By: Debbie Moore-Black, RN

Today. Finally, a day off.

I could oversleep, roll out of bed, then make a pot of coffee — and prepare for a “do nothing” day.

But today is the day.

After dealing with more electrical problems on this 160,000-mile-plus car, I will say goodbye, turn in the keys, and walk away.

This car holds memories: Taking the kids to the beach. Driving to our last trip to the mountains. My best friend’s Miami wedding. Taking our kids back to college.

I’ll say goodbye to the other baggage, too: Watching my now-deceased husband back out of the driveway to anxiously go on another trip out of town to meet with his business partner/lover. Another speech to convince me, “it’s just business.” Another trip to the airport to watch him leave again to England to meet with health care officials to plan health care educational films with her.

And then there are the memories of pictures splashed across social media of the two of them snuggled up in the backseat of a taxi. Memories of the trip he took to Boston to meet his work crew. His business buddies. And her. And then more pictures of them toasting their glasses of wine at a restaurant.

Their smiles flashed before me as I worked my 60-hour week to afford nice clothes for our kids, nice vacations, and college for all three — to finally buy a lovely house and leave behind that dilapidated two-bedroom mobile home.

And then, there was that other trip he couldn’t wait to go on. Only he held onto a dark secret — excruciating abdominal pain. No one knew because he wanted to make that trip to see her. All in the name of “business.”

We all found out later that my husband suffered severe abdominal pain silently until he couldn’t take the pain anymore. We all found out later that he had liver and pancreatic cancer.

I drove him to the hospital over and over again in that car — for appointments to the surgeon, oncologists, pain control physicians, the hospital, and emergency rooms for his two heart attacks. I have the memories of “I’m not having a heart attack. Leave me alone and mind your own business,” to “Would you take me to the hospital … again?” to his funeral.

That trip was his final destination in the mountains. As the wind spread his ashes across the peaks, we all said the last goodbye.

This old car.

I tried to suppress the memories that it carried for me.

But today, I remove the anchor wrapped around my ankle that tried to sink me to the bottom of the ocean.

Today, I leave this car on the lot.

Today, I drive away — in a new car.

I open up the windows and breathe again.

………

Originally Published at KevinMD.com

By: Debbie Moore-Black, RN

He was in his ICU bed without movement or brain stem involvement. His weight was down to 90 pounds.

His six-foot frame and skeletal body made me gasp.

After countless sessions with the patient’s daughter to make her 92-year-old dad “comfort care,” the intensivist sadly hung his head down low.

The daughter insisted on doing everything for her daddy.

It was my night shift, and I knew what was to be expected. Another endless code. A futile event to please a family member.

I’ll never understand this.

He coded twice on this day. The ICU doctors called in the ethics committee. But that was a process, and we had run out of time.

He coded on me this night — his third code blue in 24 hours. We pushed the code blue button. The nurses, an intensivist, a virtual ICU MD, respiratory therapists, and CNAs to assist in CPR showed up promptly. We all had our roles.

He was already on the ventilator.

Unresponsive.

Central line.

Levophed, vasopressin, and bicarbonate drips infusing.

His heart stood still.

Asystole.

The daughter and her husband insisted on watching the code. They wanted to make sure that everything that could be done was done.

They said they would have their lawyer “after us” if we did not do everything.

They watched us do CPR. They listened to his frail body as we cracked his ribs. They watched me push epinephrine, and we announced each medication we gave IV push — epinephrine every three to five minutes.

The doctors begged the daughter to let us stop.

He said that this treatment, this code was futile. It was brutal.

Yet, she refused.

After 15 minutes of CPR and never regained a pulse, asystole was his only rhythm. He essentially had “died” 15 minutes earlier.

And the ICU doctor said: “Stop CPR.”

The doctor addressed the daughter.

“After 15 minutes of vigorous CPR, epinephrine IV push, your father has not responded. He is without a pulse. He died. There’s nothing more we can do.”

