Why Did the Orange Stop?

An Intensive Care Nurse is an incredible blend of the art and science of Nursing. She is a talented, intelligent caring soul, tasked with lifesaving abilities, instant critical thinking, constant alarms and alerts, and the heavy pressure of attending to the relentless and precious needs of patients, families, and colleagues. 

Sadness and Sorrow

An Intensive Care Nurse constantly faces sadness and sorrow as another patient passes from Earth before his eyes, despite modern medicine, and all he has done to save a life. And, yet again, she washes her weathered hands to openly receive another human and hopes for a seamless recovery.

Joy?

Adding joy to the day of a Critical Care Nurse seems like it might remain at the bottom of our ‘to do’ list, and oh so difficult to see through all the pain.

One such day as I listened to my fellow Critical Care Nurse give me her detailed shift report, I recall her last words, “It appears Mr. M., does not respond.” Her words, and what they really meant, made my open and big heart sad. 

Mr. M. had been hospitalized for months. His tall, thin body lay listless in his hospital bed, and his hollowed cheeks and chin were stubbled with grey hair, he was attached to many machines to keep him alive, one machine was a ventilator.

Lost His Ability to Breathe on His Own

Over the many months of his hospitalization, Mr. M., had lost his innate ability to breathe and because of this he had received a surgical hole in his neck, where a tube called a tracheostomy was hooked to a ventilator to give him timed breaths.

People with ‘trachs’, can’t generally talk because the little plastic tube doesn’t allow air to travel past their voice box, unless a special device is capped on the end of the trach. I noticed this special device (called a Passé Muir valve) lay unopened next to his ventilator.

And I admit, I agreed with my colleague, he did not appear to respond.

I Imagine Mr. M. Before All ‘This’

I took a moment to imagine Mr. M. before all ‘this’.  I envisioned him as a high-powered executive, playing with his only grandchild after a stressful work day. His crisp tie askew, as he joyfully held the reigns of his grandson’s hands, while he straddled his leg riding it like a cowboy. The image made me smile, and helped me connect to the real Mr. M.

I continued to assess him (my eyes never stop assessing), while bathing and shaving his thin, white, skin, all the while having a one-way chit-chat explaining each step, what the weather was like, and the color of the sky as I drove into work. Of course, I shared crazy cat-lady escapades from my morning routine.

Why Did the Orange Stop?

Eventually, I told him my favorite (really bad) go-to joke, “why did the orange stop in the middle of the road?” I giggled to myself while Mr. M. laid in stillness, his blue gown cascading the crisp, clean linens.

Mr. M. never responded to my chit-chat, never made eye contact or seemed to notice my goofy stories. At times I wondered if it was worth all the fuss, and I recall feeling ashamed I sometimes felt that way.

Just Having Fun

A couple colleagues popped behind the curtain to ask me what the ruckus was.  I smiled and explained that Mr. M. and I were just having fun, and could they help me lift Mr. M. into a chair? His wife was coming to visit.  All three of us gently, and expertly transferred Mr. M. up and out of his bed into a chair. 

He stared ahead, his freshly shaven cheeks sunken in, and black, straight hair combed back on his head.

Hoping He Would Say '“Hello”.

Once Mr. M. settled, I opened the brand-new Passé Muir valve and alongside Ryan, the Respiratory Therapist, we put the speaking valve onto Mr. M.’s trach, hoping he would say “hello”. 

Silence. He blankly stared while the ventilator’s whoosh filled his frail ribcage.

Wife of 40 Years

After a while, Mr. M.’s wife of 40 years arrived. Her tiny, slim frame floated to her husband’s side. Her eyes glistened under funky red glasses perched on her nose. She exclaimed, “John!  You look so handsome!” She glided to her husband, placed her small hand on his smooth cheek and gently kissed his lips, he blinked, and his eyes opened brightly. 

And with an airy, raspy and stuttered voice said, “Joan, why did the orange stop in the middle of the road?”

I felt my heart skip a beat.  My skin chilled and my breath escaped. 

It Ran Out Of Juice!

“It- ran- out- of-juice!”  His crooked, joyful smile was ALIVE, and as the two held hands and shared this precious moment, I held back tears as joy flooded into my heart. 

I often recall this surprising twist to a ‘normal’ day as an ICU Nurse, because sometimes I feel like the orange, like I have run out of juice. But then somehow, my heart opens up again to receive the joys of the day, even if it may appear it is not responding.

You are loved,

Nicole xo