Wednesday, May 14, 2008

Nurses dispense comfort, compassion, and caring without even a prescription. ~Val Saintsbury

Fall of 2002

I began a new job now that wedding was over and we were settled into our new home. I started working in the ICU. The unit has two wings to it, the Surgical Intensive Care Unit (SICU) and the Medical Intensive Care Unit (MICU). Starting a job in the ICU was ironic in many ways. When I was in nursing school I wanted to be an OB nurse. That was my major goal until I had my first clinical rotation in the OB unit. I was in a major Cleveland hospital and was not accustomed to the many things I witnessed. My whole rotation which was one semester in length I had ONE couple that was a married couple. The majority of the patients I cared for were single moms, (no dad in the picture now that the mom was pregnant), many of the patients had a substance abuse problem, and sexually transmitted diseases. One day I had a patient that was 12 and just gave birth. Yes, I typed that right, 12! When I went into her room for postpartum care she was watching cartoons and someone had brought her some coloring books that she was coloring in. As I observed her I then noticed the precious baby that she had given birth to moving around in her bassinet. I was so sad for both of them. I tried to picture myself in her shoes and I was unable. At 12 years old I did not even know what sex was. At 12 years old I was still playing with dolls and Barbie. I then tried to imagine telling my mom that I was pregnant at 12 and again this was hard to imagine, because I was not even into boys at this age.
When faced with these situations as a nurse all you can do is be there for the patient and try very hard not to be judgmental. I was not there to judge these individuals, but was there to learn. Therefore I learned that I was not meant to be an OB nurse. After this experience I decided that I really wanted to go into critical care and be an emergency room nurse. So working in the ICU was a great way to get some experience. The ironic thing though is that in nursing school I was so scared in my critical care clinical. I avoided a ventilated patient as long as possible. The tubes, beeping, IV lines, ventilator, etc. all contributed to sensory overload for me. I took the job and after a week or two all of the “stuff” used to keep that patient’s alive became just that. Something not to be afraid of, but something that you know is helping this patient to live. It is knowing how everything works that calms you.

The patient who taught me more than he will ever know:
I was at work one night. When we got to work we went to a dry erase board to pick the two patients that we would care for. I picked my two and then went to rounds. One thing I loved about the ICU is that because the patients are so critical the ratio of nurse to patient is much lower than on other floors. For us it was one RN to 2 patients. I learned in report that the patient I was caring for was in his late 20’s very early 30’s. He was here because he suffered a horrific fall. He was a roofer and he was at work and putting a roof on a house. This house had skylights. He forgot about the hole for the skylight and apparently walked backwards and fell through the skylight hole. He suffered a broken arm, and horrible brain damage. The first 48-72 hours after a brain injury are the most critical. He ended up doing okay throughout the night. There were no major changes in his status.

I went to work the following evening and again had this patient. I now had met some of his family members. He was newly married (celebrating his one year anniversary the following week) and his wife was very pregnant. They did not know the sex of the baby, because they wanted it to be a surprise. Today when I got report there were no significant changes, but some concern over the patient’s vital signs. As the night progressed the patient started taking a change for the worse. He had an Intracranial Pressure device in his head. (ICP) The monitor started registering larger numbers than where it was prior. His vital signs also started to increase. I spent the majority of my night on the phone with the resident Dr. He was also now coming to the floor to check the patient again. I was crying, family members of the patient were crying, and the resident was calling other Dr.’s even at other hospitals to seek advice on any medications that could be given. We tried everything we could. I had never seen a patient have a systolic blood pressure number of 230 and not respond to medication. At one point the ICP hit in the 100’s. These are all very severe signs that things are not going to turn around for the patient. I called his wife in and talked to her. She spent some time with her husband before calling the remainder of the family. That night we gave him Morphine and as peacefully as possible let him pass away.

This story is important to me in many ways. First of all it does not matter how young or old you are. It can happen to me and it can happen to you. The fact that the patient was so young and newly married was something that I could relate to. He went to work and that ended up being a place where he would suffer a fall that would later kill him. The next lesson I learned was to be a bit more spontaneous. I decided that I did not want to wait the next 2 years or 5 years to make sure all my ducks were in a row before trying to have children. What were we waiting for? We will never have ‘enough’ money in the bank. Why put our hopes and dreams on the back burner while we plan? We are a loving couple that is married and have a great deal of love to give.
When I got home that morning Jeff had not left for work yet. He knew how much this patient had affected me and he was there to give me a big hug and kiss when I walked into the door. It was after this patient that Jeff and I sat down and started talking about kids. We knew that we both wanted kids so what was it exactly that we were waiting for when it came to trying to get pregnant?

I bought a few fertility books and Jeff and I started trying to conceive. I found out I was pregnant in December of 2002.


Jocasta said...

Thanks for writing this post. When I was 18 my boyfriend died of massive head injuries after a motorcycle accident. He tried to avoid a couple of kids that ran out on the road and in the process hit a parked car. We had been together for a couple of years and the grief pretty much ruined the end of my teenagehood. Obviously my recollection is quite traumatic but I do remember the caring doctors and nurses around. It must have been difficult for them to have to deal with a large number of young people in quite a state.

It's nice to know that the medical staff around do care about their patients and they are not just another body.

And you are totally right - life is not for taking a backseat!

angie said...

Wow........this post is incredible.....thanks for sharing a time that changed you, and for telling us what you learned.....

Tracy said...

That you can walk away from so many hard situations - learning lessons to live life better & to be a better person - and not to be jaded or hardened is truly inspiring.

Kim said...

It really takes a special person to be a nurse. To have your job have such an impact on your life is a great job to have, I think.

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