Tired

My Monday night shift was one of the most emotionally wrecking shifts I've had, ever. Not all bad, but definitely draining. I've been thinking that I wanted to utilize the employee assistance program counseling at our hospital for a while now just with all the stress and anxiety from COVID, but after that shift...yeah, I'm gonna need it.

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A coworker of mine called me in to help sit her patient up in bed, and she had warned me earlier that this patient wasn't doing well at all. The patient was a million years old, and had refused all care because she "just wants to go home." At first, my coworker thought that she wanted to go back to her residence, but the patient then said "don't do anything, I'm going to take my last breath here and I know where I'm going." My coworker was a little freaked out, so she called me in to help. Just before walking into the room, she told me that she was afraid when we sat that patient up that she would pass.

I helped my coworker sit this ancient patient up, she took a few deep breaths, and then over the next ten minutes we held her hands as she died. It was peaceful. It was devastating. It hurt me, to know that she would have died all alone if we weren't sitting there. I was thankful that I was the person my coworker asked to come in with her, but it was hard. We both cried, a lot. You could see the patient just...let go. She was there, and then she wasn't.

After that, we took a few minutes to gather ourselves and then immediately went into the next room to take care of a patient slowly, excruciatingly, trying to fight end stage liver failure and a wound infection. Their family wants everything done so they can get better and come home. They aren't going to make it though this.

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I spent part of the shift in triage as well, getting yelled at by everyone in the city who doesn't want to wear a mask, or gets pissed when they can't have four friends come back to their room with them, or went out to a big house party two weeks ago and now feels short of breath with an SpO2 of 84% but flat out denies that they had any exposure to COVID.

I also had to help keep an eye on the waiting room for the family members of a traumatically deceased patient, which is a moment I absolutely dread.

***
The last half of my shift was up in our trauma bays, where we took care of a very critical patient for hours. The trauma surgeon, normally excellent and one of my favorites, got sloppy and left a sharp on the tray. When I was moving the tray off the patient, I felt a poke in my finger and realized that he had left a needle unaccounted for even after saying he had gotten them all. I scrubbed and scrubbed and scrubbed my hands with soap and water and betadine, but we all saw the blood it drew. Everyone in the room witnessed it, including the surgeon who instantly and profusely apologized.

I had to go through the whole process of paperwork, lab draws, house supervisor, everything. It sucks. I go in to employee health on Friday to hear his lab results and find out if I have to start taking any medications, but this waiting period is the absolute worst. Does he have HIV? Hepatitis? Do I? It fucking sucks. This is the first time I've ever had an exposure to anything. I feel a little bit numb, but mostly I'm angry.

I know the surgeon didn't maliciously leave that sharp on the tray, but this is the second time in a month that I have personally berated him for leaving sharps on the a tray - he left an open scalpel in a tray a few weeks back that nearly nicked me when I moved the trash aside. He apologized then, but after Monday I'm wondering if I'll be able to trust him anymore when working a trauma. We rely on each other to stay safe - there's so many opportunities to get hurt in a busy trauma. I do my part to keep my coworkers healthy, but who is looking out for me?

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The other day I found out that a physician I used to work with at Home Hospital lost both her sister and her father to COVID. They were also physicians, which is just heartbreaking.

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I'm just exhausted. COVID has really stretched us thin, and after this night and everything else going on in this world, I'm realizing I need to take advantage of the free counseling at work. No shame in doing that. I'll keep you guys updated on how it goes. Thanks for listening.