As we enter into the hospital each day, our goal is giving patients the best care we can provide. We get a list of patients that we will take care of each day, and as we get that list, we start thinking about what we should monitor in terms of their physical exam, lab results, and vital signs to ensure that their hospital course runs smoothly for the day.
However, at a moment’s notice, a patient’s course can become critical, and our training comes into play as we try to save our patients’ lives.
Most of the time, this happens with patients that we are worried about coming into the day, those who have had a tenuous hospital course and who are being watched closely by many health care professionals. Sometimes, however, it can happen with a patient that seemed to be doing well up to that point, who had stable vital signs, stable labs, and no significant change in their physical exam. Once things become critical, the code bells go off, and numerous health care professionals rush into the room. Doctors, nurses, physician assistants and nurse practitioners run into the room with emergency equipment and medications reserved for life-threatening events. Medications are infused, chest compressions are performed, and external shocks are being delivered to the heart in the hope of saving a patient’s life that is on the brink of being lost. For a moment, our insecurities are put to the side, and we believe in ourselves and our abilities that much more as we hope to rescue a patient on the brink of death. At times, we are successful, and we breathe a sigh of relief, but other times, all of our efforts are futile no matter how hard we try, and the patient that we worked hard to save passes away in front of our eyes.
As the time of death is pronounced, families are notified, coroners are called, and the equipment and medications are moved away. We all stand there in shock, exhausted and saddened by the course of events. We huddle together and debrief about what led to the patient’s death and ask what could have been done differently. Understandably, some people are shaken up and trying to process everything. What is weird, however, is that it is still the middle of the day; there are still patients to take care of, and as hard as it is to believe, we are expected to put aside in our minds what we just went through and continue to care for others as if we had not gone through that experience.
When I think about these particular experiences and discussions I have had with other health care professionals over the years, it strikes me that in many other professions, there would not be an expectation to continue on with daily affairs immediately after the experience of a loss of a loved one. A break is usually recommended given the gravity of that loss. However, for us, we are still expected to keep going through the day, trying to manage our emotions as we see other patients. It is as if we are called to be superhuman in the most human of experiences, encountering the human experience at its deepest, rawest and most vivid form as we endeavor to save the life of a critically ill patient. It is an interesting situation because we are still human at the end of the day, full of emotions that are trying to rise to the surface as we are involved in these critical situations. Given the busyness of the work day, recuperation is short-lived in the moment, and we continue on with our day.
Over time, as we continue to encounter these events through our careers, the importance of self-care becomes much more paramount. Through conversations with friends and family members who are inside and outside of medicine, through time away from the hospital, and through other extracurricular activities, we find time to recuperate. Our mental, physical, emotional and spiritual well-being comes to the forefront in those moments, and we are reminded of our humanity. We realize that even though we may feel superhuman in those critical moments, there is still a human being underneath that still needs that crucial rest.
Perhaps it is the unique form of our training that allows us to deal with these intense situations at a moment’s notice, and over many years of training and practice, we find mechanisms to help us to persevere even after going through a deeply human experience. At the end of the day, however, our well-being is still important. We must take care of ourselves before we can take care of others, and when we inevitably have to go through a raw experience where the saving of a life is paramount, be it as a doctor, nurse, physician assistant or nurse practitioner, we can draw on our strength as a team and be superhuman together from an emotional standpoint, in the most human of circumstances.