It isn't often that I get two bad call shifts in the same week. This week was the exception. We're on call for 24 hours over the weekend, once every five to six weeks. Today is my day - I'm technically still on call until 7 tomorrow morning.
My last patient of the day was an emergency case flown in from a smaller hospital. The odds were stacked against her, and we all knew it. She would have known it, too, but she had already suffered a cardiac arrest and had been resuscitated, so she was still unconscious. If she had surgery, she probably wouldn't make it. If she didn't have surgery, she had no chance. There was really no choice.
So, we took her back, hoping for the best. And we worked and we worked and we worked, for hours. And, in the end, her poor little heart gave out. We couldn't save her.
When you lose a patient, even if you haven't cared for the patient for very long, the sadness is visceral. It hits you like a punch in the stomach. Except that the pain from the punch might go away in a few minutes, while the pain from the loss lingers for days or weeks. You go back over everything you did, over and over, wondering if there was anything else you could have done. Wondering if you could have changed the outcome.
I guess my face showed how I felt as we cleaned up the operating room after the case, because one of the nurses said to me, "Terri, you have to accept the fact that you do not have the final say over who lives or who dies!" And I know this. But knowing it doesn't help.
My feet hurt, my back hurts, my head hurts and my heart hurts. I'm going to bed. good night, all.