for pain, but the ICU nurse was adding a new pressor med, and another ICU nurse had joined us for moral support, (and to hold her down because it really did hurt,) and we were all presenting a united "refusal to give pain medicine" front...So, it hurt her really really badly.  But she lived through the procedure.

Dr. G said this is the first time he's drained a gallbladdder without giving some serious meds to get through it.  The three of us just put on our callus nurse faces and said, "Well, now you can check that off your list."  And we all thanked each other for the good work, and I went home, slurping on my drink and wishing I hadn't shared the last of my chips with the doctor...

So, what do you want to eat when you are stressed?  Do you eat at all?  Do you go into a frenzy of activity?  Perhaps you curl into the fetal position and stare at the ceiling fan...

5 comments:

Freckled Hen said...

All in a days work? I can't believe you do what you do! I think I would fall apart...
I suppose I'm the opposite when it comes to eating- I eat when I'm happy. It's always hard for me to eat when I'm stressed.
I gave up Dr Pepper last April, can you believe I made it this long???

Michelle said...

And I thought my job was tough (SAHM). You are a Rockstar and deserve your chips and DP.

I used to eat a bag (not a little either) of Salt & Pepper Chips and a pepsi. Now I'm reformed and I eat plain natcho chip and salsa girl with DDP (Diet Dr. Pepper). All the consolation without the guilt. :)

Megan said...

JUNK FOOD! Not that I'm the most healthy eater normally, but when I'm stressed it's all about the chips, soda and candy! Then after that, I stress about the fact that all that junk food went straight to my hips!!

MommaMindy said...

All I could think about when I read this story, was that in my 8 year history of thyroid cancer I've learned a few things about nurses.

A crappy, crabby one can ruin your stay, a kind, patient one can make your day. I cherish the memory I have of a kind, tender nurse speaking to me in the middle of the night when I woke up in pain about Paul's thorn in the flesh.

May the Lord give you extra wisdom and grace in your healing ministry. I could never do what you're doing. :) Blessings to you!

MommaMindy said...

I guess I should have been a little more clear, of course, I was putting you in the kind nurse category. :) Even though you gave the bold, honest facts about your side of the day to us, I know the people receiving your care felt your compassion.

And yes, that nurse face is important. I've had to hear some pretty hard news, and if my nurse had been weeping or distraught, I couldn't handle it. Their calm confidence gives me the confidence to face the facts.

I'm just thankful there are many Christian nurses out there!