Some sad times

My time at work has been sad lately.
My current rotation has been a mighty mishmash of cardiopulmonary pts on intensive and progressive care units, orthopedic pts, and frequent floating back to the neuro floor and ICU. In short, my pts have been much more acutely ill than on my other rotations.

It's very depressing seeing pts on multiple admissions for severe COPD or CHF exacerbations. People who are far past where cardiopulmonary rehab can be beneficial. I've had several pts travel back and forth from the regular floor to the ICU, but I have a couple that I'm concerned aren't likely to come out. I've had to get much more diligent about checking with nurses even for follow up sessions since my pts fluctuate considerably from day to day. Got as close as I care to get to a pt coding... me throwing on a contact isolation gown and slapping a vitals machine onto a lady who was hyperventilating, desatting, and gasping in pain. Fortunately the doctor and charge nurse were right behind me, so I was able to excuse myself and let them perform the rapid response and take her to the ICU.

My neurology pts aren't faring much better. Someone I evaluated several weeks ago while on that rotation is now nearing a full 2 months hospitalized and has just gotten progressively functionally worse. I wonder if she would have been happier if the surgeons left her brain tumor in and let her live out the rest of her life still able to walk and talk and recognize her family. Her shoulder now has a finger width subluxation that I feel personally responsible for.

She is one of several people we've had with GBMs lately, a particularly nasty type of brain tumor with very poor prognosis. Also had the readmission of a young CA pt that I worked with prior, who was intubated, had to get a PEG tube, and generally declining. I couldn't even look toward the back corner of the unit without choking up.

I've also had some personal disappointment lately, and have felt pretty bad for being swayed by that at all, having any negative emotions over this minor speed bump in life when I still have life and many of my pts are losing theirs. So it's been a very emotional time, a lot of tears at home, some at work. Not such a great time lately, but it will improve, I hope.