Most assignments have something in common, whether it be the people, or the cases. Also, most places do organ harvesting, and most staff do not enjoy being in those cases. I had gotten more accustomed to them working the overnight shift at my home hospital. This particular evening, I was assigned to do a harvesting, I go into the OR and began gathering my equipment and making sure all my ducks were in a row. Organ harvestings are an interesting dynamic as we partner with the procurement team, who may fly in from any surrounding hospitals and assist them in retrieving the organ they will take to their patient waiting.
The staff from the organ harvesting team began to roll in, asking if I had certain items, and I felt prepared. A scrub tech walks in from the organ harvesting team and begins to get very mouthy, almost in a rude condescending way demanding me to do this or grab that. I am immediately turned off by her demeanor. I hope once the doctors arrive, she will settle down in her place. We are only procuring the Liver tonight, so it shouldn’t be a very long case.
The harvesting doctor has arrived, we send for the patient, and they prepare to do an honor walk in the hallway. The walk is usually compromised of family and staff that honor the sacrifice that this person is giving their organs for the greater good of someone else. The patient arrives, and I verify his armband ensuring we have the proper patient. The organ harvesting team also verifies his organ donor band, and we begin to position the patient on the bed. Positioning for a patient who is going to die looks so brutal to me, the main goal is to tuck arms as tightly as possible by the sides to give more room for the surgeons to stand. Not like normal cases where we worry about nerve injuries.
We have a moment of silence, another honor procedure for the patient, and incision is made. The surgeon and his resident are working quickly to expose the liver. The surgeon begins talking faster and faster, I can’t quite make out the message. He turns around and asks me to pull up the CT scan. I was kind of shocked, usually all of those things are done prior to this point. I pull it up and scroll for him to the slices of the image he wants to see. He stops, he says “there, that right there is not plaque, it is a tumor”. He breaks scrub and says we are done here. I stood there in shock. What about the patient who is still wide open? Why wasn’t the scan read properly? What do I do?
The mouthy scrub tech is still scrubbed in, and I said I think we should close him up and take him back upstairs to die with his family. She states, “no, he should die down here”. I was furious, who was this lady to decide how this man dies, or where he dies. He came down here to donate his liver, and now he can’t, he should be closed and taken back upstairs to have care withdrawn. During our discussion the anesthesia doctor was getting antsy up top, he wanted to go home. Within minutes of our discussion, with no decision made, he pulled the ET tube and extubated him. The scrub tech had closed the patient, and almost everyone was out of the room.
Sitting there looking at the EKG monitor, watching his heart begin to change rhythms, I felt such shame for this patient and the complete immorality some healthcare providers have. Anesthesia was tired and pulled the plug, this patient wasn’t even worth the dignity to be returned to his family to die with. The mouthy scrub tech who had no business even adding her opinion on what should happen. I should have stood my ground and demanded better for this patient. I didn’t even know him, and I felt sorry for his last moments. Dying in OR 12 with a nurse you don’t know, cold, naked, and alone.
I stayed in the room with him until his heart stopped, watching it slow down, no respirations due to brain death, but the heart continued for many minutes until it slowly died from oxygen starvation. Death is always such a heavy thing to deal with, slowly getting more numb to it as the years of nursing pile onto you. You begin to get darker, trying to protect yourself from the emotions that come with such loss. Trying to turn your emotions off and separate it from home so you don’t come home carrying the sadness you witnessed at work watching someone die before your eyes. I hope for this man, his death released his pain from this life, and I am truly sorry I didn’t stand my ground for you to give you what I believed would have been a better end, surrounded by family.