Lana Seay

I am a registered nurse and my mom was an amazing lady. The fact that I am a nurse will be important later. I fight sepsis in hopes that one day my mom’s death will not have been in vain. It was December 2014 and getting close to Christmas. My dad’s birthday was December 20th and we all met at a local restaurant for dinner. My mom was kind of tired and said she didn’t feel well that evening, but didn’t seem serious, she was a previous cardiac patient and she was 72 years old. It was not uncommon for her to not feel well at times.

Christmas Day came and my Dad showed up to my house and mom wasn’t with him. My mother had never missed a holiday in my life; I was 44 at this time. I had always seen every family member on Christmas Day; I was very concerned that mom would be so ill she couldn’t celebrate Christmas. I called to check on her and she did sound very ill and stated she just didn’t have any energy and she was very sorry she was missing Christmas. I was a little concerned but knew my mom was also very depressed, my oldest sister had passed away that July and I was skeptical that mom did not want to celebrate without her.

That evening I called her again and she still sounded like she did not feel well, she sounded a bit better but told me she had not had the energy to open her gifts yet. I talked to Dad and told him to call me if he needed anything or if he needed me to come check on her. Mom assured me she would be fine and not to worry. The next day I called and she sounded quite a bit better and also said she felt better and was even asking for something to eat and had opened her gifts. I chatted a few more minutes and reiterated to her to call if she needed anything or if she started feeling worse again.

Saturday, 2 days after Christmas, about 6 pm my dad called me and said I needed to come check on my mom because she was hollering and screaming at him to get out of the bedroom and quit shaking the bed and he had been downstairs at this time. I live 35 minutes from my parents so I told him to call 911 and I would meet mom in the ER at the hospital where I work. I had worked in the ED for 13 years and called ahead to let them know she would be on her way via EMS. My dad called and told me when the ambulance had left so I could time my arrival.

In the ED mom was given 3 liters of fluid, blood drawn and a urine specimen obtained. Diagnosed with UTI and pyelonephritis she was admitted. (Sepsis and Urinary Tract Infections) I got her settled in and went home. I know all of the nurses at the hospital and my sister, also a nurse, was the nursing house supervisor on nights, so she was taken care of and if she needed anything my sister was in the building. She made it through the night but it was rough, she had been confused and disoriented all night and had continued to get a large amount of fluid and some IV antibiotics through the night.

Sunday I stayed with her most of the day in the hospital room. When my sister returned that evening to work her regular shift again I had planned to go home, because I had to work, in the hospital, on Monday. About 10 pm I told mom I was going to go home and get some sleep before work tomorrow and that my sister, who was checking in on mom at this time, was working again tonight if she needed anything. My mom, still a bit confused, looked at me with her eyes open wide and said, “You’re going to leave me here so I can die alone?!” My sister and I looked at each other because as nurses we know that if a patient tells you they are dying or going to die, they almost always do.

Needless to say, I did not go home I spent the night in the hospital room with my mom. About 2 am she went rapidly downhill. Multiple conversations with the physician about her worsening condition did not cause him to change his care or treatment plan. I noticed at this time that she was third spacing (when the IV fluid someone gets does not stay in the vessels it leaks out into the tissues) and that she would need a medication called albumin and then also would need Lasix. He refused the albumin stating she needed more fluid to keep her blood pressure up. Long story short, they gave my mother more fluid and her confusion increased and he then gave her Haldol (an antipsychotic) to help with her agitation and confusion. Long story short, no change in condition, had multiple attempts to keep my mother calm and bi-pap to help with her increasing shortness of breath. This physician, prior to his department from the facility, never looked me in the face again.

By the 7 am shift change a new hospitalist was on duty and immediately ordered my mother’s transfer to the ICU and for intubation and was initiating a transfer to a larger hospital. My sister and I called my Dad and told him he should come to the hospital ASAP, mom was not doing well and they were transferring her. Well, my mom never got transferred. She did get intubated and arrangements were made. Of course, the EMS crew that came to pick her up I had known for years, from my time working in the ED. We got her loaded up and my husband and I left ahead of the ambulance so we could beat them to the hospital. About 3 miles out of town I got a call from a very good friend, a nurse in the ED; she asked where I was and then told me to turn around and come back.

My heart is in my throat when I asked her why and all of my thoughts were swirling in my head what was happening. My mom had coded in the back of the ambulance before they had even pulled out of the ambulance bay. My husband turned around immediately and we returned to the ED where I had worked with all of my co-workers, and friends, and went to the room my mom was in. I knew everyone in the room and knew my mom was getting the best care possible and it was the quietest code situation I had ever been in. My mom’s face was blue and her pupils were fixed and dilated. She was gone and I knew it but they had gotten her pulse back, so of course, I still wanted to hang onto the hope that she would recover.

Two minutes later she flat lined again and my friend started CPR again and my dad was there by then and screamed at her, “You can’t do that she has had her chest cut open twice! You will kill her!” I looked at my friend and told her to stop and then the ED physician looked and me with a questioning look, and I told him to stop. We called the code and my mom was pronounced dead at 1:12 pm 12/29/14. This was the absolute worst day of my life. I had been a room with many dying patients when everyone working knew there was no hope and this decision had been made many times in my presence, but this time was different. This was my mom. I knew right then that my life would never be the same, and it hasn’t.

As I look back on the night she got so much worse so quickly, I find myself feeling guilty that I didn’t get more aggressive with the physician. I had it in my head that I worked here, I couldn’t be that family member who was throwing a fit over what might be nothing. Knowing what I know now about sepsis, I wish I had thrown a fit. Maybe the outcome would have been different. I will never know, but I do know I can’t spend my life feeling guilty for something I had no control over.

The reason the fact that I’m a nurse was important at the beginning is that I was a certified ED nurse and had had multiple courses in trauma and emergency nursing, but I did not recognize the signs of severe sepsis &/or septic shock. Now I work as a core measure data abstractor, auditing charts for sepsis process and protocol compliance, I realize what exactly I had seen. I can’t stress to the nurses in the ED and on the floors enough how important early recognition and early interventions are for survival. I tell my mom’s story in every class I teach and every side bar conversation I have with a nurse who is confused about how the sepsis screenings work and what SIRS criteria are, and how relevant a rapid response is when you get push back from a physician who won’t order the proper fluids or other treatment that is necessary for the patient to be treated aggressively. My mom will always be remembered and many nurses in the facility where I work tell me they often think of me and her as they screen a patient’s and discover they are severe sepsis and start the process for rapid intervention. My mom is always with me and she and I have saved some lives here.

Source: Laura Murrell - daughter