Wednesday, December 10, 2008

Don't Watch

Yep, I stole that pic from the internet. But notice the lovely PB 840 Ventilator in the lower left corner??? By far my fave!

Here is the deal, peeps. We do some things that are uncomfortable for a patient when in an ICU. The list is numerous: chest tubes and a-lines and don't forget intubation. A tube made of polyvinylchloride is not a pleasant thing to have jammed into your airway. But we do it out of necessity. Not rosey and cute. But required. Then occasionally we have the patient who is having trouble breathing and we try to intervene on their behalf to actually avoid intubation. Whatever unpleasantness I could be up to is nothing compared to days of mechanical ventilation, I assure you. What am I getting at? Well here it is:

I know the patient I am taking care of may be your sweet mother. I completely understand that. I had a mother once before. I know you do not want to leave her side. Your presence at her bedside 24/7 is as much your way of ensuring we are giving her adequate attention as it is for tou to assure her with your presence. But when I come into an intensive care room, it is a sign that sweet Mom is just not breathing so well on her own. She needs some sort of help, whether that be in the form of aerosolized meds or oxygen, bronchial hygiene or mechanical ventilation. But please know that I am good at my job, even if that job is not all sunshine.

So you are at Mom's side. Great! But when I tell you I am about to do something unpleasant and encourage you to leave the room, please follow my advice. The most recent situation was the nasotracheal suctioning of an elderly lady unable to speak, and unable to adequately clear her airway with cough. DO NOT insist on watching me thread a catheter up her nostril, through the pharynx and into her trachea. She is not going to like it. She will cough and gag, and naturally try to fight me, at which point I will have to firmly insist she stop. I need to do this. I do not want the process to take so long that she becomes hypoxic or starts to brady down. That would be bad ju-ju. What I can say is that, while unpleasant, she will feel better when I am finished and have removed the nastiness from her. She may hate me, but she will feel better.

Please do not watch me, then get angry because I upset dear Mom. I am not concerned with Mom being upset with me at all. My job isn't to have tea with her or to convince her that I am worthy of her adoration. My job is to ensure that her respiratory function is intact. Making her mad is just a side effect.

If you can't handle the heat, stay out of the kitchen? More like if you cannot handle the unpleasantness, stay out of the ICU (other than for standard visiting hours, of course.)

1 comment:

DK said...

Well said. And ps, I love that you have a favorite ventilator...