As an ER nurse one critical step you learn during rapid sequence intubation is to always give the sedating medication before you give the paralytic. There are a handful of meds commonly used when intubating a patient. Often in the ER, the physician is at the head of the bed giving the order for what two medications he or she would like to be used and what the dosage for each medication needs to be. As the nurse you are expected to know what the medications you are giving are for. I think the patients would expect and appreciate that too. 🙂A great nurse doesn’t blindly follow orders, but knows which medications are given for what reason and what to expect when given. This should be the case for any medication a nurse administers, but it’s incredibly important in this case. Why?
Well, the sedative obviously relaxes the patient, and it’s important that the patient have that on board before they are given the paralytic that will initiate an otherwise terrifying loss of control of all muscles and movement. Imagine being the patient that received the paralytic with no warning or sedative first. The thought of suddenly losing your ability to move, scratch your nose, to breathe, to walk, talk, swallow, and all the things we take for granted being able to do daily without a second thought is a terrifying loss of control over things that just moments ago seemed so ordinary, so simple, so thoughtless, so automatic. In medicine, the paralytic must always come with warning and a sedative first. To do otherwise would be an inhumane experience for the patient. Imagine watching life pass but not being able to engage in it or process it, wanting to move, to feel again, but not being able to. You might be wondering at this point where I’m going with all this and why in the world I’m talking about nursing and paralytics…..well it’s because one day I woke up and realized how relatable this all was to a period of time in my journey.
When we found out the diagnosis and prognosis of our sweet twins our hearts were shattered. The transition from being pregnant with thriving twins , giving birth, meeting and holding our sweet babies, to then saying goodbye in the same hour, and then days later laying them to earthly rest just down the road from where we had hoped they would grow up with their big sister rocked me….to my core.
As a grieving mother there were many things that I fully expected after their death. Heartache, pain, sorrow, confusion, anger, questions…..all things you hear about as grief’s traveling partners. I expected them. That is not to say that it made them easy, but knowing they are an expected part of grief allows me to navigate them more clearly. What took me by surprise completely was the absolutely paralyzing effects that grief had on me. I was stricken by the greatest paralytic of my lifetime without any warning and certainly without any sedative. I couldn’t move beyond the bare minimum daily necessities. Suddenly, I couldn’t do all the things that had just been so automatic before without a great deal of thought or effort. Everything felt heavy, even the smallest of things, even the simplest of tasks. Everything began to pile up around me, and while I was able to manage the bare minimum requirements for myself and my family daily, it was all I could do to get beyond that. I couldn’t move. I couldn’t breathe. I needed time to stop so I could catch up to it. I needed to feel everything and nothing all at once and I needed special moments and milestones to stop until I was ready to be able to fully celebrate them as I felt so deeply they should be. I wanted to, but I was paralyzed. But life doesn’t work this way. Life kept moving right in front of my eyes. I was watching it from the inside pass me by and as badly as I wanted to reach out and touch it, embrace it , celebrate it, I couldn’t even move a muscle. Being paralyzed in your own reality is infuriating and heart breaking. It riddled me with an overwhelming sense of mom guilt for not being able to feel fully present or have the ability to celebrate each passing milestone with my husband and daughters. I love my family so much and each of my children mean the world to me, so I felt beyond frustrated and guilty to not feel that I was able to give the celebration to each passing milestone that I felt it truly deserved. As much as I needed time to stop; people to stop; the rotating motion of the earth to stop; it didn’t. It just kept going and I laid there unable to move and unable to experience life to its fullest.
That is when I heard it; the still small voice in the darkness of my despair. His still small voice. He had been there all along. He was there the day we came home with the first devastating ultrasound report. He was there the day I cried out to Him from my living room floor in desperation. He had rushed in with a peace that passed all understanding and because of Jesus, our Lord and Savior being there that day and all the other days, I was able to have a full term pregnancy with our twins that I truly celebrated each and every moment of. He was there the day they were born and the next hour when we got to hear them cry and coo. He was there as they passed from our arms into Glory. He was certainly there the day we celebrated their lives and laid them to earthly rest. It was a beautiful and beyond peaceful day and there’s no question He was there, and He was still there, just a cry away. Why did it take me so long this time to realize? Perhaps it was the unexpected SMACK of the paralytic without warning that blindsided me and knocked me off my game . Perhaps it was the overwhelming realization that the pregnancy was now over, their lives here had ended and I wasn’t sure how to keep living here without them. The enemy will take advantage of those moments and loves surprising us. I can say with confidence that the enemy is the master of paralyzation. Make no mistake, the enemy took advantage of my weakened state and wanted to keep me paralyzed so that nothing good could come of this heartbreak, so that I would be rendered ineffective for the Kingdom. He sees the work that God is doing in our story and he will do anything to stop it. Oh, BUT GOD….. I am overjoyed to report that Satan couldn’t keep me there, because in that quiet moment, when I couldn’t even speak, with tears rolling down my face I responded in my heart to the still small voice of my Redeemer and He reached down into my ocean of sorrow, shame, guilt, regret, endless pain and He rescued me, once again. Today I no longer live paralyzed. Today I live fully engaged in the beautiful life around me, embracing the joy and peace that only our Savior can provide. Do I still have hard days or moments? Of course, but I don’t stay there.
 It is my prayer that the overwhelming sting of the great paralytic won’t get the best of you as it did me. But maybe it already has and you’re reading this now praying for a Rescuer. In fact, I would venture to say that God gave me these words and the courage to share them because someone else out there needed them. I don’t know what you are going through today, or what you might be going through in the days to come, but I do know a God that is bigger than ALL of it. I feel like someone needs to hear today that its OKAY to need to be rescued and it’s okay to allow the Savior of the Universe to recue you today, so you can live life to it’s fullest again. We know all too well how short and precious this sweet life can be. He wants to lift you up so you can live life more abundantly. Hold on to hope dear friends. This world is not without storms and this life is not without trial, but there is an overwhelming power in John 16:33 which says; These things I have spoken unto you, that in me ye might have peace. In the world ye shall have tribulation: but be of good cheer; I have overcome the world. And THAT is a comfort that NO sedative can match!
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