**Note: All names have been changed to protect patient confidentiality. This post contains graphic content and portrays the events of the shift without disclosing any patient specifics.
I originally started on a medical-surgical floor to utilize and master all of the nursing skills that were practiced in the skills lab. The first year on my own, I had an oncology patient that decided my specialty.
Oncology has always fascinated me, both biologically and emotionally. Each cancer patient I cared for were always so humble and gracious to receive the care that was provided for them in the hospital. I had one family that I will never forget.
This family came in and out of the unit every few weeks to either receive chemotherapy or to receive treatment from the complications that the chemo had caused.
This day was the beginning of the end for the Smiths. Sean could not stay awake and was increasingly disoriented. He would have brief episodes of lucid behavior and his wife would cling to these moments with all of her hope. She had a faith that could move mountains. She believed in miracles and frequently voiced how God would turn this around. I would sit with her and pray for strength and healing regardless of the outcome.
Sean’s H/H continuously decreased. He was passing clots through his rectum. I have never seen anything like it before and still have yet to witness such a horrifying event. Bright red blood passed like a fountain through his rectum whenever he stood up. It covered the floor and looked like a bucket of red paint was knocked off of the table. Luckily, his wife was not there to witness this. We safely got the patient back to bed and bleached the floor. You could still smell the scent of the massive GI bleed that had just occurred.
He had a critical hemoglobin, hematocrit, and platelet level. The oncologist had ordered 2 units of platelets, 1 unit of plasma, and 2 units of PRBCs. I remained in this room until late that afternoon. Due to the massive influx of IV fluids, Sean went into fluid overload. He was prescribed lasix in an attempt to counteract the extra fluids, and then we waited to see what his labs looked like the next morning.
Long story short, He died that night. I remember that I cried the next time I came back to the hospital and heard this news. I knew deep down that this was probably for the best as he was suffering, but I could not help thinking about the beautiful conversations of hope and healing I had with this family… and all the prayers that were not answered as we had hoped.
I sent a condolence card to the funeral home, but did not attend the funeral. The city was over two hours from my house, and I decided not to go. Now, two years later, I wish that I had.
I got a recognition letter from my manager the day after this shift to recognize the hard work I had put in to keep this family comfortable. Oncology continues to be a specialty that I will pursue whenever an opportunity arises.
Until next shift,
Shania