I watched the daughter as she shook her head. “Daddy, you almost made it to 100 years. We tried daddy. We tried.”

I was in disbelief. I could not comprehend the brutality in this, how this was so inhumane.

How sad that we can end our own pets’ lives when they are suffering and dying, but we can’t accept humans to die peacefully.
This scene tormented me for months.

That song, “How could you be so heartless,” rang in my head over and over again.

…….

Originally Published on Kevin MD.com

By: Debbie Moore-Black, RN

Maybe we can take a deep breath. And breathe out slowly. Check our pulse. Go on that vacation far away or just visit a beach and watch the crashing waves. Listen to the seagulls, the breeze, the blue skies. And turn our cell phones off.

But as an ICU nurse who loved this speciality, Covid patients in the ICU was a war zone.
One ICU room would now carry 2 patients. Short staffed, our work load doubled, as we were also faced with lack of PPE’s.

The violins and trumpets and guitars blasting out at the employee entrance with big banners telling us we were heroes, when we knew it was just a smoke screen. The truth was lack of PPE’s. Put your N95 mask in a paper bag and wear it every day with every patient for one full week. Gown and glove, and face shields. Hurry and use the bathroom because you may not be able to visit the toilet for the next 12 hours.

As I interviewed several Frontline ICU nurses in the aftermath of Covid, I watched them talk to me, with their head hanging low. Monotone voice. And I heard the same replies.

Anxiety. Depression. Defeat. Death.
And it didn’t matter how many balloons or banners were at our front gate, we knew that we were working with the minimum. And we knew the outcome usually was death.

Camaraderie weakened and the need for critical care nurses grew exponentially throughout the USA. Some hospitals offering $5000-$6000 per week. And the ICU nurses knowing the chaos, the shortage of nurses, ran to other jobs for the money. And why not?
Leaving a huge gap with the ones left behind.
We isolated ourselves from our own family, fearful.

Fearful that we may be carrying the virus. Fearful of spreading it to our loved ones. There were no hugs and kisses and mommy/daddy…. We’re home from work. It was “don’t hug me, don’t touch me” as we took our decontamination shower and isolated ourselves.

We knew the drill. Bipap, then ventilator, central line, arterial line, IV pressors, steroids, plasma, dialysis. Prone position. Experimental drugs. Scrambling to see which one would work. Medically paralyzing the patient to get maximum oxygenation. Physicians and nurses and respiratory therapists working side by side.
A team of dwindling hope.

The patients not getting better. Nurses and physicians communicating via FaceTime with family members. Do everything. Crying, defeat.
The final goodbye as the nurse stood in for the family, holding the hand of a patient as they let out their last gasp. Watching a heart rate go from 140 to 40 in a split second.

And then the laypeople. The ones with no medical knowledge. The disrespect. The refusal to wear masks in public. The politics. The hoax theme. If they only knew. If they only were in our shoes in any ICU. If they only saw the battle of fighting for someone’s life and failing over and over again.

Depression, anxiety, helplessness, lack of sleep, fear, worry, empathy. And then came the physical signs of fatigue and defeat like headaches, nausea, exhaustion, breathlessness. Loss of appetite. And failure.

We didn’t need the music and the balloons and the banners clocking into the hospital. We didn’t need the “Hero status”. We didn’t need the pat on the backs.

What we needed were appropriate and plentiful PPE’s, safe nurse-patient ratio. Equipment that worked.

And day after day we knew after one patient we mechanically kept alive for 20 to 30 days and then pronounced their death and wrapped them up in a body bag, environmental services would hurry and clean and sanitize that bed for the next one. One after another. Only to know the outcome was death.

And now we can be thankful for those that stood in line and took the vaccine. We finally see the numbers go down. A sigh of relief.

A deep respect for this virus. A deep respect for science. For nurses and physicians and respiratory therapists. For the environmental services. For the educators that kept pounding away the message that this is real.

We bow our heads. And take that deep breath.
And I watch the waves crash into the sands.
And I empty my thoughts and can only hope and pray.

Never again.