We already have a huge patient census (9 ICU patients!), which is miserable enough on its own. But who would have thought that out of all our patients, it's our brain dead patients that cause the most trouble. You would think these two patients -- these two motionless bodies that, for all intents and purposes, are dead -- would be the easiest to take care of. But no.
As each patient has family that will not accept the fact that these patients' brains are technically dead (perfusion studies have shown that their brains are not receiving blood flow), they refuse to allow us to perform a "terminal extubation" ... meaning they won't let us disconnect the ventilator from the patient so that the patient may die.
At first we thought we could invoke California state law, which mandates that once a patient is declared brain dead, terminal extubation must be performed within 12 hours. Unfortunately we couldn't take advantage of that law because we could not just yet declare them brain dead. And what was the reason for that? Because a patient cannot be declared brain dead until all of their electrolyte abnormalities are normalized.
So ... in an effort to declare these patients brain dead, we are busy correcting their low sodium, elevated blood sugars, and elevated creatinine. Which means we are giving our dead patients saline, insulin, and (get this) dialysis. Even better, one of them has an anemia, so he is about to be transfused with some red cells.
I don't want to come off as insensitive, since I know this must be a hard situation for any family, but there comes a point when evidence makes it clear the patient will never recover. I guess it's easy for me to think like this, since it isn't my loved one that is affected.
In any case, it's quite a hassle taking care of our dead patients.
(With all that said, I hope someone from above doesn't strike down upon me with great vengeance and furious anger.)