January 21, 2016 at 0730:
Sixteen months ago, I stood at the bedside of my critically ill patient and flushed his arterial line after checking for a blood return. I reinflated the pressurized bag of saline, checked the output from his wound drains and chest tubes, and dopplered his legs to listen for his weak pedal pulses that were a result of the vasopressor medications that were keeping the majority of his blood near his heart. I used my stethoscope to auscultate his heart and lung sounds. I reviewed the settings depicted on my patient’s ventilator machine and shifted the positioning of the intubation tube in his mouth. I checked for new signs of skin breakdown and redressed his surgical wounds. I watched the continuous EKG to check for any irregular patterns in his heart rhythm. Then I sat down next to him and began to record all of my findings, his vital signs, and all the settings his medical equipment were set for. He was sedated, but I checked for any indication that he might be in pain. He looked peaceful, but he was barely alive. I untangled the lines from his plethora of IV bags as I watched the sunrise painting the sky outside. Before I left the room to call his family with an update, I squeezed his hand and told him I’d be back soon to check on him.
May 7, 2017 at 0600:
This morning, as the sunrise was painting the same sky many months later, the alarm on my cell phone went off. I barely heard it from my deep sleep, but I sat up anyways. I opened up a saline syringe and cleaned off the end of a central line with 2 alcohol pads. I flushed the line and connected it to the IV tubing I had primed the night before. The pump played a little tune as I powered it up and initiated the infusion. I untangled the IV tubing and stretched it out to its full length so I could lay back down. The central line I flushed hadn’t been my patient’s; it was my own. My eyes began to close again, and I slept for another 8 hours as my modified TPN solution infused into my venous system. The beeping of the pump woke me up in the afternoon and I laid there for a moment trying to get my body to move. I had to take my empty fluid bag down and flush my line again with saline and heparin to prevent it from developing a clot. I then proceeded to crush my pills and empty the capsules into a spoonful of applesauce. The bite of medicine-filled applesauce would be the only thing I’d eat until 8 or 9pm that night, when my hunger would finally outweigh my desire to remain as pain free as possible.
The first scenario you read took up about one hour of my day. I was working on a cardio-thoracic surgical ICU where it was my job to care for one or two patients for a 12 hour shift. Many of these patients had undergone open heart surgery and became too unstable for the surgeons to complete the surgery or to wire their sternum shut again. Those patients were sent up to our unit with something similar to sterile “Saran Wrap” covering their open chest until they had improved enough to tolerate the closure procedure. Some of the other patients were post transplant or had developed serious septic infections or had recently undergone various other major cardiac surgeries. It was my responsibility to monitor their condition, watch for any decline, and keep some of the sickest patients in the whole hospital alive. The second scenario you read took up about 10 hours of the time frame I previously would have been at work. I am now a patient, but I am also still a nurse. It is my responsibility to care for myself, advocate for myself, and keep myself alive. My shift never ends now, but I couldn’t do it without help.
I have a homecare nurse who comes to my house every week to draw blood, check my vitals, and change the sterile dressing around my central line. When I am too sick to even be at home, I have had countless incredible nurses in the hospital care for me. When I go to any number of the doctors I see, first I catch the nurses up on the changes in my condition. Every once in a while, I get to see my friends from nursing school when they come to visit from Ohio. I love hearing about their work stories and how many patients they have helped.
This is Nurses’ Week and nursing has been a huge part of my life for the last six years. For four years, I worked my butt off in the nursing program at Kent State University. I completed my senior practicum in the Cuyahoga Falls Emergency Department . Then, I graduated magna cum laude and as a member of the International Honor Society of Nursing. I knew I wanted to work a high-action job and my 5 year plan was to work in the ICU and/or ED until I could apply for a spot on the life flight team. I went for a ride along with the life flight team that summer, just to be sure it was what I wanted to work towards– and it absolutely was. When I interviewed for the position in the CT-ICU, I realized that was the job of my dreams (or as close as I could get until I had enough experience and autonomy to fly in the helicopters). I was over the moon when I got the job and I loved every second of it. I knew I was making a difference, and that is a feeling I have missed every day for the past 16 months. When I got sick, I kept assuming this was something minor and very short term. Surely they’d be able to figure things out and treat me right away so I could get back to my life. If only I had been right.
During this illness, I have probably been seen by about 25 different doctors. Aside from the gastroparesis, I still have yet to be diagnosed. We know it is something rare and most likely my case is presenting oddly. Many of those doctors have let me down. Some of them haven’t even had the decency to be nice about it. But throughout all of this, I have had many, many nurses. With the exception of maybe a couple, I have loved them all, and I’ve even had a few make a profound impact on me and my quality of life. Nurses are not taught to diagnose. They are taught to care. That is one area I have not been disappointed with, and I have all my nurses to thank for that. I may not be a nurse to patients right now, but nursing has been engrained into my identity. I am proud of the profession I chose and am grateful that all my nurses caring for me chose it as well.
As a patient, I want to take a moment to thank my wonderful and selfless nurses. As a friend, I want to recognize and give a loving shout out to my fellow nurse friends, especially our “Crew” (pictured below). As a daughter, I want to thank my parents for being honorary nurses during my illness when I’ve been too sick to help myself. As a former student and new nurse, I want to appreciate and thank all the amazing professors, preceptors, and orienters for giving their time to shape the minds of newcomers to the profession. And lastly, as a nurse, I want to thank everyone for celebrating what we do with a National Nurses Week. I am proud to be a BSN, RN and I am grateful to be a patient surrounded by kickass nurses. Take a moment to thank a nurse today!