Monday, May 30, 2016

He knows...

I don't know what the man in bed 5 was thinking.  For most of the day, he just lay there.  Still.  Calm. Not moving much.  I think most of the movement was from his eyes as they quietly took in the ebb and flow of life on a medical ward.  There was the near constant rumble of the the oxygen machine nearby.  For some unknown reason, it would alarm.  A cue to a passing nurse that the machine needed to be restarted.  There was the sliding of the medication box.  The crackle of the dispensing envelopes.  And not far away came the moaning of a man whose body was shutting down. 

And he lay.  

The doctors eventually made their way to his bed.  He was calm and quiet.  

But despite his wide eyes, his body slipped the secret.  

He had no palpable blood pressure.

The order came.  Give Normal Saline until a palpable blood pressure.  

He wasn't my patient.  I've been sorta of a gopher the last handful of days.  

Start an IV here.  Give this medication.  Draw blood on this patient.  

I heard about him.  And to be honest, I was a bit intrigued.  A non-detectable blood pressure?  And he was awake?

As I passed by his beds a good handful of times. I saw him.  Open eyed for the most part.  Simply observing.  Quiet.  

Shortly before 4 PM, I looked over and saw him trying to get up.  I went over to help him.  

Beads of sweat were gathered on his brow.  His arms were both clammy and cold.  His nail beds a dusky shade.  

None of those were good.  I asked a student nurse to get the blood sugar machine.  I grabbed the blood pressure cuff and oxygen tester.   

And has had been reported, I could not obtain a blood pressure.  I could neither hear nor see a fluctuation on the mercury as it slithered down from numbers over a hundred to ninety... to seventy... to sixty... to fifty.  There was a slight jump on the mercury near the forties.  That I could see... but I couldn't hear the sound to confirm what the mercury was showing me.  

The pulse ox machine didn't provide much more hope.  Due to his clammy skin and dusky nail beds, the machine struggled to pick up an oxygen level.  

His abdomen was both hard and swollen.  

And he wanted to get out of bed.

And I didn't want him to get out of bed.

And so in my very broken Luganda... I told him no.

Not enough oxygen, no palpable blood pressure, and a hard abdomen.... are all variables that can result in a catastrophe.

There were so many things that my training wanted me to do in that moment.

Drop a foley.
Put in another IV.
Hook him up the heart monitor.
Call a rapid response.
Get blood work STAT.
Put him on oxygen. Keep him in bed.
Put a tube down into his stomach.
Get the doctor bedside STAT.

The list could go on and on.

And yet the oxygen tank was in another room.  It was a massive tank... nearly as tall as myself.  There were no wheels and so it was brought over slowly slowly by a nurse.  The slowly slowly was mostly due to the huge size of the tank and the lack of wheels underneath it.

That tank didn't work.

Next a machine was brought over and plugged in.  I switched on the power and the tech switched on the machine.
The outlet wasn't working.

I mentioned to the nurse I was with that he hadn't urinated.

She told me they knew.

There was so much my training wanted to do... and yet, I didn't know how things were run here.

I asked if we could call the doctor.

I didn't get a response.

His family arrived.

The oxygen was finally connected.  The patient relaxed a bit.

The nurse I had been working with had gone downstairs to the other patients.

I found a lady wearing a doctor's coat at the nurses station.

I approached her and told her that the patient in bed five was not fine.

Gave her the information I had gathered.

She was gracious.  She was interested.  And she stood from where she was and walked over to bed five.

She took out her stethoscope.  She tapped his stomach.  And she assured me she would call the doctors who had worked on him earlier.  She would also find out what doctor was on call for the night.

I prayed with the man from bed five that night.  I put my hand on his clammy arm and prayed with him.  Over him.

And shortly after the lady in the white coat saw him, I left.

The man from bed five has been on my heart multiple times since.

And I've prayed.

And I've wondered.

Tomorrow, I'll hopefully find out what happened.

Was he taken to surgery?  to the ICU?  or did his body succumb to hours of no palpable blood pressure?

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And tomorrow has come.   I returned back to the hospital that has my attention for the next near 8 weeks.  I had no sooner put my bag down when I was asked to help in the "last office" care of a patient.  Last office?  I had no idea what I was being asked to do.  Until someone clarified.  Someone had died and we needed to prepare the body.

And so I did.  I told the student nurse that I was working with that he was the chief.  He would tell me what to do.  Death is a universal reality, but the cultural realities surrounding death is super unique.

I asked what the "last office" stood for.  The student nurse I was working with had no idea.  He just smiled and giggled.  I was definitely curious, but didn't push it too much.  I just helped him with the "last office".  Delicate care of the an individual who has passed away preparing them for the morgue.  

And after the last office was complete, we put him on a trolley and prepared for his last ride.  The journey lasted about 5 minutes.  It was a somber journey that was slowed down both by respect and the bumps on the path.

We reached.  And we handed off this man to the gentlemen at the morgue.  The student nurse I was with signed the patient in.  And as he did, I saw the names of two different individuals that I had taken care of on Friday.

It was clear by his name entered into the morgue book that the man I had worked with from bed 5 on Friday had succumbed to the war raging on within his body.

I found myself staring at his name.

I didn't know him.  Only spoke broken Luganda with him.  Prayed over him.  Put my hand on his clammy arm.  Adjusted the oxygen on his face.  Asked the doctor at the nurses station to see him.

I talked with the nurse that was with him in the early hours of Saturday.

He had been well surrounded in his final moments.

I am thankful for that.

Did he know the presence of Jesus in those final moments?

I do not know.  But I can't help but rest in the character of my Jesus.

He knew this man.  To Him, he was not simply the man in bed 5.   He knew the things that brought this man joy.  He knew the pains of heart.  The things that he shard openly and the things that remained hidden in his heart.  He knew his family.  He knew the size of his feet and the exact number of hairs on his head.  He KNEW him.

He knew His frame.

He knows my frame.

And I'm clinging to that.  I'm clinging to that truth that God knows my frame as I interact with those around me.

As I hop on a motorcycle each day and head to a hospital and take care of patients.

As I get the privilege of doing things I didn't even know I missed.

Like bed baths, IV starts, and intense medical moments.

But God knows my frame.  And he knew I've been missing these things... even more than I did.

And as I see nursing done so differently than how I've been trained... He knows the struggles in my heart.

He knows my frame.

As I feel the stress of trusting Him with my needs after the recent break-in.

I can choose to rest.

He knows my frame.

When my heart is light and I know His joy.  I can celebrate.

He knows my frame.

He knows your frame.

He knows....

11.  For nas high as the heavens are above the earth,
so great is his osteadfast love toward pthose who fear him;
12  as far as the east is from the west,
so far does he qremove our transgressions from us.
13  As ra father shows compassion to his children,
so the Lord shows compassion pto those who fear him.
1 For he knows our frame;1
he sremembers that we are dust.
15  As for man, his days are like tgrass;
he flourishes like ua flower of the field;
16  for vthe wind passes over it, and wit is gone,
and xits place knows it no more.
17  But ythe steadfast love of the Lord is from everlasting to everlasting on pthose who fear him,

Psalm 103

He knows...

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