Hi! I'm applying as a transfer student to Rice University. I also happen to be a critical care nurse. This essay is for the prompt, "The quality of Rice's academic life and the Residential College System are heavily influenced by the unique life experiences and cultural traditions each student brings. What perspective do you feel that you will contribute to life at Rice?"
"You have patient 11 and the open bed in 12, OK?"
My stomach took a somersault - my charge nurse had assigned me the open bed, yet again. If anybody in the whole hospital or in the ER takes a turn for the worse, or God forbid, codes (in layman's terms, undergoes a cardiac or respiratory arrest), I'd be the lucky (hapless) fellow to admit that patient to the MICU.
The mounting sensation of dread in my chest finally broke loose a few hours later, when my charge nurse told me that I was admitting Ms. M, a 64 year old female who came in the ER with shortness of breath.
They hastily wheeled in on a stretcher Ms. M, who had an endotracheal tube taped to her lips, with the respiratory therapist manually ventilating her lungs. She was pale and swollen like a melon. Hanging around her neck was a clump of tangled IV tubing with medications that supported her blood pressure. She was still awake, peering at me from her crusted eyes with a mixture of shock and confusion at the commotion. "You're doing OK, Miss M, we'll take care of you," I comforted her. I repositioned her, gave her some sedation, and within minutes she was asleep.
Ms. M, as I learned from her patient chart, was diagnosed with ovarian cancer several months before. Her oncologists initially treated her with aggressive chemotherapy during a previous hospitalization, but it was now apparent that it failed to stop the cancer from metastasizing.
The cancerous lesions in her lungs that had grown too big and the numerous blood clots in her pulmonary arteries impeded her ventilation, and, as it were, were choking her from the inside. None of her doctors, however, seemed to have the honesty to tell her that it was terminal.
So when her dyspnea worsened, she decided to call an ambulance to take her back to the ER, led by a false sense of hope that there was still something that could be done. When they asked her in the ER whether she wanted intubation or CPR, if or when she undergoes a cardiac or respiratory arrest, she said yes, and agreed to be "full code."
As I tidied up her belongings and tried to put them away, I found a tattered, dog-eared notebook in her bag. I desperately needed to talk to a family member, relative or a close friend regarding her hospitalization in case of an emergency, but none of the numbers in her chart worked. So I opened her notebook, hoping that I'd find a useful contact number in there.
That notebook, I soon found out, happened to be Ms. M's catch-all personal journal, phonebook, and organizer, complete with the calling cards of her doctors and therapists.
Ms. M recounted in it the sinking feeling she felt when she first got word of her diagnosis, and her grim determination to beat her disease. She voiced her fear and misgivings about receiving her chemo treatments, since it caused her so much nausea and discomfort. But she wanted to stick with it, because she did not want to give up against "this cancer."
I found out how life was so difficult for Ms. M after her discharge a few months ago. She was single and lived alone, and her closest family member was a younger sister, who was disabled herself. She would lie on her chair for hours despite the throbbing pain on her back, because she was too weak to stand up. She would get turned and cleaned only when her home health nurse would come, once in the morning and another in the afternoon. It then dawned on me how she got that large open sore on her buttocks.
I saw how she desperately tried to budget her finances. She had a thousand dollars left on her savings account, which got decimated by all her deductibles. She knew needed to go to a rehab facility, but she wrote that she could not afford it despite Medicaid coverage.
I learned that Ms. M was devoutly Christian and fervently hoped that the Lord Jesus would cure her. I admired her childlike expressions of faith, her thoughts peppered with quotations from the Psalms on how God promised those who trusted Him to provide all their needs.
I stood there, tears welling up my eyes, motionless and overwhelmed. Ms. M was not just a 64-year old female with acute respiratory failure secondary to lung mets, she was far more than that: she was M the sister, M the neighbor, M the Christian believer, M the former artist and substitute teacher. I realized that her illness did not define her identity. I felt such an intense pang of loss considering how close she was to dying.
I mourned for Ms. M, and I mourned for the thousands of others like her whose lack of finances and impaired access to medical care gave way to misguided, often difficult choices regarding end-of-life care. I mourned for the countless Eleanor Rigbys who died in intensive care, helpless, in pain, and alone. And I mourned the fact that more often than not, we health care providers end up betraying our oath to do no harm in our relentless pursuit to cure disease.
I hurriedly wiped my eyes with my sleeves, and proceeded to do my work. I gave her a warm sponge bath, and tucked her under a couple of warm blankets, hoping that I made her as peaceful and comfortable as possible.
Bed 12 was empty when I came back the following night. Ms. M's younger sister, whom I tried in vain to contact that night, chose to withdraw life support from Ms. M around two in the afternoon. She died half an hour later.
Please, do tell me what you think. Thanks!
