21 June 2015

So. I have neglected this blog.  A lot.  For a time it was lack of time, lack of initiative, lack of inspiration.  The last year has been from an over abundance of pain, sorrow, and soul breaking loss. In March of 2014 I was taking care of a dear friend in labor.  She delivered a beautiful baby girl, a baby she had tried for two years to conceive.  And then everything went sideways.  She started to bleed and nothing we did seemed to help.  All the experience I've had with high risk obstetrics, all the post partum hemorrhages I have been a part of, all of it meant nothing.  She fought a good fight, but it wasn't enough to tie her to this earth, to tie her to us.   She was my patient but she was also my coworker and my friend.  It's bad enough I couldn't save my patient, but to not be able to save my friend is devastating.  It has fundamentally changed me, not only as a nurse, but as a person.  Everything I knew to be true, is no longer true.  I feel as if I failed her.  Afterwards, her mother came to me and said "She told me she trusted you with her life." I know she meant that I did all I could, she wasn't blaming me, but I blame myself.  What didn't I know?  What should I have done differently?  Could advancing my education with an advance degree have helped?  There are no answers for me.  The hospital did a Risk Cause Analysis, and allowed us to review it.  After it had gone to Big Navy and the Joint Commission.  I read the review and was astounded at how the timeline was wrong, how events were out of order, how events were even completely missing.  So, not only do I have my own guilt, now it looks like I don't know my ass from a hole in the ground. Rage is also  something I am well acquainted with.

But, I keep going to work.  I keep doing my job, and fighting to be me.  I tell myself and others it's my way of honoring her.  Continuing to do the job she always wanted to do.  And it is. I don't think badly of those who could not continuing working where we all experienced such a horrifying tragedy; far from it.  We all have our trials, and we all have to do wheat's best for ourselves in any situation.  I feel like my life is a giant Jenga game; let's pull this piece from your foundation and see if you can remain standing! It's not my first rodeo with grieving, and I know the second year is always the worst.  When the bad times hit, they are really bad. I swing from incredibly high to crawling into a hole low.  Sometimes all I want to do at work is stay in my room and not interact with anyone but my patient and her family.  Then again, sometimes the last thing I want is to be anywhere near a pregnant woman.  My logical, critical thinking brain takes a hike if I see any tinge of blood in a catheter.  I know that it's the position of that baby's head on mom's bladder, but I am instantly thrown back into that labor room.  Was that the moment she went into DIC? Could I have changed to outcome at that point?  The logical answer is no.  I know that.  I have spent the last 15 1/2 months reliving March 9th over and over again, just trying to see if I can spot a point when we could or should have done something different.  If we could have gotten a second line in, if the art lines hadn't have failed, if the IO hadn't failed, oh my God, we stuck her everywhere. To no avail.  I have no way to reconcile what happened and why it happened.  I've seen worse hemorrhages and my patient lived; why was this different?  Why couldn't she stay?  I have no answers.

She was a beautiful, caring, loving, funny wife, mother, friend, nurse, and Naval officer.  Her name is Moani.  So, in respect for Mo and in her honor, I'm posting the song her parents sang at her memorial before she went home to Hawaii.

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