ICU is unique. So much goes on behind those closed doors. Humanity pushes science to its limits (or vice-versa), knowledge competes with expectation, hope mingles with despair, and basically, life and death are at war.
Mortality strips away pride, and the words humble, and grateful, consistently come to mind. Working in there changes you - for better or for worse - but it changes you.
The scariest thing of all, is experiencing ICU from both sides of the fence. I believe that only a select few medics haven't found themselves in this position. The lines between patient/relative, and medicine, become jagged and blurred. Judgement becomes clouded by emotion, and what you know, clashes with what you want to know. It hurts. And it hurts in a place that most medical personnel prefer to keep under wraps. Simply cause it's easier, and less time-consuming than spilling your guts and analysing the contents. Too busy, too tired, too whatever ... And what poor sod would you empty out your soul's trash onto anyway? But it does teach you something about yourself, and others.
Believers feel the Presence ... non-believers feel the force ... but nobody escapes ICU unscathed no matter what they claim. It is this thought that I try to apply to some ICU personnel. You know, the ones with the compassion of a broken bottle. And trust me, they do exist. I can understand that for reasons of self-preservation one sometimes needs to distance oneself from certain situations. That sheer exhaustion can change the meekest of lambs into a raging bull. And that the stress can get too much. But what I cannot fathom is the power-game some ICU personnel play. I don't want to generalize, but this sometimes takes the form of sister-in-charge, and usually accompanies a transfer.
What is gained by shouting, ranting, raving and merciless bitching? Over a patient on a stretcher nonetheless? No patient is ever transferred without the necessary arrangements, and without dr-to-dr communication. If internal ICU communication systems are not up to scratch, why should the accompanying dr, and most importantly the patient and the relatives take the flack? I was recently subjected to such an abusive situation. Personally I'm long past allowing such crap to affect me (too much that is), but I died a thousand deaths on behalf of the relatives. The patient was old, with no prognosis. and no time, but he was still someone's father, brother and uncle. And all those significant someones, were subjected to the most shrewish, screeching ICU reception, I have ever had the misfortune to experience.
What's happened to professionalism? What's happened to respect ... both self-respect and that of a dying person? What's happened to compassion and common decency? And bloody self-control?
I really don't know. But I do know that I was embarrassed on behalf of certain members of my profession. The ambulance driver put it quite eloquently .... " guess she needs to get laid" ...
It was not quite a good enough excuse for me. The patient died two days later.