Tuesday, September 14, 2010

The Fascinating World of Death and Learning

(A Replay: Posted at multiply last March 26, '09 3:06 AM)


Philippine General Hospital. PM shift. OB ward. Trophoblastic Disease. Cancer. You name it. Almost Every disease associated to female reproductive system is there, hence the name.






I was assigned to a close monitoring patient. Usually it is considered as such when the patient is near the nurse's station. Opposite my patient is another of those close monitoring ones. Ayet handled her. Judging from the way she looks, I think she has H-mole because of her big abdomen but I am not really sure. Group mates, please correct me if I am wrong, I honestly could not remember her case and please forgive my failing memory.

Looking at her during rounds, I recognized that she is a former occupant of the "Ferdinand Mariano Ward". So I guess she is transferred nearer the nurse's station so as to gain an easier access to her. Using my clinical eye, which is partially open during that time, I concluded that she will "go" within the shift or during the graveyard shift.

Her eyes were open and it was scanning each and every one of us while on rounds. For a moment she seemed to have noticed that I was looking at her. As a normal nurse's reflex, there is a need for you to smile a bit and say: Good afternoon po, then you may have the excuse to leave. On her case, when I greeted her, she struggled to talk but was not able to. She was able to smile though. It was obvious; she is struggling for her life. After that, I excused my self and went off to other patients.

4pm. I saw her relative crying while talking to somebody on the phone. Around 5 pm, I made a simpleng silip on that patient to see what is happening to her. I saw that her eyes and her mouth is slightly open. She looks weird but more like dead to me. I asked ayet about the patient, she already endorsed to her buddy nurse the patient's status and vital signs.

I have also noticed that residents have started to increase in number because they have become incredibly noisy and irritating. Also, they kept on stealing the charts and the seats. After giving the 6pm meds to my patients, I went back to my close-monitoring-patient to check on her. Then I saw that popong was about to change the GTD patient's IV. He was able to assess that the patient was not breathing. He reported it to the nurse's station.

After which, I heard nothing but running footsteps and the word:code! code! code waaaahhhh code! Two of the residents checked... and further screamed: code! maaaaam code! code! %^$%@#@@! code!

The next thing I knew, I was enjoying all the action. The nurses run along with the doctors. Dammit, with that kind of running, who would want a tight-in-the-ass pants? Nurses should work-out too. A board was inserted under the bed. The bed was lowered to assume the patient in a supine position. The doctors attempted intubation (don't know why the tube wasn't inserted). The nurse did chest compressions. The E-cart came along with the suction machine. Etc. Etc. Etc.

If you were to ask me why we were just watching during that time, well, my response to you is: how in the world can you be able to help with a sea of doctors rushing like tidal waves on the bedside? At that time, all you will see in that area are white uniformed backs, where one is kneeling on the bed and is bent down, doing chest compressions.

After attempts of intubation and continued chest compressions to my surprise: a resident said: DNR tayo. In a split second, the people vanished leaving the patient like a rape victim. "Baket nag-sign ba?" the nurse said. "Basta DNR tayo" the bitchy resident said. I was waiting for her to declare the time of death but i heard none. From then on, the nurses have been engaged in a heated discussion of something but I could not eavesdrop because someone has died.

Entering the ward, there was dead silence. The people's eyes were fixed on the dead body lying on the bed. Walking near the dead is such a creepy experience. I covered the patient's naked abdomen and asked Mrs. Ramos' permission for a post-mortem care. She told us to where gloves and remove all the contraptions.



The relatives were nowhere at site. We just recovered a piece of cloth and a small amount of water from the patient's bedside table. We removed all the contraptions and wiped her clean. Touching the patient's skin, it was still warm, eyes were partially open and the jaw has dropped. ECG was taken, the line was flat. She was definitely and undeniably gone. We prayed for the patient before the manongs took her away. Goodbye ma'am, i thought.

Now this is what you call real-life hospital drama. Not that I am watching it for pleasure but I am learning as well. Learning the dynamics of code blue. Learning the dynamics of Life. This is a learning medium that a school could not re-enact nor money can buy. This is a learning medium that hammered my rock-hard intellectual capacity. Death and dying, it is an unexpected mystery that even the smartest person in the world could not understand.
I am just happy that patient is in a good place now and i was able to embede a simple smile on her face despite the excruciating pain she was feeling. Bye now. Kindly tell Bro I said Hi.

To the gagang doktora, buti nga sa kanya. Napagalitan siya dahil hindi siya nag-call ng time of death. Kaso, ako ang napag-initan. Hehehe. Whatevah doctora, sino ba ang napagalitan? Haha. Enough with the bitchy comments. Stop na, good girl mode na.

Sorry to say but this isn't what your waiting for 'cause Baby you can drive my car! You know what i mean groupmates! hahaha.

and oh, to doctor just: how is the cancer of the eyebrow research going? Can't wait to hear all about it! You know where to find us, we are at the doctor's lounge screwing up charts from student nurses...

Dahil nandito ako, nandito ka din.

->Cha