Work has been shit lately. Covid is still surging in my ICU, and we’re busy with other things too.
Last week was an especially difficult week for our heart failure service, as every patient on service was deemed “not a candidate” for advanced heart failure treatment. Bottom line: this is end-stage heart failure and hospice is the next step. For many patients, this means removing a piece of equipment that’s been helping their heart do it’s job (like an intra-aortic balloon pump, or an Impella). This can mean almost immediate death, but many patients do go home from the ICU to die there. It’s emotionally exhausting but incredibly important work.
And it’s so important to spend some quality time with these patients. Last week, I helped a gentleman who was just days away from getting his Impella out to go home on hospice. He was itchy from laying in bed. I washed his back with real soap and water and washcloths. The put on lotion with a little massage. 20 minutes including gathering supplies. And it made his day! We chatted about traveling and life’s simple pleasures. These are the important moments at the end of life, and I was so happy to be there for him.
But despite that part of my job being so meaningful, there are other parts that are nearly unbearable. There is a day shift charge nurse who is mad at me no matter what I do, and who demands a ridiculous amount of report on our patients. She wants a full head to toe but the 90 second version. Do you know how long it takes me to prepare a cohesive and comprehensive 90 second head to toe report that also includes the plan and updates from when she was last on shift??? It takes about 5 hours to do it for 30-36 patients. And when I don’t give her all the info she wants, she asks for it in aggressive tones. If I don’t know the answers, she will eye roll, sigh and slam turn the pages of her printout. Actually, she does that sometimes anyways if she’s annoyed by something, anything.
I find this to create a workplace so toxic that it gives me panic attacks. I dread giving her report. I get short of breath talking to her. I often cry after interactions with her.
So what do I do when I tell my managers about this and nothing changes? That is the million dollar question facing me right now.
Oh, I almost forgot my dream. I had a left ventricular assist device (LVAD) in my dream, but it became dislodged internally. FYI, I’ve never ever seen this happen in real life… I was bleeding to death, surrounded by work mates. They could do nothing. And finally, as I was about to die, one of the help pressure on the bleeding spot as the warm feeling spread through my chest and I lost consciousness.
Whoa. Is that symbolic? I hope not.