God, Please help it not to kill her

It was almost midnight so I headed over to give midnight meds and that's when I found her. She was 22 year's old, a mother of a 4 day old baby, and she was now struggling for her life. As I approached her bed in the corner the light from my headlamp illuminated what I'd heard when I had entered the room. She sat upright leaning forward, breathing rapidly, exhausted, and with the look of panic in her eye. I couldn't find a blood pressure on her at all and couldn't feel her pulses in her extremities. Her jugular veins were pounding at 180/min and her respiration’s were 40. The confusing part was all the edema in her feet, abdomen, and the crackles in her lungs. Why all this fluid overload and zero blood pressure? And why were her conjunctiva completely white and her hemoglobin 12.9. I didn't understand! The family crowded around the bed as I finished examining her. I grabbed her papers and headed to wake up James.

He told me to run Ringers until I could find a Blood Pressure. I went back started a new catheter on her and ran 3 flacons of Ringer in. Her struggle for life pulled at my heart, she was the same age as me! I stood by her bedside watching the Ringers and rubbing her back. Before trying for a Blood Pressure again I asked her brother if I could pray with her. He nodded in agreement. The room became quiet and I pleaded with God. I know they didn't understand exactly what I said but I hope that they felt the peace and comfort that comes when the Holy Spirit fills a room. I checked her blood pressure, nothing, and her pulse was up to 200/min. Meanwhile the concerned husband pulls me to the side and shows me their 4-day-old baby. In the light of their lantern he peered up at me, his mouth smacking away searching for milk.

"He hasn't eaten for a day, she's stopped giving milk, what do I do?"

The only thing I could think of was the Oral Re-hydration Salts we had, other nursing women here don't like to take other people babies in. We put the ORS in a little bowl with water and sucked up some with a syringe. He latched onto the syringe with force sucking and sucking, syringe after syringe full. I told him this would suffice for tonight, but tomorrow he had to find someone to nurse him.

After giving him a couple of syringe fulls I headed over to wake up James again it was 2:00 AM and I was dreading it. I walked to the gate by the light of a large half-moon praying that God would give James the wisdom to know what to do. I told him her vitals and what I had done He was quiet and then I heard him say, "Well it sounds like we've got a cardiac problem on our hands Unfortunately it's hard to know what kind without an EKG."

He'd already tried Furosemide when she came in thinking it was fluid overload and now we'd tried giving her fluids and nothing was working. No way to test Cardiac output, no way to have an EKG, and even if we could, we did not have the medication to treat whatever it might be.

"Well, looks like there's one last option that I can think of. There are 2 flacons of Beta Blockers (Propanolol) in the OR. Take my keys and go ahead and give her 1 ml. at a time slowly waiting 15 minutes in-between watching her pulse. Hopefully it'll slow her heart down enough to allow it to actually fill up and push blood out to her body."

I grimaced, if NCLEX got a hold of this I'd be fired! "What about not knowing her Blood Pressure?"

"Liz, it's the last option, it might help, it might not, but it's the last possibility that I can think of that might help her. Just push it slow!"

"I hope I don't kill her," I said, as he handed his keys over to me.

"You wouldn't be killing her, she's going to die and there's the small possibility that this might work, if not she'll just die sooner."

I closed my eyes, squeezed back the tears, took a deep breath and took the keys. As I walked back to the hospital beneath the flowering mango trees that scattered moonlight on the path, I lifted my hearts cry to God. "Please, she's my age, help it not to kill her."

Back at the hospital, I woke up Sonya and asked her if she'd come with me, I couldn't do it on my own. With medication in hand we walked toward the flickering light of the lantern at her bedside. Sonya touched her feet, found them cold, and began to rub them while I mixed and pushed her 1st dose. Within 15 minutes her pulse was at 124/min. I gave her another ml. (5mg.) and then had to leave to start on giving 5:00 AM Quinine perfusions. As light begin to push its way through the windows and illuminated the bed of a little boy with Meningitis, a family member arrived at his bedside where I was giving meds and motioned for me to come. I knew in my heart what had happened.

I arrived at her bedside. She sat leaning up against the cushion Sonya had paced behind her, head now bowed, the struggle over. I removed her IV and turned to her husband, put my hand on his shoulder and squeezed. He stood stoic, stunned by what we all knew was coming.

Sonya and I went back to the consultation room and I finally sat down. Looking out the window we saw him sitting on a brick bench under a Mango Tree head in his hands.

As I walked home I passed him holding a donkey and waiting at the crossroads for the 4 approaching women in the distance. As I passed them the moans that came from deep inside brought on the tears that had been held in al night. I turned to look back as he pointed them in the direction they had taken his wife. The sandy path blurred in front of me. I went immediately to my cot and finally fell asleep not waking up till 1:30. The sun was now high in the sky and one of the girls had placed a bowl of beuille on my mat while I was sleeping. Before eating I closed my eyes and thanked God for giving me the strength to make it through the night. I thanked Him for never leaving me. I thanked Him for the opportunity to pray with the family and laid all them in his hands.

As I ate my beuille, I was reminded of a thought from Medical Ministries that I hand underlined and had thought about during the night as I longed to be able to speak of Jesus to them.

"Living and working under the constant impression, "Lo, God is here," brings hallowed influence which the Spirit is ever impressing on heart and mind."

It's my prayer that through our touch and the presence of God she felt this. It's my prayer that someday we'll meet in heaven.

"We shall sing on that beautiful shore, the melodious song of the blest, and our Spirits shall sorrow no more not a sigh for the blessings of rest. In the sweet by and by, we shall meet on that beautiful shore. In the sweet by and by, we shall meet on that beautiful shore.