TRIP #3 DAY 4 JOURNAL

I’m pretty disappointed that a few of the patients from last week died. I had been particularly hopeful that one, the Muslim man in his 40s, still had a chance. I was expecting the rest of the patients in the department to die, and I suppose I expected him to as well, but I was hopeful nonetheless. I had extubated him and he did okay off the ventilator for about two days until he had to be reintubated. He was even responsive and able to communicate with us. I was hesitantly optimistic he would pull through. The current batch of patients aren’t much better off than those from last week. Our death rate has decreased a bit; half of the ICU is currently non-COVID patients. Some of them are non-COVID surgical cases that just need a day or two of ICU care due to the complexity of the surgery itself. Their prognosis is significantly better than most of the non-surgical cases. We’re only averaging one or two deaths per day now, as opposed to two to three when all 14 beds were COVID patients.

I always used to get a little adrenaline rush when a patient tried to die during my shift. My training was really centered around life-sustaining medical management, as that’s what emergency services is really there for, and it used to be exciting when I actually got to use that training. It was a useful rush, one that I had learned over time to focus toward what needed to be done but one that for the uninitiated can be panic-inducing or impair judgment. I’ve lost that rush entirely, and the prospect of a patient trying to die has become no more adrenaline-inducing than writing a medical record note. Every night we’ve had at least one or two patients try to die (and a couple who succeeded). Their heart rates or oxygen levels dropped, or they deteriorated in some other way, and the stress that comes with that situation is just not there anymore. It’s more like “Oh, they’re trying to die again. I guess I have to fix that.” The lack of adrenaline hasn’t impacted my ability to do what needs to be done, but it struck me as odd to feel the same way about dragging someone back from the pearly gates as I do updating the sign-out report we give to the next shift.

Some of the nurses have mentioned how exhausted they are. They’re all seasoned ICU nurses, but even they’re not used to this much death. The burnout is really showing, and at a certain point no amount of expressed support, 7pm public ovations, free meal deliveries, or hazard pay makes up for the stress of extremely sick patients and risk of disease exposure to themselves. I still can’t help but feel sorry for their situation. It’s hard to be told you’re a superhero when the reality is we’re just not saving many people here.