Every day we get the privilege of making decisions from what we wear to how we spend our time. Most we don't even realize we are making as they don't really matter. Sometimes, they matter a lot.
There is blood on the toe of my right shoe. It is not mine. It does not belong to the patient that is on the table who was in a motorcycle accident 12 hours ago --- surprisingly. Although it could have, but I know it is not because all of his blood is rapidly running out of his spleen and into his abdomen and chest.
It is compressing his lungs and making it hard for him to breathe; making it hard for his heart to pump blood and carry oxygen to vital organs that so desperately need it. There are 8 people in this room and 7 of us are working to keep the 1 alive.
He is no longer able to tell me where he is. The team works hard to supply volume in the wa of IV fluids to keep his heart pumping. We only have 1 more bag of blood left....
Today wasn't supposed to go like this. Not for me and certainly not for this man. I am exhausted. I want to cry. Every decision has a consequence. There is no room for what I want; not right now. How did we get here?
0715: We walk down the hall of the small, Midwest rural health hospital. I am talking rapidly to my collaborating Phyician with every detail -- everything I can recall --- and I am struggling to reach every minute detail that may make a difference for this patient and whether he lives or dies.
"What time did he come in?" "Where was the accident?" "What were his vital signs on arrival, on assessment, on admission?" "When did his condition change?"
The questions come rapidly; one right after the previous. I realize how much I know --- how much I have grown as a provider over the past 2 1/2 years, but also how much I do not know.
She has an air of confidence and projects that with every word. I am glad that she is by my side today.
When I was in middle school and we played volleyball in gym class, my job -- in any position -- was to stay out of the way of everyone else so they could get the ball. I never wanted to let my team down by missing set and losing the points. Today, I am a key team member and "losing the game" means people die. I still don't want to loose and today, the stakes are higher than ever.
0745: The ambulance crew has arrived. They work alongside us. Everyone knows their role & position. Everyone plays their part.
Decisions + Actions = Consequences.
I look down at the splattered blood on the floor once again. Someone brings in a towel and covers it so that no one will step in it.
My patient is now on the stretcher and headed to the ambulance so he can get the surgery he needs. Theone that will save his live. Maybe.
After the ambulance is gone and I have called the patient's wife, I grab a heet of paper and step out of the ER. I go to the cafeteria and get some toast. I sit down at a table with a pen and my paper.
For the first time in a long time (ok, 6 months), I question whether I can do this. I question if the weight of the consequences of my decisions, both good and bad, are something I can carry on a daily basis. I take a deep breath. A tear rolls down my cheek and I wipe it away. There is no room for that today. In 30 minutes there will patients in rooms at the clinic waiting for me to see them.
I pick up my pen & poise it over my paper. I stare at the floor right in front of my feet. There is blood on the toe of my right shoe. It is not mine. So, I begin to write.....
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