The medics brought in a twenty-three-year-old woman unconscious with an overdose. They reported she had texted family members telling them she wanted to die. Then she took some pills, washed down with alcohol.
It was obvious she was really intoxicated. As we watched her, it became clear she was not breathing well, which worried me, so I performed an intubation. This means that I passed a tube into her windpipe. She was then put on a ventilator and I arranged to have her admitted to intensive care.
During this time, I asked multiple times if we had been able to reach any family. I was told no one had called us about the patient and we had no contact information for her.
My shift ends at 7:00 am. Just as I was ready to leave, Mom walked in. She said she got the suicide text from her daughter, called 911, and then, went back to bed.
As it turned out, Mom was a nurse at our hospital. At 7:00 am, she reported to work and got her assignment of patients for the day. She then decided to see how her daughter was doing. By looking on the computer system, she saw her daughter was headed to the ICU. Only then did she come down to the emergency department.
I don’t understand this. Maybe Mom had so many problems with her daughter in the past she was not up to mounting a serious concern about her that morning. Maybe she didn’t even consider that her daughter might be seriously ill. Maybe she really didn’t care. I don’t know, but it is amazing to think she had a good night’s sleep, then got up and reported to work before checking to see if her daughter was alive or dead.
As a side note, I faced an interesting medical dilemma in caring for this patient. I intubated her because she was so intoxicated she was not breathing well. Yet, as soon as I got her intubated, the irritation from the intubation caused her to wake up! She got agitated and began to bite on the tube and fight the ventilator. She would buck, eyes open widely but blindly, and bolt nearly upright in the bed. In order for her to relax and tolerate the ventilator, I needed to sedate her even more. It was like giving her more of the disease for which I was treating her! Still, I had to medicate her so she could be comfortable as she went upstairs.
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