be careful what you wish for

so i'm sitting at the nurse's station talking to a doctor on the phone about trying to discharge the 80 pound 84 year old woman who is demanding high dose percocet before she goes home.  her discharge is a hot mess, the caretaker has dementia almost as bad as the patient, and i am fully intending to send them home with a hospital oxygen tank "on accident" as hers is empty and that's sure as hell not keeping her here.

"YOUR PATIENT IS HAVING A SEIZURE!!"

oh good.  i promptly hang up on the doctor and run to the room of my patient who i had seen just a half hour before.  i had checked on the blood she was getting, started the saline to flush the rest of the unit through, then went on my way.  when i left, she was sitting at the side of the bed eating a sandwich.

was.  because now she's completely unresponsive with shallow respirations and no attempt to protect her airway.  we call a code, the code team shows up and then we do all the code things... labs, ABGs, hook up the monitors, and try to figure out what on earth just happened to this woman who was fine a few minutes ago.

encouragingly, vitals are pretty stable.  she's breathing...not particularly well, but could be worse.  but she's still unresponsive even to pain, still isn't protecting her airway and we've decided to intubate, so now we're just hanging around waiting for anesthesia to show up with the RSI meds.  they come, draw a few things up, and they push the meds.

this is terrifying, because now this patient HAS to get intubated because we have just chemically paralyzed her and i've never seen them do this to someone this alive and i am inches away from the ICU resident who is now using a tongue blade and visualizing the cords, and i feel a little sentimental because this is what i always thought nursing would be and what i imagined i would be participating in on a daily basis and the few other times i've witnessed this i have been pounding on someone's chest and frankly wasn't paying much attention.

and oh, it's just so...COOL.  i feel like a nerd for saying that.  but it is.  and once the ET tube is in, we start bagging and i get to steer the bed up to the ICU and i get to squeeze the ambu bag some when the respiratory therapist can't reach it and it feels very important.

but it's also kind of scary, and i keep wondering if i had missed something big that made this happen, and then my mind wanders to my hot mess discharge waiting to be done, all my other patients, nurse-less, on the floor while i'm up in the ICU and all the documentation i'll have to do on this code.

and then i think back to a couple days before, when i saw this team of nurses taking a patient up to the ICU and how jealous i was of them and how i wished that my job was more gratifying and dramatic and exciting.

be careful what you wish for 'cause you just might get it, indeed.