MIA No Longer

I know I've been absent for a few weeks, but with good reason, I promise.

As a PICU nurse I always knew that the day would come when I would take care of a child who's time on this earth was soon to end. Don't get me wrong, in my two years as a PICU nurse I've seen death far too many times. This time though, I was the primary nurse. And in that role, it's a whole new ball game.

Enter Alex, a 12 year old boy who has graced our ICU a few too many times. Each time he gets very sick and yet still defies every odd that gets placed in front of him. His parents have stood with him on heaven's door so many times, and yet each time, Alex remained here. So on Friday, February 18, Alex rolled through the doors with an acute GI bleed and respiratory distress. By that afternoon he was on a ventilator, with IV lines for medications, blood pressure and heart function monitoring. By the end of the weekend he was on an oscillator (an extreme type of ventilation) and his heart function was barely there. This is it whispers rang through the unit. Nope, said Alex, not yet.

And so he rallied. Again. Then on Monday, March 8, I went into his room to find him lying in a pool of blood. Through the course of the day, Alex lost 4L of blood and another 2L of abdominal fluid. For 9 hours we were doing everything we could to save this little boys life. We got the bleeding stopped, gave him and the room a bath, and allowed his parents back in the room. After many tears and prayers, they made the gut wrenching decision to make Alex a DNR. Before leaving work that night I gave his parents what I thought would be the final round of hugs. But of course, this is Alex. So it wasn't.

All night I waited for the phone call telling me Alex was in heaven. I waited the next day and the next. No phone call. I walked into work Thursday morning and there he is. Rallying once again. He's getting better his night primary says. So I spend Thursday and Friday taking care of Alex and his family. I'll be back Monday morning I said, enjoy the family weekend (Alex's siblings were coming to visit.) We will they said. See you then.

Monday morning proved to be the longest morning of my life. When I walked into his room, Alex was wide awake. He looked at me and waved. We went through our morning routine and at 1005 am, one week and one hour exactly from when he started bleeding the first time, he began to bleed again. Only this time he was a DNR. There was nothing we could do. We got his parents, who were once again faced with gut wrenching decisions. What to do? Take Alex off the ventilator? Revoke the DNR?

With tears streaming down her face, Alex's mom came out of his room and asked for the attending physician. They wanted Alex off the ventilator, all medicines stopped, and his IV lines out. It was time for him to go to heaven. We started that process at 1035. Alex went to heaven laying in his mother's arms at 1115 am, March 15, 2010.

Words cannot describe what going through this process has done to me. It was the most humbling experience I have ever had. I'm very thankful to have gone through this with a family that was out of this world amazing as well as a group of primary nurses that did everything possible for this family and child.

Prior to all of this, I was questioning my career and if this is where I wanted to stay. Taking care of Alex and his family reaffirmed in me why I'm a PICU nurse. And for that, I'll be eternally grateful.