Saturday, September 19, 2009

Conflict

Have you ever been in a sticky situation, where it called only for split seconds to make decisions? I often find myself doing that.


I once had to do a straight catheter on a man who had urinary retention. He'd been calling all shift for assistance to the bathroom, each time with zero output. Bladder scanning revealed 306ml of urine. I obtained an order for a straight catheter, which would immediately empty his bladder and offer relief. I was right INSIDE, about 4-5 inches, when a CNA slowly knocked on the door and whispered to my ear, "Sorry to interrupt, Cherie, but whenever you are done, Ms. X in Room So and So had died."


WHAT? The nearest nurse was a floor away. I told her to call the Supervisor. BUT at the same time, I had to do something, immediately. Pronouncing the dead was one thing. Making SURE that the person was truly deceased was another. To top it all, leaving the present procedure you are doing right in the middle of it just complicates everything else. What to do?


The urine by now was NOT flowing. (And to this day, I wonder why. Catheterization is a very easy procedure, and one I'd done countless of times prior to this incident.) I inserted a little more. Thirty seconds more. None. I decided to withdraw, and explain to my patient that there was an emergency. I said I was going to be back as soon as possible.


I rushed to the said room with my stethoscope, and did my assessment. The patient in Room So And So was really gone. I pronounced her dead by 1:45am. The Supervisor did not show up till after 20 minutes after that. I couldn't have waited that long.


In the meantime, no action from Mr. Catheter's room. Then, about 30 minutes after I left him, his call bell rang. The patient had GONE on his own, for some reason. My earlier poking must have stimulated his bladder, and as a result, he went and WENT, wetting his bed, and everything. By this time, he had also been waiting for me. But the CNA and I were busy with the body. And then I had to do the necessary notifications. It was all bad timing. The CNA rushed to him as soon as she was done. I was fortunate to have worked with a good one.


Needless to say, the gentleman was not very happy. To him, I would always be the nurse who left him, and from that day onwards, would not allow me to do any catheterization on him, although he would let me stick his arm for blood work.


Looking back, given the same unfortunate circumstance, I don't think I would have hesitated to do exactly the same thing. But it is instances like this that leave me bothered, wishing in my heart that things could have happened differently, but also knowing that just at that very moment, couldn't. And I am often left feeling bad about myself, sorry for the whole sick situation.

18 comments:

Cher said...

if i were to put myself in your shoes, i'll feel bad too.. perhaps even worst. :(

just think of other reasons to smile again like your litratong pinoy: karatula...

Jesusa said...

don't fret my friend. why are you still up? it's late!

Gypsy said...

Situations like that are very difficult and all you do is your best. After all, you are only one person. Timing is everything so they say but sometimes it just doesn't work in our favour or anyone elses. You are a sweet lovely lady and I'm sure most people would have forgiven for being human.

cherie said...

thank you, dearly, cher, grace, and gypsy. part of consolation is that i DID wait for the urine to come out. i did NOT leave him wet (it took roughly 30 minutes AFTER i'd gone before he urinated), and
everyone was witness to my crazy moment. he and i remained very cordial to each other until the day he left.

Icy BC said...

You did what was right at the moment, Cherie!

You're in an emergency situation, and you just prioritized which should come first, and obviously you made the right choice..

cherie said...

i thank you, Icy, for your thoughtfulness. it gets to me sometimes.

Pacey said...

That was tough but if I was on that situation, I wouldn't feel guilty at all...why? because I did my best to help Mr. cath-man, and just let it go cherie. Bad times sometimes happen. :)

cherie said...

thank you, ate pacey, that's very sweet. i was just reminded of it recently for some reason.

rainfield61 said...

We need to make decisions at any moments, be it a critical one or not, anyhow, this is part and parcel of our life.

cherie said...

that's true, rainfield. just terrible when they don't always work your way. blessed day, Rainy!

Stephanie Faris said...

I don't know how you guys do it. It's so tough! I just fix computers for a living...at worst I have two computer crashes and someone has to wait while I fix the other person's. I work for the Dept. of Health, by the way...in the bureau that licenses all of TN's medical personnel and facilities.

cherie said...

I get that all the time, Steph ~~ how we do it, you know. I don't know myself. It wears you down sometimes. --Happy birthday, dear. Paint the town red.

Betsy from Tennessee said...

Hi Cherie, You certainly did make the correct decision.. In your line of work (nurses and doctors), decisions have to be made ---and sometimes quickly. Patients are not the nicest because 'they' think they should always be first in line. I'm sure that is not the only decision like that that you've had to make. We all are human--and sometimes we second-guess our decisions AFTER the fact. AND--we learn from each one of them, good ones and bad ones.

I admire you for doing what you do. You are SAVING lives. That is special.
Hugs,
Betsy

cherie said...

hi, ms. betsy. thank you for your insight. it is true. i guess i get affected because i really want to accommodate everybody the same way. i would rather be the one hurting, than the one inflicting the pain! or causing the sadness. or whatever it's called.~~~hugs!

Whitemist said...

That would not have change my opinion of you. i would have been thankful that i got cleaned up after.
When I had lost fluid in my brain and really did not know what had gone on, I believed I was cleaned up by some nurse or CNA. Although i was not sure and they would not say, I was grateful for help when i could not help myself.

cherie said...

thank you for understanding, sir W. i am fortunate to work with a good crew wherever i go. we answer bells on the first ring, we rush to the rooms. i do a lot of what the CNAs do, i don't mind. that's part of the game, and that is one way to motivate people to work. i bless that person who cleaned you up. hope your xrays look better each chesk-up!

Ayie said...

there are things that we can't do all at the same time so just let it go....sulking on it will just make you feel worse.

cherie said...

you're right, ayie. thanks!

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