Thursday, September 18, 2008

When Saviors Fail

Health care workers life lives of deep frustration.

Doctors and nurses enter the medical profession in the hope of saving lives. Unfortunately, they must watch their patients die on a daily basis. Failure leaves a bitter taste in any person’s mouth; but for those sworn to save and redeem, failure is particularly galling, and questions their very identity.

Indeed, Moses, after the failure of his first mission to Pharaoh, protests to God:

“Why have you brought all this trouble on your own people, Lord? Why did you send me? Ever since I came to Pharaoh as your spokesman, he has been even more brutal to your people. And you have done nothing to rescue them!”

Moses doubts his own usefulness as a messenger. It’s not easy for a savior to fail.

I was thinking of this verse after reading an excellent account by Theresa Brown about what it’s like for a new nurse to watch a patient die:

At my job, people die.

That’s hardly our intention, but they die nonetheless.

Usually it’s at the end of a long struggle — we have done everything modern medicine can do and then some, but we can’t save them. …….
And then there are the other deaths: quick and rare, where life leaves a body in minutes. In my hospital these deaths are “Condition A’s.” The “A” stands for arrest, as in cardiac arrest, as in this patient’s heart has all of a sudden stopped beating and we need to try to restart it.

I am a new nurse, and recently I had my first Condition A. My patient, a particularly nice older woman with lung cancer, had been, as we say, “fine,” with no complaints but a low-grade fever she’d had off and on for a couple of days. She had come in because she was coughing up blood, a problem we had resolved, and she was set for discharge that afternoon.

After a routine assessment in the morning, I left her in the care of a nursing student and moved on to other patients, thinking I was going to have a relatively calm day. About half an hour later an aide called me: “Theresa, they need you in 1022.”

I stopped what I was doing and walked over to her room. The nurse leaving the room said, “She’s spitting up blood,” and went to the nurses’ station to call her doctor.

The patient tried to stand up so the blood would flow into a nearby trash can, and I told her, “No, don’t stand up.” She sat back down, started shaking and then collapsed backward on the bed.

“Is it condition time?” asked the other nurse.

“Call the code!” I yelled. “Call the code!”

The next few moments I can only describe as surreal. I felt for a pulse and there wasn’t one. I started doing CPR. On the overhead loudspeaker, a voice called out, “Condition A.” ….

They worked on her for half an hour…… And (then) my patient was dead. She had been dead when she fell back on the bed and she stayed dead through all the effort to save her, while blood and tissue bubbled out of her and the suction clogged with particles spilling from her lungs. Everyone did what she knew how to do to save her. She could not be saved.

Doctors and nurses cannot save everyone; even Moses had his failures. Yes, saviors fail - but failures can be saviors too. We just have to remember, every time we fail, to keep on going, because “it’s not incumbent upon us to complete the job, but we can’t quit either.”

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